I have 3-year-old boy who has been wheezing a lot this summer. Around February he had difficulty breathing. He was using his entire chest and abdomen just to breath and was lethargic. The doctors put him on a nebulizer and that seemed to help. This has happened a couple of times since then. I purchased a nebulizer with saline and the other liquid they suggested and used the machine again last week. Do I need to be concerned that a child his age would need this when he starts wheezing? Should I be more concerned and have tests done to make sure nothing is wrong with him?”
Thank you for your comments. Keep in mind that your doctor’s appointments are only about 10-15 minutes. I find it very difficult to do much teaching in this short amount of time. Your child is acting like he might have asthma. Many children’s hospitals have asthma classes, I try to make sure my asthma patients attend one of these classes.
Why do children wheeze? It could be something as simple as a respiratory virus, but if he is having multiple episodes then it is probably something more significant such as asthma. There aren’t very many tests that can be done on a child this age other than maybe a chest x-ray (which usually is not needed). Often, the best test is this: try a few different treatments and see what works the best. Knowing what treatment works best can then tell the doctor what the problem is. I know, this sounds a little backwards. Here are some of the “treatments” I try: Avoid certain foods like cow’s milk, dairy products, food dyes (e.g. yellow #5, Red #30), or foods that are high on our allergy list. If the child’s wheezing episodes stop after avoiding cow’s milk and dairy products, then the diagnosis is cow milk allergy or sensitivity. If we suspect an allergic culprit but can’t prove it, then allergy testing might be helpful, but it’s nice to confirm animal allergies before getting rid of the family pet! Often, we will use asthma medications intermittently to help with the symptoms while trying to figure out what the triggers are. Some children only wheeze every time they get a cold virus. After a few of these episodes, mom and I learn that he needs to start his asthma meds as soon as the cold symptoms start. To read more about asthma, click here.
Dr. Jim