- With Mayo Clinic emeritus consultant
Jay L. Hoecker, M.D.
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Jay L. Hoecker, M.D.
Jay L. Hoecker, M.D.
Dr. Jay Hoecker, an emeritus consultant in the Department of Pediatric and Adolescent Medicine, brings valuable expertise to MayoClinic.com in general and primary care pediatrics. He has a particular interest in infectious diseases of children.
Dr. Hoecker, a Fort Worth, Texas, native, is certified as a pediatrician by the American Board of Pediatrics and is a fellow of the American Academy of Pediatrics. He was trained at Washington University's St. Louis Children's Hospital, and in infectious diseases at MD Anderson Cancer Center in Houston. He has been with Mayo Clinic since 1989.
"The World Wide Web is revolutionizing the availability and distribution of information, including health information about children and families," Dr. Hoecker says. "The evolution of the Web has included greater safety, privacy and accuracy over time, making the quality and access to children's health information immediate, practical and useful. I am happy to be a part of this service to patients from a trusted name in medicine, to use and foster all the good the Web has to offer children and their families."
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Question
Wheezing in children: Could it be asthma?
My 11-month-old son has had several wheezing episodes recently. Does this mean he has asthma?
Answer
from Jay L. Hoecker, M.D.
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. Infections such as infectious bronchitis can cause wheezing and other symptoms in infants and young children that mimic asthma symptoms. This is because their airways are so small that any airway infection can cause breathing trouble. Up to half 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 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.
- Coughing, clear mucus and a runny nose caused by hay fever.
There are certain risk factors that increase the odds your child's breathing problems are caused by asthma:
- Wheezing that won't go away or keeps coming back
- Having a parent with asthma, allergies or eczema
- Having an allergy, such as a food allergy or hay fever
If your child does have breathing problems, talk to the doctor. If your child's symptoms are caused by asthma, early diagnosis is important. It can prevent permanent lung changes as well as relieving wheezing and other symptoms.
Diagnosing asthma in children may be difficult, because children under 5 usually aren't able to do special breathing tests (lung function tests) to make a diagnosis. Doctors have to rely on signs and symptoms, and the diagnosis isn't always reliable. If the diagnosis is uncertain, you and your child's doctor will have to weigh the pros and cons of starting asthma treatment. As a child gets older, it's easier to be certain whether symptoms are caused by asthma or something else.
Next questionInfant constipation: How is it treated?
- Expert Panel Report 3 (EPR-3): Guidelines for the diagnosis and management of asthma-Summary report 2007. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed April 23, 2009.
- Asthma in infants. Asthma and Allergy Foundation of America. www.aafa.org/print.cfm?id=8&sub=17&cont=160. Accessed April 22, 2009.
- Wheezing and asthma in infants. KidsHealth. www.kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=107&cat_id=20564&article_set=37965. Accessed April 22, 2009.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. May 8, 2009.
- Castro-Rodriguez JA. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: A systematic review with meta-analysis. Pediatrics. 2009;123:e519.
