Infant wheezing and coughing

Wheezing is a musical or whistling sound caused by narrowed lower airways; a harsh noise when breathing in may come from higher in the airway. Cough and wheeze can occur with Bronchiolitis or Acute Bronchitis. Asthma is another possibility, but an infant’s first wheeze needs clinical assessment rather than a label based on sound alone.

Note when symptoms began, whether breathing is faster, and whether the baby feeds normally. Smoke, fragrance and respiratory infections can aggravate airway symptoms. An allergic emergency can cause sudden breathing trouble with swelling, hives or vomiting.

Keep your infant upright in your arms while awake, offer usual milk feeds in smaller amounts if breathing makes feeding tiring, and keep the environment smoke-free. Do not use someone else’s inhaler or cough medicine. A clinician may decide whether inhaled treatment or Nebuliser Treatment is appropriate after examining the baby.

Count wet nappies and watch the chest while the baby is calm. Record triggers, fever, cough pattern and any prescribed medicine already given. Avoid exposing the infant to sick contacts where practical.

Call emergency services if the baby is blue or grey, has severe chest indrawing, pauses in breathing, cannot cry or feed, becomes floppy, or is difficult to wake. Seek immediate help for sudden wheeze with facial swelling, hives or vomiting because this may be Anaphylaxis. Arrange prompt assessment for persistent wheeze, worsening cough or fewer wet nappies.

Ask what the sound represents, how to measure breathing effort, whether the chest needs review, and exactly when prescribed inhaled treatment should be used.