Grunting and wheezing: when breathing needs help

Wheezing is usually a high-pitched sound caused by narrowed lower airways. Grunting is a short sound made as someone breathes out, and can indicate that the body is trying to keep the small airways open. Infants may grunt with bronchiolitis or another serious breathing problem.

Wheezing can accompany asthma, a viral chest illness, chronic obstructive pulmonary disease, or an allergic reaction. The sound alone cannot identify the cause. Look at breathing effort, skin colour, alertness, and ability to drink or speak.

Keep the person upright, calm, and away from smoke or a known irritant. If they have a prescribed reliever inhaler, help them use it according to their action plan. Do not give another person’s inhaler or delay help while trying home remedies.

For a child, watch feeding, wet nappies, alertness, and pauses in breathing. A clinician may listen to the chest and decide whether inhaled medicine, oxygen, or further care is needed. A nebuliser is not suitable for every cause of wheezing.

Call emergency services for severe breathlessness, grunting with chest pulling in, blue or grey lips, pauses in breathing, collapse, sudden facial swelling, or inability to speak or drink. Urgent assessment is also needed when breathing worsens quickly or a prescribed reliever is not helping.

Ask: Is this wheeze coming from the lower airways? What is the correct inhaler technique? What warning signs should prompt emergency help? Could allergy, infection, or asthma explain the sound?