Wheezing in Babies

My ten month old baby has had intermittent cough with some wheeze and I am worried that he may have asthma. G James, Wolverhampton

Recurrent wheeze in infancy is very common and it is sometimes difficult to find the underlying cause.

Most doctors do not like to diagnose a child as having asthma in the first year of life as younger children often have quite marked wheeze in response to viral infections such as colds, etc. This wheeze tends to resolve once the cold has cleared and does not tend to lead on to asthma in the long term. It is important to consider other causes of wheeze in infancy as well as the possibility of asthma. Bronchiolitis is caused by a viral infection affecting the lungs which causes a marked cough with wheeze and can give rise to recurrent episodes of wheezing with further viral infections for the following two to three months. In small babies it is important to remember the possibility of regurgitation of feeds causing cough and wheeze.

If you or your partner smoke, it can also have a major influence on your child's breathing.

Some babies are intolerant of cow's milk protein and this can cause mucus congestion with cough and wheeze. This is best managed by a two to three week trial during which you exclude dairy produce, but this should only be done under medical supervision.

There are a number of other rare conditions which can cause recurrent wheeze such as abnormalities of the lung, airway or heart and cystic fibrosis, all of which are uncommon, but which your doctor would almost certainly consider if symptoms were severe.