What a Wheezing Cough Means in Babies and Toddlers

Is your child making a high-pitched whistling sound when she coughs? The culprit could be bronchiolitis, asthma, or something else entirely. Learn more about the causes, symptoms, and treatment options for wheezing coughs.

Baby with mother at routine medical appointment
Photo: FatCamera/Getty Images

When your child isn't feeling well, it can seem disconcerting to hear her 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 herself 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 infected coughs, sneezes, or respiratory droplets. 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 become especially 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 dust, illness, exercise, 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 he suffers 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."

Other Causes of Wheezing Cough in Babies and Toddlers

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.

  • 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 he's 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.
  • Acid reflux that releases stomach contents into the lungs
  • Bronchitis or pneumonia
  • Croup, a viral infection associated with a barking cough
  • Congested nose due to a cold or allergies

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.
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