What should you know about bronchiolitis and wheezing?

Bronchiolitis affects the smallest air passages. Swelling, mucus, and narrowing can produce a musical or whistling sound, usually more noticeable when breathing out. The illness may begin with a runny nose and cough, then make feeding or sleeping harder. Not every noisy breath is wheeze: a harsh sound when breathing in can come from the upper airway and should be described to a clinician.

Listen for changes while the child is settled. Count pauses, observe the chest and neck for pulling in, and notice whether the child can drink and stay alert. A wheeze does not by itself establish asthma, and a child with bronchiolitis may need a different assessment.

Keep the child upright when awake, offer smaller feeds more often, and use gentle nose-clearing before feeds if congestion is interfering. Keep air free of cigarette smoke. Do not use a borrowed inhaler or nebuliser, and do not start antibiotics unless prescribed. Record breathing effort and feeding so you can explain the trend clearly.

A [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/) allows a clinician to examine the child and decide whether treatment is needed. More information is available on [Bronchiolitis](/conditions/bronchiolitis/) and [Wheezing](/symptoms/wheezing/).

Get emergency help if the child has blue or grey lips, pauses in breathing, severe struggle, is unable to drink, or is difficult to wake. Seek urgent medical review for rapidly increasing wheeze, chest indrawing, breathing that remains hard while resting, much less urine, or exhaustion during feeds. A mild wheeze with comfortable breathing still merits monitoring because symptoms can change.

Ask what sound the clinician hears, whether the pattern fits bronchiolitis or another airway problem, how to monitor breathing, whether any inhaled treatment is indicated, and when follow-up is needed.