Baby Wheezing

Symptoms of Wheezing in Babies

Wheezing is a high pitched whistling sound that usually happens when your child breathes out. It is usually caused by some kind of blockage in the small airways or bronchioles that carry air in and out of your lungs. The blockage could be narrowing due to inflammation or a build-up of mucus. As air squeezes through the narrowed passage, it creates the wheezing sound. It is similar to the whistling noise that you might hear when your baby has a blocked nose, but it happens deeper inside the chest.

Recognising wheezing isn’t always easy because the normal sounds that babies and children make when breathing can vary. Babies often grunt or make sighing sounds as they breathe, but wheezing is something different. It is usually a consistent noise that happens during most breaths in or out. You might also hear a rattling sound in your child’s chest, which is caused by loose mucus moving around when your child breathes. It is often possible for you to hear your baby wheezing as he or she breathes, but sometimes the sound is so faint that it can only be heard through a stethoscope. You might not know that your baby is wheezing until you visit the doctor for other reasons such as a cough.

Wheezing may be accompanied by other symptoms, which will depend on what is causing the problem. You might notice that your child also has a high temperature, headache, cough, or other symptoms if the cause is an infection. Symptoms such as breathlessness, coughing, or watery eyes could be signs of other issues, such as asthma or an allergy.

Since there are so many possible causes of wheezing in children, it is important to identify the other symptoms that are present. For example, if it comes with a fever then it is likely to be the result of a chest infection. You should also take note of when the symptoms tend to appear as this can provide clues to the cause. Wheezing is often linked to specific triggers when it is caused by allergies or asthma, so it may happen in certain places or after specific activities. The more that you can tell the doctor when you describe the symptoms, the easier it will be to narrow down the possible causes of a child or baby wheezing.

Causes of Wheezing in Babies

Wheezing can have many different causes. It can be a symptom of an infection such as a cold, bronchiolitis or pneumonia, or a sign of a condition such as asthma or cystic fibrosis. Finding out what is causing the wheezing is important as it will determine the right course of treatment.

Some of the possible causes of wheezing in children and babies include:

• Respiratory infections such as bronchiolitis and pneumonia
• Allergies such as hay fever
• Gastro-oesophageal Reflux Disease (GORD)
• Asthma
• Foreign objects that have become in the airways, such as pieces of food or small toys
• Rare congenital conditions such as cystic fibrosis that affect the lungs or airways
• Chronic respiratory conditions such as bronchopulmonary dysplasia (BPD), which are more common in babies who were born prematurely

Wheezing is more common in babies and young children because they have smaller airways that can more easily create these kinds of sounds. Even a mild cold can cause wheezing in babies because it can increase the amount of mucus that is present in the already narrow airways, so there often isn’t anything to worry about when your baby is wheezing. In some cases, wheezing in children under the age of three doesn't have a specific cause. Some children just seem to wheeze for a while at this age. It may be a sign that a child is more likely to develop asthma at a later age, but this isn't always the case. We aren’t able to accurately predict which children will go on to develop asthma.

Although some of the causes of wheezing in children can be serious, it is most likely to be a sign of a chest infection or allergy. However, if your child has severe symptoms or wheezes a lot it is important to seek medical advice as there is a chance that it could be a sign of something more serious.

When to See a Doctor?

You should see a doctor if you are concerned about your child's wheezing, especially if you are unable to work out what is causing the problem. If you are sure that the wheezing is just part of a mild infection such as a cold or the flu, you may not need to see a doctor unless the symptoms are severe or your baby is very young. Wheezing that is associated with mild, cold-like symptoms that don't seem to affect your child's breathing or general well-being is unlikely to be serious. However, you should seek help if the wheezing is associated with severe symptoms, such as a very high fever, if your child is experiencing breathing difficulties, or if you suspect that your child might have pneumonia.

It is also a good idea to seek medical advice if your child has persistent wheezing, as it could be a sign of a chronic condition like asthma or an allergy like hay fever. If the wheezing has been present since birth or your baby is having frequent chest infections then it could be a sign of a congenital condition such as cystic fibrosis. Frequent or persistent wheezing should always be checked by a doctor as it could be caused by one of these potentially serious conditions. It is always important to find out why a symptom such as wheezing keeps coming back.

If a young child suddenly starts to wheeze and cough it could be due to inhaling something into the air passages so it is important to seek urgent medical help. You should always call an ambulance or go to the nearest A&E department right away if your baby appears to be having difficulty breathing whether it is due to an infection, a foreign object or anything else.

Diagnosis and Treatment of Wheezing in Babies

Wheezing can be a symptom of many different conditions, so the first thing your doctor will need to do is to work out what is wrong. Any other symptoms you have identified can help with the diagnosis, but your doctor may also need to perform a physical examination and to run some tests in order to find out what is wrong. Samples of blood or any mucus that is being coughed up may need to be tested in the lab to look for signs of infection, and your child's lungs may be checked with a breathing test to check for problems like asthma. Sometimes it is very easy to identify the causes of baby wheezing, but in other cases it can require multiple tests to rule out different potential causes.

Once the cause of wheezing has been identified, the doctor will be able to recommend the best course of treatment. If the cause is a minor infection, you may be able to treat it at home in the same way as a normal cold or the flu. Your child might just need some rest, plenty of fluids, and infant paracetamol or ibuprofen to tackle any other symptoms, such as headaches or joint pain. The same treatments can also work for mild chest infections, bronchiolitis, or pneumonia. However, your doctor may also want to prescribe antibiotics to help clear the infection if it is being caused by bacteria. If the symptoms are very severe and your child is having trouble breathing, he or she may need to be admitted to hospital for additional treatment. This could include having an IV fitted to provide fluids and antibiotics, and a face mask or breathing tube to ensure your child is getting enough oxygen. An inhaler may be given to administer medication to treat wheeze if asthma is diagnosed. Most infections will clear up quickly once your child is getting the right treatment.

If the wheezing is persistent and not associated with an infection, the most likely cause in older children is asthma. Wheezing babies are less likely to have asthma as it tends to appear in slightly older children. Most children will show the first symptoms of asthma before the age of five, but it isn’t always diagnosed until later.

The doctor may recommend trying an inhaler for a while to see if the symptoms improve as this can be the quickest way to determine whether the cause of wheezing in children is asthma. If the medication helps to stop your baby wheezing then the doctor will diagnose them with asthma and recommend an action plan to treat it in the future.

Asthma is a long term condition that requires careful management. Your child may need to carry an inhaler to use when their symptoms flare up or to take medication daily to prevent wheezing and other symptoms. You might also need to make some changes at home to reduce exposure to potential asthma triggers such as dust mites and pet hair.

You will also need to avoid triggers if the wheezing is linked to an allergy such as hay fever. If it isn’t possible to avoid the allergen completely then the doctor may recommend medication to help ease the symptoms when they appear. Some allergies are mild and children may grow out of them, but a severe allergy that affects your child’s breathing could be potentially life threatening if it isn’t managed properly. Wheezing after eating certain foods or coming in contact with specific allergens should always be discussed with a doctor as it could be a sign of a serious allergy.

Other conditions can also cause wheezing too. Your doctor may need to run additional tests in order to identify less common causes of wheezing, which may require different kinds of treatment. If your child suffers with recurrent wheezy episodes and does not seem to respond to inhalers then other conditions need to be looked for by a paediatrician respiratory specialist.

If your child is wheezing then there are also some steps you can take at home to manage this symptom alongside the treatments provided by your respiratory specialist. You can treat baby wheezing at home by:

• Preventing exposure to second-hand smoke
• Making sure that your child is well hydrated as this can help to loosen the mucus in the airways
• Using a humidifier to add some moisture into the air at home as this can make your baby more comfortable
• Using a bulb syringe to gently clear out blocked nasal passages

Additional treatment may be required if your baby has a chest infection or a respiratory condition such as asthma, but it is sometimes possible to manage baby wheezing at home. In most cases, it is simply a sign of a respiratory infection that should start to improve within a week or two.

If you notice your baby wheezing or you are concerned about wheezing in an older child then you should make an appointment with Professor Habibi. Identifying the cause of severe or persistent wheezing is important as it can be a sign of a serious infection or a chronic condition that will require ongoing management.