How can I tell if my child is wheezing from a cold or if they have asthma?

Winter months can be a tough time for infants and young children who can develop wheezing as part of an upper respiratory infection. Most of the time this wheezing, which is also known as bronchospasm, is relatively mild and self-limited. For a small percentage of infants and toddlers, wheezing will be more severe and they may need extra treatment, even to the point of being hospitalized. 

Another challenge is that once these young children have had an initial episode of wheezing, they can easily have repeated episodes when they develop other colds and respiratory infections. If a child has enough repeated wheezing episodes, they will likely be given the diagnosis of asthma. Many children will grow out of this diagnosis by the time they are four or five, but some will have this condition well into the school-age years and beyond.

RSV (respiratory syncytial virus) is probably the best-known virus that can cause wheezing in infants and young children. This virus comes around every year, generally peaking in January or February. One curious feature of this virus is that people generally do not develop long-term immunity against it, so even adults can get infected year after year. There is not a vaccine to prevent infection, so reducing your child’s exposure to other infected people is the only way to reduce their chance of getting ill.

Treatment for wheezing in young children is basically done through supportive care. Albuterol nebulizations – a prescription medicated mist – can be very helpful for some children with repeated episodes of wheezing. Steroids, either by mouth or inhaled through a nebulization, can also be helpful for some young children who experience repeated wheezing. Antibiotics, on the other hand, are generally not necessary. If you have further questions about wheezing in younger children, please ask your health care professional.

This column is intended to provide general information only and not medical advice. Contact your health care provider with questions about your child. Dr. Peter Dehnel is a board-certified pediatrician and medical director with Blue Cross Blue Shield of Minnesota. Send questions to [email protected].

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