More often than not, first-time parents are told their child is wheezing. The typical question that immediately follows is, "Does that mean my son has asthma?" And while a simple yes or no answer is what the parents are looking for, it is important to realize many factors are involved as to whether a child will ultimately have asthma. And although your pediatrician may often have some suspicion about a first time wheezer ultimately becoming asthmatic, it is important to emphasize just because a child wheezes, it does not necessarily point to a lifetime of asthma. In fact, only 30% of children less than 1 year of age who do wheeze, go on to develop asthma.

But let's take a step back for a moment and clarify this concept of wheezing. Simply put, wheezing typically follows constriction of the lower airways of the lungs — that is, the bronchioles. In its milder form, wheezing may sound like a whistle when a child breathes out (the expiratory phase of breathing). Now, the patho-physiology behind wheezing is quite detailed but as with any medical condition, think of two factors playing a role in why your child might wheeze. Firstly, if mom and dad are asthmatic or a significant family history of allergies and/or eczema is present, then a genetic predisposition for their child to wheeze may exist as well (something researchers spend a great deal of effort trying to determine). Secondly, think of the environment we live in. Think of all those viruses/colds and environmental allergens (grass, dustmites, exposure to smoke, and even cockroach carcasses) we come across on a daily basis, any of which can trigger an inflammatory response in the lungs leading to the constriction process mentioned above.

And some other reasons your child might wheeze? Gastroesophageal reflux disease (aka GERD or reflux), vocal cord dysfunction, and any foreign object accidentally swallowed that ends up in the airway.

And one last bit of insight for the parents of a child who may be wheezing? It may not be wheezing you are hearing but rather upper airway obstruction noises (i.e., all that mucus from a cold stuck in the nasal cavity that creates that whistling sound). But if there is any concern your child might be wheezing, please come see one of us at Boulevard Pediatrics.