If your child has one episode of wheezing, does that mean it's asthma for sure? In many cases — no. Younger children also can wheeze because of a variety of other conditions.

Respiratory Infections

Babies and toddlers frequently may develop “wheezy” bronchitis or bronchiolitis from an array of viral infections. These infections generally occur before their immune systems have matured.

Since viral infections can be triggers to more serious asthma symptoms, it may be difficult to determine with a child's first wheezing episode whether it is an infection or asthma. Sometimes, a baby could have conditions such bronchitis and asthma at the same time.

However, if the wheezing symptoms continue to come back with every cold your child gets, asthma could be considered to be the culprit in this case.

Also, if your child gets pneumonia, bronchitis, or bronchiolitis several times or he has a persistent cough, especially at night and with activity, it might be asthma in this case.

GERD

Gastroesophageal reflux disease — better known as GERD or acid reflux — can lead to coughing and wheezing, especially at night, among children of all ages — including infants. GERD occurs when stomach acid travels up the esophagus and irritates its nerve endings, causing coughing and wheezing. Sometimes, it may reach the throat and be sucked or breathed into the lungs — irritating the airways. (See Chapter 3.)

Among small infants, GERD is usually easy to detect by observing the baby's wet burps and spit-up. However, for older infants and toddlers, some additional testing may be needed to determine if acid reflux is present and if it is triggering asthma.

Croup

With symptoms such as a barking cough and rough, troubled breathing, croup may sometimes be mistaken for asthma among children usually age four or younger. Croup is inflammation of a child's voice box and windpipe that is usually caused by an upper respiratory infection.

Cystic Fibrosis

Cystic fibrosis is another chronic condition that has symptoms similar to asthma. It is an inherited disease. Your child's health care provider may request testing for this disease in order to determine if it is — or is not — asthma.

Aspiration

Sometimes babies may have trouble swallowing, and they may cough and sputter when they drink fluids that appear to “go down the wrong tube.” When fluids are drawn into the lungs while they breathe (also known as aspiration), this may produce symptoms similar to asthma such as coughing, congestion, and wheezing. Your health care provider can order special X-ray swallowing tests to rule this out.