What exactly is preschool wheeze? Isn’t that just asthma? Many parents find the diagnosis of preschool wheeze confusing. In this article we try to explain the difference between preschool wheeze and preschool asthma, and why it can be difficult to diagnose asthma in a young child.

What is a wheeze?

Wheezing is a high-pitched, whistling sound caused by narrowed airways. Wheezing can be a sign of asthma. However, wheezing in children between one and five years old is often caused by viral illnesses. Many preschoolers who experience wheezing, do not go on to have asthma when they are older.

What’s the difference between preschool wheeze and preschool asthma?

Often people use the terms wheezing and asthma to mean the same thing, but for health professionals it has different meanings.

An infrequent preschool wheeze is used to describe a mild wheeze that only affects your child when they have a virus, but otherwise they are wheeze-free. It may be treated with a reliever inhaler.

Preschool asthma is when your child frequently experiences wheezes (more than every six to eight weeks) or severe flare ups with viruses, or has other symptoms between viruses or flare ups, like regular night waking with either a cough or wheeze. If your child responds well to treatment with an inhaled corticosteroid inhaler (like Flixotide), that is another indication they may have preschool asthma.

How is it diagnosed?

To make this diagnosis, health practitioners need to understand your child’s and family’s health history, the frequency of their symptoms and how they respond to treatment before they can be sure that your child’s wheeze is preschool asthma. It is a diagnosis that can take time and may change as your child gets older. For that reason, it can be frustrating for parents trying to understand what is going on with their child. If you think that your child’s wheeze is changing, or becoming more frequent or serious, always contact your health practitioner.

What will your health practitioner need to know?

To make a diagnosis, your health practitioner will ask you about how often the wheeze occurs and how long it last. They will also want to understand what triggers the wheeze; it might be exercise, laughing, crying, cold air, allergies or a virus. They may listen to your child’s chest and check their temperature and oxygen levels. It is unlikely they will test their lung function using spirometry or peak flow, as these tests aren’t usually suitable for preschool lungs.

What treatment is given to preschoolers with a wheeze?

The treatment will depend on how often your child is experiencing wheezing and how severe the symptoms are. Health practitioners might give your child a reliever inhaler and then try other preventer medications if needed. Always talk to your health practitioner if you feel that the treatment is not controlling your child’s symptoms or if they are getting worse.

Will preschool asthma or preschool wheeze go away as my child gets older?

It might, which is why it’s important to get your child reviewed when they are school-aged. At this age health practitioners may be able to do lung function tests like peak flow measurements that will help with a diagnosis. It also could be the time to reassess medication. If your school-aged child is diagnosed at this point, their diagnosis will change from preschool asthma or preschool wheeze to asthma.

It can be important to know if your child’s preschool asthma diagnosis has changed as it can have consequences for their future. It could limit job opportunities (Police) or recreational activities (diving) and it can affect travel and life insurance, although many people with asthma as children will have no limitation on what they can do later in life.

What can I do to help my wheezy preschooler?

Ask lots of questions when you visit your health professional. Ask them to explain what can cause a wheeze and what they think is happening for your child. Ask what treatments are available in this situation and what other information they can provide you. Ask about how to best use a spacer and inhaler, if this is prescribed.

Keeping your home smokefree, and as warm and dry as possible will also help your child. Encouraging regular handwashing, keeping up with immunisations and reducing exposure to triggers like dust, mould and pet fur will also make a big difference to your child’s health.

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