Causes of wheezing in infants

Bronchiolitis commonly causes noisy breathing with a runny nose, cough and feeding difficulty during a viral illness. Acute Bronchitis can also irritate the airways. Some infants wheeze after exposure to smoke, fragrances or other irritants, while recurrent episodes may need assessment for asthma or another airway problem.

Allergic Rhinitis is less typical in very young babies but can cause nasal symptoms, and Anaphylaxis can begin suddenly with wheeze, facial swelling, hives, vomiting or unusual sleepiness. A recording of the sound can help a clinician, but it should not delay care when breathing is difficult.

Keep the infant upright while awake, offer usual feeds more often if they can manage them, and clear visible nasal mucus gently. Keep smoke and strong scents away. Do not give cough medicine, honey or someone else's inhaler unless a clinician has advised it.

Watch breathing, alertness, wet nappies and feeding. Contact a clinician promptly for a new wheeze, worsening cough, reduced feeding, repeated vomiting, fever in a young baby or fewer wet nappies. A Nebuliser Treatment is used only when clinically indicated.

Call emergency services if the infant is struggling for each breath, ribs are pulling in, lips look blue or grey, there are pauses in breathing, the infant is floppy or difficult to wake, or swelling follows a possible allergen. Seek urgent assessment when feeding drops markedly or breathing becomes faster and noisier.

Could this be bronchiolitis, an allergic reaction or another airway problem? Is the feeding and wet-nappy pattern safe? How should I monitor breathing at home, and which changes mean I should return urgently?