Causes

• Main cause in the first 2 years of life: Bronchiolitis (peaks at 6-12 months). This is a viral infection (usually RSV) of the small airways. These small airways are called bronchioles.
• Main cause after age 2: The first attack of asthma.

Return to Child Care or School

• Your child can return to child care after the wheezing and fever are gone.

1. What You Should Know:
   • Wheezing is a high-pitched purring sound.
   • Wheezing means the lower airway is tight.
   • This is often part of a cold, but it can become worse.
   • Here is some care advice that should help until you talk with your doctor.
2. Coughing Fits or Spells:
   • Breathe warm mist (such as with shower running in a closed bathroom).
   • Give warm clear fluids to drink. Examples are apple juice and lemonade. Don't use before 3 months of age.
   • Amount. If 3 - 12 months of age, give 1 ounce (30 ml) each time. Limit to 4 times per day. If over 1 year of age, give as much as needed.
   • Reason: Both relax the airway and loosen up any phlegm.
3. Homemade Cough Medicine:
   • Do not give any over-the-counter cough medicine to children with wheezing. Instead, treat the cough using the these tips:
   • AGE 3 months to 1 year: Give warm clear fluids to treat the cough. Examples are apple juice and lemonade. Amount: Use a dose of 1-3 teaspoons (5-15 ml). Give 4 times per day when coughing. Caution: Do not use honey until 1 year old.
   • AGE 1 year and older: Use HONEY ½ to 1 teaspoon (2-5 ml) as needed. It works as a homemade cough medicine. It can thin the secretions and loosen the cough. If you don't have any honey, you can use corn syrup.
4. Nasal Washes To Open a Blocked Nose:
   • Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use warm tap water.
   • STEP 1: Put 3 drops in each nostril. (If age under 1 year old, use 1 drop. Also, do 1 side at a time.)
   • STEP 2: Blow (or suction) each nostril out while closing off the other nostril. Then, do the other side.
   • STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
   • How often: Do nasal washes when your child can't breathe through the nose. Limit: No more than 4 times per day.
   • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
   • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of warm water.
   • Reason for nose drops: Suction or blowing alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
   • Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
   • For young children, can also use a wet cotton swab to remove sticky mucus.
5. Humidifier:
   • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.
6. Smaller Feedings:
   • Use small, frequent feedings whenever your child has the energy to drink.
   • Reason: Children with wheezing don't have enough energy for long feedings.
7. Avoid Tobacco Smoke:
   • Tobacco smoke makes coughs and wheezing much worse.
8. Return to School:
   • Your child can return to child care after the wheezing and fever are gone.
9. Call Your Doctor If:
   • Trouble breathing gets worse
   • Wheezing gets worse
   • Your child becomes worse