Wheezing in children: Could it be asthma?

My 11-month-old son has had several wheezing episodes recently. Does this mean he has asthma?

- No name given / Missouri

Answer

Not necessarily. Wheezing is a classic sign of asthma. However, not all children who have wheezing episodes will develop asthma, and not all children with asthma wheeze.

Wheezing is a high-pitched, whistling noise that usually occurs with exhaling. Certain viral infections commonly cause wheezing in infants and young children. This is because their airways are so small that any airway infection can cause breathing difficulties. Up to 50 percent of children have at least one episode of wheezing before they're 3 years old. But only about one-third of these children develop asthma before age 6 years.

In addition to wheezing, several other signs and symptoms may indicate asthma in a young child. They may include:

• Breathing problems, such as breathing that is louder than normal or faster than normal (Newborns typically take 30 to 60 breaths a minute. Toddlers typically take 20 to 40 breaths a minute.)
• Frequent coughing, or coughing that worsens after active play
• Lethargy
• Difficulty eating (or sucking, in infants)
• Softer than normal crying

Diagnosing asthma in infants may be difficult. In older children and adults, special breathing tests (lung function tests) can be used to make a diagnosis. But these tests are less practical in very young children because they require cooperation and understanding to get good results. Children usually don't develop these skills until the time they're 4 years old.

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