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  • Wheezing (Other Than Asthma)

    Definition

    • Wheezing is a high-pitched purring or whistling sound
    • You can hear it best when your child is breathing out
    • Use this guide only if your child has not been diagnosed with asthma

    First Aid Advice for Anaphylaxis – Epinephrine

    • Anaphylaxis is a life-threatening allergic reaction.
    • If you have epinephrine (such as Epi-pen), give it now.
    • Do this while calling 911.
    • Over 66 pounds (30 kg): Give 0.3 mg. Epi-Pen.
    • 33-66 pound (15-30 kg): Give 0.15 mg. Epi-Pen Jr.
    • Less than 33 pounds (15 kg): Give dose advised by your doctor.
    • Give the shot into the upper outer thigh in the leg straight down.
    • Can be given through clothing if needed.
    • Benadryl: After giving the Epi-pen, give Benadryl by mouth. Do this if your child is able to swallow.

    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.

    When to Call Us for Wheezing (Other Than Asthma)

    Call 911 Now (your child may need an ambulance) If:

    • Starts to wheeze suddenly after bee sting, taking allergic food or medicine
    • Severe trouble breathing (struggling for each breath, very tight wheezing, can barely cry)
    • Passed out or stopped breathing
    • Bluish lips or face
    • Recently choked on a small object or food
    • You think your child has a life-threatening emergency
    • You think your child has a life-threatening emergency

    Call Us Now (night or day) If:

    • Wheezing, but none of the symptoms above. (Reason: Needs a doctor’s exam.)

    Care Advice for for Mild Weezing (Use this until you talk with your doctor)

    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.

    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.

    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.

    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.

    Humidifier:

    • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.

    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.

    Avoid Tobacco Smoke:

    • Tobacco smoke makes coughs and wheezing much worse.

    Return to School:

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

    Call Your Doctor If:

    • Trouble breathing gets worse
    • Wheezing gets worse
    • Your child becomes worse

    Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

    Author and Senior Reviewer: Barton D. Schmitt, M.D.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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