Wheezing in children 1-3 years

Wheezing in children 1-3 years: What a whistling breath means

Wheezes that whistle on exhalation (wheezing, візинг) — this is a high‑pitched sound that occurs when air forcefully passes through narrowed lower airways (bronchi or bronchioles). It is not a disease but an important clinical sign that always indicates bronchial obstruction (narrowing of the bronchial lumen). The appearance of wheezing in an infant, especially if accompanied by shortness of breath, warrants immediate medical consultation.

Why do wheezes occur? Mechanism of bronchial obstruction

Narrowing of the bronchi in young children can be caused by three main mechanisms, often acting together:

1. Mucosal edema: In response to a viral infection or allergen, the bronchial mucosa becomes inflamed and swollen, reducing its lumen.
2. Bronchospasm: The smooth muscle surrounding the bronchi reflexively contracts, further narrowing the airways.
3. Hypersecretion of mucus: In response to inflammation, a large amount of thick, sticky mucus is produced, clogging already narrow bronchi.

Most common causes of wheezing in toddlers

• Obstructive bronchitis: The most frequent cause. This is an upper respiratory infection (URI) in which the primary inflammatory process occurs in the bronchi and is accompanied by their narrowing. In most cases it is viral.
• Bronchial asthma: Chronic allergic inflammation of the airways. Recurrent episodes of wheezing, especially triggered by allergens, physical exertion, or cold air, can be the first signs of asthma.
• Foreign body aspiration: Sudden onset of wheezing in a healthy child during play or eating may indicate that something was inhaled.

Treatment of wheezing depends on its cause. For obstructive bronchitis and asthma, inhaled medications that dilate the bronchi and reduce inflammation are used.