Advice: Wheezing

Questions?

301-279-6750

Phone

15204 Omega Drive

Suite #100 Rockville, MD 20850

Wheezing

Wheezing basics

Wheezing is a specific sound in the lungs that is only heard with a stethoscope.
Wheezing is caused by turbulent, restricted air movement in the small airways in the lungs. This occurs when the airway is narrowed because of bronchospasm (twitching or spasm of the muscles around the airways), excessive mucus production, or inflammation.
Wheezing can range from mild to life-threatening. If you notice increased work of breathing (such as very fast breathing, shortness of breath, retractions, lethargy, or color change) you should seek care immediately.
If your child is diagnosed with wheezing it does NOT always mean your child has asthma. The most common cause of wheezing in young children is something called ‘viral induced wheeze’ which is wheezing due to the inflammation and mucus created by a viral respiratory infection.
Children that have wheezed with illness in the past are more likely to wheeze with illness in the future.

Treatment

Albuterol: Albuterol is an inhaled medication that is administered through a nebulizer or an inhaler with a spacer. It helps treat bronchospasm and may be prescribed for asthma or viral induced wheeze. Albuterol can be given every 4 hours. Specific treatment regimens may vary from child-to-child and should be outlined by your provider. Side effects of albuterol include elevated heart rate and ‘jitteriness,’
Oral Steroids: Dexamethasone and prednisolone are examples of oral steroids. Oral steroids help reduce inflammation in the airways.
Inhaled Steroids: Medications like Flovent, Qvar, or Pulmicort are examples of inhaled steroids. These are typically reserved for children with asthma or recurrent wheezing and are not needed or helpful in children with sporadic or viral induced wheeze.
Allergy Medications: If your child’s symptoms are related to allergens like pollen or animals, they may also benefit from antihistamines like Zyrtec or Allegra
Nasal hygiene: Frequent nasal suctioning with a bulb suction or ‘NoseFrida’, humidifiers, steam showers all help clear the nose. Post nasal drip can worsen cough.
Cough: Honey, for children older than 1 year, is the most helpful and only recommended cough medication.
Over the counter cough medications are NOT recommended for children under age 6.

When to seek care

If and when you are instructed by your provider. Some children will need to be seen to check symptoms and/or receive another dose of medication after an asthma visit. Other children will need to be followed regularly by their Pediatrician for long-term treatment.
If your child has increased work of breathing: breathing harder, breathing faster, or having difficulty catching their breath.
If symptoms are worsening or albuterol doesn’t seem to last the full 4 hours
If symptoms last more than 2-3 days.
If you are concerned

When to go to the Emergency Departent

If your child is in respiratory distress (nostrils flaring, ribs showing, significant belly breathing, head bobbing, grunting, or very fast breathing)
If your child is needing albuterol every 2 to 3 hours or more
If your child is lethargic or difficult to arouse
If your child is showing signs of severe dehydration: lethargy, little/no urine output, dry lips, sunken fontanelle (soft spot)
If you are worried

Additional Resrouces

Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.