Wheezing is common in small children — around a third of all
children will have an episode of wheezing before they are three
years old. Although it’s common, we still don’t quite know the
best thing to do about it. The problem is that wheezing, like
fever, is a symptom of a disease, not a disease itself. It’s not
one thing. Every physician who treats small children in the
office, the emergency department, or the pediatric intensive
care unit is often faced by the dilemma of what to do with a
wheezing small child. In such children wheezing is often
triggered by a viral illness. When it happens in infants it is
often caused by a virus we call RSV (short for respiratory
syncytial virus) and causes a disorder called bronchiolitis. For
those children, we know that not much of anything helps the
symptoms — all we can do is provide supportive care and wait for
the illness to run its course. What about wheezing children who
don’t have bronchiolitis? Can anything help them? The problem
facing the doctor is that all th