What a Wheezing Cough Means in Babies and Toddlers

When your child isn't feeling well, it can be worrisome to hear them let out a dry, wheezing cough. This high-pitched whistling noise happens during exhalation because of a blockage in the lung passages. It's usually caused by one of two factors—bronchiolitis or asthma—and can often be treated at home. Learn more about toddler and baby wheezing coughs, with tips for making your little one feel like themself again.

Wheezing Cough from Bronchiolitis

Bronchiolitis happens when the airways become inflamed and constricted—usually from a virus that reaches the small airways in the lungs. A majority of bronchiolitis cases are caused by respiratory syncytial virus (RSV), although parainfluenza virus and adenovirus may also be the culprits. To hear what that wheezing sounds like, you'll want to watch this video of a baby breathing with RSV (who thankfully fully recovered).

Bronchiolitis is most common around the winter months, and sufferers are generally under 2 years old. Premature babies, boys between 2 to 6 months old, those with lung or heart diseases, and children who have never been breastfed may be especially prone to getting it.

Kids contract bronchiolitis through breathing in infected coughs, sneezes, or respiratory droplets expelled by someone around them. Symptoms initially resemble a cold, and they include stuffy nose, sneezing, and fever. Rapid breathing, difficulty exhaling, wheezing cough, and a decrease in food intake may appear in the later stages.

In babies under one year old, bronchiolitis can potentially become life-threatening without proper treatment, warns David Rubin, M.D., chief of pediatrics at St. Barnabas Hospital in the Bronx, New York. That's because mucus formation can cause a baby's delicate lungs to plug up, possibly leading to inflammation, lung tissue collapse, and infections such as pneumonia.

Wheezing Cough from Asthma

Coughing and wheezing might also be caused by asthma—a chronic disease characterized by lung inflammation and breathing problems. The condition gets triggered when your child's airways swell from illness, exercise, dust, or other irritants.

Asthma is rare for babies younger than 2 years old. Experts don't entirely understand the cause, although genetics may play a role. A child's risk of developing asthma also increases if they suffer from eczema or food allergies, or if you have a family history of allergies or asthma.

During an asthmatic episode, the airways swell and spasm, leading to a wheezing cough. Other symptoms may include chest congestion, fatigue, and shortness of breath. Since doctors can't perform asthma tests on young children, however, babies and toddlers with these symptoms are said to have "reactive airway disease."

Wheezing Cough From Other Causes

While bronchiolitis and asthma are common causes of a dry wheezing cough, other factors can trigger it as well. Here are some other causes of a wheezing cough in babies and toddlers.

Acid Reflux

Acid reflux is caused when the stomach releases stomach contents into the lungs. This can irritate the lungs and throat, resulting in inflammation, discomfort (often called heartburn), and potentially, a wheezing cough.

Other Infections

There are a variety of other infections besides bronchiolitis that can result in a wheezing cough, including bronchitis, colds pneumonia, and COVID-19. Croup, which is viral infection associated with a barking cough, can also result in a wheezing cough (or may be mistaken for one).

If you notice other signs of illness, such as fever, congestion, body aches, or sore throat, along with the wheezing cough, be sure to check in with your child's pediatrician so that you can determine which kind of infection they have—and how best to treat it.

Allergies

A wheezing cough can also be caused by a congested nose due to seasonal or other allergies. Allergies may be due to seasonal changes in pollen or be caused by other irritants such as pets, dust, or mold. While it can sometimes be tricky to distinguish between allergies and infections, for the most part, allergy symptoms are concentrated in the head (such as stuffy nose and itchy, watery eyes) rather than causing full body symptoms like fever or body aches.

However, note that babies and toddlers have tiny nasal passages making them more prone to have a runny nose. Check with your child's medical provider if you suspect your child has an allergy to determine the best treatment options, if needed. Allergy testing can pinpoint if your child has an allergy and what they're allergic to.

A Blocked Airway

A piece of food or small toy is lodged in the airway. Partially lodged objects (your child can breathe normally) might release with pats on the back, and doctors can help if the item is still stuck afterwards. But if the item is restricting your baby's airways—and they're making throat-grabbing motions without sounds, has pale or blue skin, and appears in obvious distress— try removing the object immediately and call 9-1-1.

Other Possible Causes of Wheezing Cough

When to Call the Doctor for Wheezing Cough

Call your doctor for a wheezing cough, especially if it's accompanied by breathing difficulties. The symptom might require immediate treatment if your child is younger than 4 months, or if she has any of the following symptoms.

• Severe breathing difficulties
• Shallow and/or rapid breathing (50 breaths per minute or more)
• Bluish or pale skin
• Appearing lethargic
• A sucking or retracting motion in the stomach
• Flaring nostrils
• Refusal to drink and signs of dehydration
• Sustained or rising fever

Wheezing Cough Treatment in Babies and Toddlers

Most wheezing coughs can be treated at home. However, severe cases of bronchiolitis might require hospitalization to treat respiratory distress (with an oxygen tube) or dehydration (with intravenous fluid). If asthma is suspected, doctors can ease open airways with a liquid form of albuterol; it might be administered as a mist through a face mask in cases of respiratory distress. Older children may need to use an inhaler as a long-term asthma solution.

When treating wheezing cough at home, don't give your child cough medicine or syrup. The American Academy of Pediatrics says these medicines are ineffective for those under 6 years old, and they're unsafe for anyone under 4. Instead, try some of these natural baby and toddler wheezing cough treatment options.

• Give your child plenty of fluids to prevent dehydration. Staying hydrated also loosens the mucus in your baby's respiratory tract.
• Set up a cool mist vaporizer in your little one's bedroom. The extra moisture might relieve wheezing cough in babies and toddlers.
• Position your child in an upright position to open her airways.
• Ease congestion with over-the-counter saline nose drops.
• If your child has a fever, you might relieve it with acetaminophen such as Tylenol. Always ask your doctor first.
• Don't smoke near your child.