Asthma and wheezing in infants

A baby cannot describe chest tightness or perform standard breathing tests reliably. Clinicians therefore look at repeated symptom patterns, triggers, family and allergy history, examination findings and response to treatment.

Asthma in a young child may present with recurrent wheezing, coughing during sleep or activity, faster breathing, tiring during feeds, or reduced playfulness. Viral infections frequently bring on wheezing in infancy, and not every baby who wheezes has asthma.

Noisy breathing can also come from the nose or upper airway. A phone recording of the sound and notes about when it starts can help the clinician distinguish wheeze from congestion or other noises.

Keep the baby away from tobacco smoke, vaping aerosols, incense and strong fragrances. Give only medicines prescribed for the child, using the spacer and mask as demonstrated. The mask should seal gently around the mouth and nose so the inhaled medicine is not lost.

Record coughing, wheezing, feeding changes, sleep disruption and possible triggers. Arrange medical review for repeated episodes, symptoms between colds, or uncertainty about device technique. Do not give an infant someone else's inhaler or cough medicine.

Get emergency help if the baby has blue or grey lips, pauses in breathing, severe chest pulling, grunting, unusual sleepiness, poor responsiveness, or cannot feed because of breathlessness. Urgent assessment is also needed when breathing is rapidly worsening or prescribed reliever treatment is not working as the child's plan describes.

Ask what sound or behaviour should trigger treatment, how the spacer and mask should be cleaned, and when the baby needs reassessment. Confirm a written plan for worsening symptoms and whether allergy, reflux, infection or an airway problem needs consideration.