Wheezing
Wheezing refers to a high-pitched whistling sound that occurs when a child breathes. It is produced when air flows through narrowed airways in the lungs, making it harder for the child to breathe. This narrowing can be due to various factors, including inflammation, mucus buildup, or airway constriction.
While occasional wheezing may occur in young children with mild viral respiratory infections like the common cold, persistent or recurrent wheezing can be a sign of asthma or other diseases.
Key characteristics of wheezing:
- High-pitched sound, especially during exhalation.
- Shortness of breath or fast breathing is often associated
- Dry cough, particularly at night or early morning
Red flags that must alert the parents to seek immediate medical attention:
- Fast breathing especially with chest indrawing or nasal flaring (chest sinking in with breathing)
- Child appearing visibly out of breath or unable to speak
- Child appears lethargic or listless
- Bluish colouration of skin or lips
- Oxygen saturation below 92% (if parents are monitoring at home)
Causes of Wheezing in Children
Wheezing can be caused by a range of respiratory conditions. Some of the most common causes of wheezing in children include:
- Childhood asthma
- Bronchiolitis
- Lower respiratory tract infection triggered wheeze
- Gastro-esophageal reflux disease
- Foreign body aspiration
- Other chronic respiratory conditions like cystic fibrosis
Evaluation of wheezing in children
History and physical examination usually help to identify the cause of wheezing. Additional tests, such as chest X-ray, blood tests, or allergy test, may be required to determine the underlying cause. Pulmonary function tests, such as spirometry, are usually performed in older children to assess the airflow and function of the lungs. Less commonly, the child may require a bronchoscopy to evaluate the cause.
Treatment
Treatment depends on the underlying cause. Some of the most commonly prescribed medications include:
- Inhaled bronchodilators (salbutamol)
- Inhaled steroids (e.g. budesonide)
- Leukotriene receptor antagonists like montelukast
If you are concerned about recurrent or persistent wheezing in your child, consult a pediatric pulmonologist for complete evaluation.