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Asthma

My 5 Month Baby is Coughing and Wheezing

01/27/2011

Question:

Dear Dr

I have a 5 months old baby. he got cold when he was 3 months a cough that lasts for 3 weeks. the dr heard wheezing in his chest so he gave him ventolin inhaler and we did neubilization for him for the phlem for three days, then he was fine. after one month he had again a runny nose and cough and the dr heared wheezing again so he gave us ventoline + flixotied(cortisteroide) inhaler for 2 weeks, but some wheezing is still there.

is my baby diagnosed with ASTHMA ?? or just he is having some sort of Viral infection?

why he is not improving this time with the ventolin and flexotide inhalers?? and Why he is having recurrent cough and wheezing? ( please note we are in winter season now)

Thanks a lot

Answer:

There are a number of reasons an infant might have repeated episodes of wheezing. When he is overall well, with no trouble between "episodes," but repeatedly has trouble with wheeze during colds, the first suspicion is that he may have what I call "infantile asthma." We believe these children have a tendency to react to minor viruses with spasm of the muscles around their airways, and also swelling within the airways, leading to the cough, wheeze, and sometimes difficulty breathing. About half of the infants who do this have the problem for only a year or two, and then "outgrow it." The other half goes on to have more classic asthma symptoms. (which lasts longer, may have other triggers besides just colds, etc.) We are not very good at predicting which infant will do what, we have to wait for "time to tell." Both situations tend to respond to "asthma medication," which your son has been prescribed.

The steroid inhaler your son was prescribed usually works better to prevent wheezing. It is pretty weak, and doesn't always stop wheezing that has already started. So, the fact that he still has some wheeze might mean he needs a stronger medication. At his young age, it also might mean he has another reason to be wheezing. Your next step is to return to the doctor and let him/her know that things aren't working and you need the next step in care.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University