• Main cause in the first 2 years of life: bronchiolitis (peaks at 6-12 months). This is a viral infection (usually RSV) of the small airways (bronchioles).
• Main cause after age 2: may be the first attack of asthma.

Return to Day Care

• Your child can return to day care after the wheezing and fever are gone.

Call 911 Now (your child may need an ambulance) If 

• Wheezing started suddenly after medicine, an allergic food or bee sting
• Severe difficulty breathing (struggling for each breath, making grunting noises with each breath, unable to speak or cry because of difficulty breathing)
• Your child passed out or has bluish lips
• Child recently choked on small object or food 

Call Your Doctor Now (night or day) If 

• Wheezing but none of the symptoms described above 

Warm Fluids for Coughing Spasms

• For any bouts of severe coughing, offer warm apple juice or lemonade if over 4 months old. (Reason: These can relax the airway and loosen up sticky secretions).
• Do not give any cough medicine.

Nasal Washes to Open a Blocked Nose:

• Use saline nose drops or spray to loosen up the dried mucus.  If not available, can use war tap water.
• STEP 1: Instill 3 drops per nostril. (Age under 1 year, use 1 drop and do one side at a time)
• STEP 2: Blow (or suction) each nostril seperately, while cloding off the other nostril.  Then do other side.
• STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
• Frequency: Do nasal washes whenever you child can't breathe through the nose.
• Salin nasal sprays can be purchased without a prescription
• Saline nose drops can also be made: Add 1/2 teaspoon (2ml) of table salt to 1 cup (8 ounces or 240 ml) of warm water.
• Reason for nose drops: suction or nose blowing alone can't remove dried or sticky mucus.
• Another option: use a warm shower to loosen mucus.  Breathe in the moist air, then blow each nostril.
• For young children, can also use a wet cotton swab to remove sticky mucus.
• Importance for a young infant: can't nurse or drink from a bottle unless the nose is open.

Humidifier

• If the air is dry in your home, run a humidifier.

Smaller Feedings

• Encourage small, frequent feedings whenever your child has the energy to drink. (Reason: Child with wheezing doesn't have enough energy for long feedings).

Avoid Tobacco Smoke

• Active or passive smoking makes coughs much worse.

Contagiousness

• Your child can return to day care after the wheezing and fever are gone.

Call Your Doctor If

• Breathing becomes difficult, tight or loud
• Wheezing becomes worse 

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.