amily Health

Wheezing Versus Asthma How to identify respiratory conditions in your child, and when you should be concerned

By Pramod Narula, md.

My four-year-old daughter loves to run around and play outside! However, sometimes when she is particularly active, she will start to wheeze. It often resolves within a few minutes, but I am concerned. Does this mean she may have asthma? Y ou are right to be concerned that your daughter’s wheezing may be indicative of a respiratory issue. However, asthma is not the only condition that causes activityinduced wheezing. There are a number of different conditions that could be the cause. I would recommend taking your daughter to a pediatric pulmonologist, who can identify the source of the wheezing, and then develop the most effective course of treatment.

That whistling sound you hear when your daughter wheezes is caused by a narrowing of her airways. Exercise and physical activity is a common precursor to wheezing as it increases one’s rate of respiration. A common cause of this is, as you suspected, asthma.

16 NewYorkFamily.com | April 2020 Asthma is a chronic condition in which the airways constrict or fill with mucus in response to particular stimuli or “triggers,” one of which is exercise. Other triggers may include, dust, mold and pet dander. Children with asthma are generally reactive to a number of different triggers, rather than just one. Asthma is treated with corticosteroids, which control inflammations, and are usually taken in the form of an inhaler.

Wheezing may also be caused by environmental allergies brought on by pollen, ragweed, dust and many other substances. An allergist can determine if your daughter has environmental allergies and to what she may be allergic to. Treatment for environmental allergies may include taking a daily antihistamine or receiving a course of allergy shots. However, asthma and allergies are not mutually exclusive. Approximately 90% of children with asthma also have allergies, and allergies can sometimes make asthma symptoms even worse.

Acute respiratory infections, often caused by viruses, may also cause wheezing and are extremely common in young children. Rhinovirus (the common cold), influenza and respiratory syncytial virus are usual causes of wheezing. Although the virus causing the wheezing needs to work itself out, corticosteroids used to treat asthma may provide temporary relief and would not need to be used long term.

It is encouraging that your daughter’s wheezing episodes are mild. However, it is important to know the signs for when you should take her to the emergency room. If the wheezing does not abate, and she starts breathing extremely hard, you will need to seek immediate medical care. That being said, the sooner your daughter is assessed by a pediatric pulmonologist, the less likely you will encounter an emergency situation like this one. With proper diagnosis and management, your daughter will be able to play safely.

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