When your child isn't feeling well, it can be worrisome to hear them let out a dry, wheezing cough. This high-pitched whistling noise happens during exhalation because of a blockage in the lung passages.
In young children, wheezing is usually caused by one of two factors—bronchiolitis or asthma—and it can often be managed at home. In rare cases, wheezing can point to acid reflux, seasonal allergies, or something caught in your child's throat.
Learn more about toddler and baby wheezing coughs, with tips for making your little one feel like themselves again.
Wheezing Cough from Bronchiolitis
Bronchiolitis happens when the airways become inflamed and constricted—usually from a virus that reaches the small airways in the lungs. Many bronchiolitis cases are caused by respiratory syncytial virus (RSV), although the culprit might also be human rhinovirus (common cold), parainfluenza, coronavirus, influenza, or other viruses.
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Bronchiolitis is most common around the winter months, and it's most likely to affect children under 2 years old. Children at increased risk of bronchiolitis include babies born prematurely, those younger than 6 months old, and those with a history of heart or lung problems.
Kids typically contract bronchiolitis-causing viruses through contact with saliva or mucus from an infected individual who is coughing or sneezing around them. Bronchiolitis symptoms initially resemble a cold, and they include stuffy nose, fever, and mild cough. Rapid breathing, difficulty exhaling, wheezing cough, and a decrease in food intake may appear in the later stages.
Young children are at increased risk of severe complications from bronchiolitis and should be monitored closely, warns David Rubin, MD, chief of pediatrics at St. Barnabas Hospital in the Bronx, New York. That said, there's no treatment that prevents progression from mild to severe infection; the focus is easing your child's symptoms to make them comfortable. Children with severe bronchiolitis might need treatment in the hospital.
What Does Wheezing Sound Like?
If your child is wheezing, it probably sounds like high-pitched whistling or purring, and it's most noticeable when they're breathing out (exhaling).
Wheezing Cough from Asthma
Coughing and wheezing might also be caused by asthma—a chronic disease characterized by lung inflammation and breathing problems. The condition gets triggered when your child's airways swell from illness, exercise, dust, or other irritants.
Asthma diagnosis is rare for babies younger than 2 years old. Experts don't entirely understand the cause, although genetics may play a role. A child's risk of developing asthma also increases if they suffer from eczema or food allergies, or if you have a family history of allergies or asthma.
During an asthma attack, the lower airways constrict, leading to symptoms like wheezing, cough, shortness of breath, and difficulty breathing.
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Wheezing Cough From Other Causes
While bronchiolitis and asthma are common causes of a dry wheezing cough, other factors can trigger it as well. Here are some other causes of a wheezing cough in babies and toddlers.
Acid Reflux
Acid reflux happens when the stomach releases contents into the esophagus. When these contents go into the lungs, this is called aspiration, and it can trigger wheezing. Acid reflux is a relatively uncommon cause for wheeze in children.
Other Infections
Wheeze is a symptom of a lower airway infection that can be caused by many viruses, including COVID-19. If you notice other signs of illness (such as fever, congestion, body aches, or sore throat) along with the wheezing cough, be sure to check in with your child's pediatrician so that you can determine which kind of infection they have—and how best to treat it.
Allergies
Seasonal or environmental allergies can cause nasal congestion, cough, or wheezing. Allergies may be due to seasonal changes in pollen or be caused by other irritants such as pets, dust, or mold. While it can sometimes be tricky to distinguish between allergies and infections, for the most part, allergy symptoms are concentrated in the head (such as stuffy nose and itchy, watery eyes) rather than causing full body symptoms like fever or body aches.
However, note that babies and toddlers have tiny nasal passages, making them more prone to nasal congestion. Check with your child's medical provider if you suspect your child has an allergy to determine the best treatment options, if needed. Allergy testing can pinpoint if your child has an allergy and what they're allergic to.
What to Know About Indoor Allergies in Kids
A Blocked Airway
A piece of food or small toy lodged in the airway can cause wheezing. Partially lodged objects (indicated by your child breathing normally) might release with pats on the back, and doctors can help if the item is still stuck afterwards. If your child has something lodged in their airway and they're making throat-grabbing motions without sounds, they have pale or blue skin, or they appear in obvious distress, call 911.
When to Call the Doctor for Wheezing Cough
Call your doctor if you have concerns that your child is wheezing, especially if it's accompanied by breathing difficulties. They might require immediate evaluation if your child is younger than 4 months, or if they have any of the following symptoms.
Fever in a child less than 2 months oldSevere breathing difficultiesGrunting noisesShallow and/or rapid breathingBluish or pale skinAppearing lethargicA sucking or retracting motion in the stomachFlaring nostrilsRefusal to drink and signs of dehydrationSustained or rising fever7 Common Baby and Toddler Illnesses and How to Treat Them
Wheezing Cough Treatment in Babies and Toddlers
Sometimes wheeze and cough can be treated at home. However, severe cases of bronchiolitis might require hospitalization for respiratory support (this can include oxygen or a breathing tube in very ill children) or treatment of dehydration (with intravenous fluid). If asthma is suspected, medications can be given to treat an asthma attack and prevent symptoms in the future.
When treating wheezing cough at home, don't give your child cough medicine or syrup. The American Academy of Pediatrics says these medicines are ineffective for those under 6 years old, and they're unsafe for anyone under 4. Instead, try some of these options to help alleviate symptoms in a baby or toddler.
Give your child plenty of fluids to prevent dehydration (depending on their age, this can be breast milk, formula, Pedialyte, or water. Note that young babies shouldn't have water). Staying hydrated also loosens the mucus in your baby's respiratory tract.Set up a cool mist vaporizer in your little one's bedroom. The extra moisture might relieve wheezing cough in babies and toddlers.Ease congestion with over-the-counter saline nose drops. For babies, suction the mucus from the nose with a bulb syringe.If your child has a fever, you might relieve it with acetaminophen such as Tylenol. Always ask your doctor first.Don't smoke near your child.Upright positioning can be helpful (Only hold an infant upright if you're awake and watching them)
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