Is Wheezing In Children A Sign Of Asthma? Types, Causes And Treatments

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Wheezing is characterised by a whistling sound made when a child or baby breathe, especially when they breathe out. It is considered a common disorder as around 50 per cent of children experience episodes of wheezing during the first year of birth. [1]

There are around four main types of wheezing: never wheezing, early transient wheezing, persistent wheezing, and late-onset wheezing. Factors such as genetic and environmental mainly contribute to the development of wheezing in children. Wheezing usually go away with age but recurrent or persistent wheezing can lead to conditions like asthma. Take a look at the details about wheezing in children.

Types Of Wheezing In Children

There are two categories under which wheezing is divided: duration and pattern.

1. Wheezing according to the duration

• Never or infrequent wheezing: It includes children who never have any episodes of wheezing in their life.
• Early transient wheezing: It includes children whose wheezing episodes have started in the first year of their life, followed by the second and third year, but had no episodes after the age of six. Also, wheezing is not genetic in this case and can be due to maternal exposure to smoking, low socioeconomic status, low maternal age or low birth weight. [2]
• Persistent wheezing: Here, wheezing episodes start at around six months of age. It is of two subtypes: nonatopic and atopic. In nonatopic persistent wheezing, viruses such as rhinovirus, human metapneumovirus, influenza virus, or coronaviruses can be the main cause. [3] Atopic persistent wheezing starts in the second year of life and often persists longer. The main cause is house dust mites, family history of asthma or early food sensitization.
• Late-onset wheezing: It is characterised by infrequent wheezing between 6-42 months of life and then frequent or persistent wheezing from 42 months up to the age of 6 years. [4]

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2. Wheezing according to pattern

• Episodic wheezing: For a particular period and is often identified by clinical evidence of a viral cold.
• Multi trigger wheezing: Episodes of wheezing apart from acute viral episodes.

Causes Of Wheezing In Children

Wheezing occurs when the passage of air in the windpipe gets disrupted due to narrowing of the airways. Also, children tend to have small bronchi and less elastic tissues compared to adults. These factors cause respiratory distress or resistance to total airways, leading to wheezing.

Causes of airways compression include:

• Cystic fibrosis
• Allergies
• Asthma
• Bronchiolitis
• Gastroesophageal reflux disease
• Neuromuscular disease
• Chronic lung disease
• Metabolic diseases
• Foreign body aspiration

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Treatments Of Wheezing In Children

• Bronchodilator: It is mainly used for the treatment of acute wheezing symptoms such as cough, wheeze and shortness of breath. These medications are effective in treating wheezing problems in children who are younger than two years.
• Systemic steroids: It is given as a short course of therapy for recurrent wheezing patients who have had rhinovirus infection.
• Inhaled steroids: It is suggested for persistent and late-onset wheezing patients. Inhaled steroids are suggested mainly for recurrent episodes of wheezing. [5]
• Antileukotriene: It is mainly suggested for treating postviral wheezing.

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Is Wheezing A Sign Of Asthma?

Cough and wheezing are common in small children. Though not all wheezes are a sign of asthma, the symptom can become persistent and lead to asthma. Also, wheezing is not always a common symptom in the diagnosis of asthma. This is why, patients with episodic respiratory problems and with a history of asthma are often asked about the wheezing. [6]

Therefore, if you notice signs of wheezing in your children, it is best to go for diagnosis as it helps in identifying the exact cause and severity of the condition and may also help prevent the risk of asthma, if it is in the family.