Wheezing

Wheezing is a high-pitched, whistling sound due to a narrowing of the airways, making it difficult to breath (Mayo Clinic. Wheezing 2018). Wheezing typically occurs when breathing out (expiration) but can also occur when breathing in (inspiration).

It is a common problem in infants and young children, and approximately 25–30% of infants will have at least one episode of wheezing during infancy (Weiss 2008). Children wheeze more often than adults purely because of the physiological differences in the size of their airways (Weiss 2008).

Wheezing & CMPA

What causes wheezing in infants?

The most common causes of wheezing in children include asthma, allergies, infections, gastroesophageal reflux disease (link to Reflux and Regurgitation), and obstructive sleep apnea (Weiss 2008).

Could it be Cow’s Milk Protein Allergy?

Up to 30% of infants with Cow’s Milk Protein Allergy (CMPA) will present with a respiratory symptom such as wheezing (Høst A. 2002). In infants with immediate symptoms of wheeze after consuming milk/dairy, CMPA should be suspected (Caffarelli C et al 2010). Ear infections are also more common in infants with CMPA (Vandenplas et al 2022).

However, when considering the diagnosis of CMPA, it’s important to consider that the majority of infants with CMPA have at least two symptoms affecting at least two different organ systems (Lifschitz C. and Szajewska H 2015; Høst & Halken 1990; Høst et al 1994).

Therefore, it is important to consider the individual child as well as the magnitude of their symptoms. This can be achieved using an awareness tool such as the Cow’s Milk Related Symptom Score (CoMiSS®) which will help you determine if CMPA might be indicated (Vandenplas et al 2015;Vandenplas et al 2022) .