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Why is my baby wheezing? Causes and treatments

Wheezing or a high-pitched noise that comes from the chest during breathing is common in babies and children.

Between 25-30 percent of infants will experience at least one episode. Around 40 percent experience it by the age of 3 years old and almost 50 percent by the age of 6 years.

The most common causes are asthma, allergies, infections, and gastroesophageal reflux disease (GERD).

Fast facts on baby wheezing:
  • Many parents are scared when they hear their baby wheezing, but it is very common.
  • Babies and children are more likely to wheeze than adults. Factors that contribute to this include the higher airway resistance in children’s lungs, and their smaller bronchi or small airways.
  • Some babies are born with inherited and congenital conditions that may contribute to wheezing.


Why is wheezing common in children?

Children’s lungs are smaller, have less airway resistance, and have less elastic recoil and fewer collateral airways, so they are more easily obstructed than adults

What do different types of wheezing mean?

Father holding baby over his shoulder.
Asthma or allergies are common causes of wheezing in babies.

If the wheezing is seasonal or happens when a baby is exposed to a particular environment, such as dust or air pollution, the most likely causes of wheezing are asthma or allergies.

If the wheezing started suddenly, it is likely to be the result of a respiratory infection or inhaled foreign body.

Persistent wheezing from birth suggests a baby may have been born with a congenital anatomic anomaly.

Children who persistently wheeze and suffer recurrent respiratory illnesses should be tested for cystic fibrosis, agammaglobulinemia, and primary ciliary dyskinesia.


Common causes of wheezing in children and infants

Allergies: If your child is allergic to a substance, such as pollen or dust, their body sees that substance as a foreign body, and their immune system responds. Part of this process causes the airways to narrow, meaning air is forced through a smaller space. This narrowing causes a whistling sound.

Asthma: Children with asthma have sensitive airways that can become inflamed when exposed to triggers and irritants, such as cigarette smoke or air pollution. This leads to wheezing, coughing, shortness of breath and tightness in the chest. Symptoms tend to be worse at night.

Gastroesophageal reflux disease (GERD): Known as GERD, this is a condition in which stomach acid leaks back into the esophagus or food pipe. Small amounts of this fluid can then be breathed into the lungs, causing irritation and swelling of the small airways, which in turn causes wheezing. Regular burping, during feeding, and sitting your baby in an upright position for at least 30 minutes after feeding can reduce the risk of GERD. Infants tend to outgrow the condition by the time they reach their first birthday.

Infections

Pediatrician listens to babies breathing and heartbeat using a stethoscope.
Most chest infections in infants can be treated at home, but medical attention should be sought if there are unusual or serious symptoms present.

Some chest infections can lead to a baby or infant wheezing. These include lower respiratory infections, such as bronchiolitis and pneumonia.

Upper respiratory infections, also known as the common cold, can also cause noisy breathing but will not cause wheezing unless the lower airways are affected, as well.

In most babies, these infections will get better by themselves with treatment at home, rest, and plenty of fluids.

A small number of infants with bronchiolitis, while seeming otherwise healthy, will still have symptoms, including wheezing, a dry cough, and vomiting after feeding after 4 weeks have passed. 

Parents should seek medical attention if the child is under 12 weeks old, has an underlying medical problem, is struggling to breathe, is feeding poorly, has not had a wet diaper for more than 12 hours or has a temperature of 100.4°F or above.

Parents should seek immediate medical attention if their baby is pale or sweaty, their tongue or lips are blue, or there are long pauses in their breathing.

Symptoms of pneumonia can develop suddenly, over 24-48 hours or may come on slowly over several days. Pneumonia symptoms include:

  • a cough
  • breathing difficulties
  • a rapid heartbeat
  • fever
  • sweating
  • shivering
  • loss of appetite

Babies and very young children have an increased risk of developing pneumonia, but most cases in preschool-age children are viral, meaning the only treatment is supportive, such as rest and fluids.

If a baby has chest congestion, a cough, a runny nose, a fever of 104°F or more, and is unable or barely able to keep fluids down, the parents or caregivers should speak to a doctor.


Uncommon causes of wheezing in children and infants

When feeding infants, ensure they eat slowly, only manageable pieces, to avoid choking.
When feeding infants, ensure they eat slowly, and only manageable pieces, to avoid choking.
  • Bronchopulmonary dysplasia (BPD) is a chronic condition that usually develops in premature babies who have been on ventilators and oxygen because their lungs were underdeveloped at birth. Babies with BPD may need additional oxygen after being discharged from the hospital.
  • If a baby has inhaled a foreign body, and it has obstructed the airways, they may wheeze, cough or choke. This can happen during eating or playing. Someone should immediately place the baby in an upright position and seek urgent medical attention.

To prevent choking from happening, children younger than 4 years of age should not be given food, such as popcorn, peanuts, hard candy, large pieces of hot dogs, or hard, raw fruits or vegetables.

When caring for a toddler, a person should encourage them to sit quietly while eating and only offer one piece of food at a time.

Children under 3 years old should not be given toys with small parts because of the risk of choking


Rare causes of wheezing in children and infants

If a baby has been wheezing since birth, the reason might be a congenital one. Congenital condition can include:

  • congenital vascular abnormalities
  • cystic fibrosis
  • immunodeficiency diseases
  • primary ciliary dyskinesia
  • tracheobronchial anomalies
  • vocal cord dysfunction

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