Causes of Wheezing in Infants and Children

A common cold in an infant can be worrisome enough, but when your baby starts wheezing, even the most experienced parent can have serious concerns. However, up to 50 percent of infants will have an episode of wheezing before their first birthday. As a parent, it’s important to be informed about the most common causes of wheezing and know when to take action.

The majority of infants who wheeze have bronchiolitis, a viral infection that infects the lower lungs. When a baby’s small airways get inflamed from a virus, air does not easily move through the lungs, causing a high-pitched sound when your baby breathes. Common viruses that cause wheezing include respiratory syncytial virus (RSV), rhinovirus, and adenovirus. In addition to wheezing, other symptoms may include nasal congestion, cough, fever, decreased activity, and poor appetite. Bronchiolitis symptoms tend to worsen over the first few days, peak around day four of illness, then slowly improve over the next several days.

There are other less common causes of wheezing in children. Babies who have severe gastroesophageal reflux or anatomical problems such as weak cartilage in the trachea or larynx (tracheomalacia or laryngomalacia) can cause wheezing. In an older baby, a foreign body such as a small toy or piece of food might have become lodged in the lungs, causing abnormal lung sounds. A child who has been introduced to a new food may wheeze during an allergic reaction. This may even be the first episode of asthma in a toddler. It is important to have your child seen by the doctor to determine the cause.

While all wheezing in infants and young children should be checked out by a doctor, here are some signs that your baby may need to be seen immediately:

1. Breathing much faster than usual
2. Using the muscles between the ribs and under the ribcage when breathing
3. Seems to be having difficulty catching breath
4. Appears pale or blue-gray around the lips
5. Appears lethargic or difficult to wake up

Your doctor will be able to determine the cause of wheezing and recommend any treatment or further workup that may be needed.

Sources:

• American Family Physician
• The Diagnosis of Wheezing in Children. Duke Health
• Wheezing Infants. Pediatrics
• Diagnosis and Management of Bronchiolitis.

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