Wheeze in the first years of life is common and usually triggered by viral infection. Many children outgrow it, so a first episode does not establish asthma. Features that raise the likelihood of persistent asthma include wheeze between colds, eczema, allergic rhinitis, a family history of asthma and allergic sensitisation.
Label carefully, treat the episode on its merits, check inhaler or spacer technique if a device is prescribed, and review the pattern over time rather than starting long-term controller treatment on one episode.
- Ask whether wheeze occurs only with colds or also between them.
- Record eczema, nasal allergy and family history of asthma.
- Check spacer technique and adherence before escalating treatment.
- Review the pattern at follow-up rather than labelling asthma after one episode.
Why it matters
It stops a transient viral illness being turned into a lifelong label.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for top clinical updates, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free