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Feature Article

Wheezing infants and toddlers: a practical approach

Craig Mellis

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Abstract

Although a very common problem, wheezing in infants and toddlers remains a difficult and confusing problem for clinicians. The wheeze is not usually due to asthma but asthma medications have a role if there is significant breathlessness and ongoing morbidity.

Key Points

  • Although wheeze in infants and toddlers is very common, it is not usually due to asthma.
  • A systematic approach to wheeze in children in this age group should enable GPs to determine an appropriate management strategy, including parent education.
  • Determining the pattern of wheeze has limited utility in individual patients.
  • Recognition of the infant with acute viral bronchiolitis is important, to avoid unnecessary interventions.
  • If the wheezing is associated with significant breathlessness, a trial of an inhaled bronchodilator (reliever) is appropriate – provided the infant is over six months of age.
  • If the wheeze and breathlessness is causing significant ongoing morbidity, a one-month trial of an inhaled corticosteroid may be indicated.

    Picture credit: © DNA illustrations Inc.

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