Que devez-vous faire si votre enfant siffle ?

Qu'est-ce qui cause la respiration sifflante chez les enfants ?

At least 2 enfants sur 5 have at least one episode of wheezing before they are 6 years old. When my patients think of sifflement in their children, they almost always assume it's due to asthme .En fait, il existe de nombreuses autres causes de sifflements — et parfois, comme nous le verrons plus tard, ce qui ressemble à un sifflement chez un jeune enfant peut ne pas être du tout un sifflement.

Le sifflement est un son produit lorsque l'air est expiré (ou plus rarement inspiré) à travers des voies respiratoires rétrécies. Parce que les voies respiratoires des enfants sont plus petites que celles des adultes, elles se rétrécissent plus facilement, provoquant plus souvent un sifflement. Dans l'asthme, les voies respiratoires sont rétrécies parce que le muscle qui les entoure se contracte. Cependant, le mucus ou d'autres sécrétions qui bloquent partiellement la voie respiratoire peuvent également provoquer un sifflement. La inflammation de la muqueuse des voies respiratoires peut aussi en être la cause. Moins fréquemment, un objet inhalé peut se coincer dans les voies respiratoires.

Infections virales

The most common reason for wheezing in children is infection with viruses such as the ones that cause the rhume. Cela s'appelle 'sifflement viral'. Beaucoup d'enfants atteints de sifflement viral ne sont pas essoufflés ni stressés et se rétablissent rapidement sans effets secondaires.

Croup is a viral infection most common in children aged between 6 months and 3 years old. Classically, it gives rise to a barking cough, caused by inflammation of the vocal cords in the larynx. It can also cause essoufflement and it may sound as if your child is wheezing.

Bronchiolite is also caused by a virus - in this case usually the bronchiolitis means inflammation of the bronchioles. It is usually caused by a virus called the respiratory syncytial virus (RSV). It's most common in babies aged 3-6 months and is much less common in toddlers and older children. Along with cold symptoms, babies often develop wheezing, rapid breathing and sometimes difficulty breathing.

Quelle que soit la cause des problèmes respiratoires, il y a certains signes à surveiller si votre enfant souffle ou tousse.

Si votre enfant présente ces symptômes, consultez d'urgence un médecin.

There is some good news for parents of wheezy babies and toddlers. Perhaps counterintuitively, as a rule, the earlier the child gets wheezy for the first time, the more likely they are to grow out of it quickly. There appears to be something of a arrêt vers l'âge de 2 ans: la plupart des enfants qui consultent un médecin pour une respiration sifflante avant cet âge cessent d'avoir des symptômes à la mi-enfance

In adults, there are various reliable tests for diagnosing asthme. Celles-ci incluent :

• Spirométrie - a simple breathing test that measures the amount and speed of air flowing in and out of your lungs.

• Test de réversibilité - si/à quel point votre capacité respiratoire augmente après avoir inhalé un médicament pour dégager vos voies respiratoires.

• Test de l'oxyde nitrique exhalé fractionnel (FeNO) - une mesure de la quantité d'oxyde nitrique dans votre souffle.

• Surveillance du débit de pointe - measurement of how hard you can blow out using a portable monitor you can use at home. This isn't as reliable as the other measures above but can be useful to monitor your asthma.

Unfortunately, it's almost impossible to get reliable readings from children aged under 5, which means your doctor will have to rely on their symptoms and examination to make a diagnosis. For instance, while almost all children get intermittent cough, wheeziness and/or symptoms brought on by exercise, 3 enfants sur 4 don't have asthma.

Identifier les indices de l'asthme chez les enfants

If you're concerned your child has asthma, speak with your GP. If their assessment suggests a high probability that your child has asthma, they'll prescribe un médicament inhalé and review them to see how they responded.

There's no doubt that having a child with asthma is a concern, and that children can become unwell rapidly. Children younger than 5 years old with asthma are plus susceptible de nécessiter des soins d'urgence than any other age group with asthma.

Part of the problem is that younger children in particular can't expliquer leurs symptômes in the way adults can. If your child has asthma, it's natural to be on the lookout for symptoms - especially since you should have been given advice on what treatment to offer if your child is wheezy.

Lors d'une crise d'asthme, la muqueuse des bronchioles (petites voies respiratoires) devient enflammée et les muscles entourant les bronchioles se contractent. Cela provoque un essoufflement et des sifflements.

Hopefully, if your child has asthma, you'll have been given an plan d'action pour l'asthme, explaining what to do if your child is wheezing or breathless. But knowing if your child is wheezing is not as straightforward as it sounds. In younger children in particular a whistling sound often comes from the upper airways, including the nose, rather than from the lungs. In practice, parents and their doctor or nurse disagree about whether wheeze is present in plus de la moitié des consultations.

If you're not sure how to identify if your young child is wheezing, a validated device such as the Omron Wheezescan uses an algorithm based on over 600 children with asthma symptoms, to tease out the difference between the sound of wheezing and other lung sounds.

Le sifflement, bien sûr, n'est qu'un des signes à surveiller. Votre médecin ou votre infirmier(ère) vous aidera à identifier les déclencheurs qui indiquent que vous devez donner à votre enfant son médicament de soulagement. Si votre enfant présente l'un des « signes à surveiller » mentionnés ci-dessus, vous devez toujours consulter rapidement un professionnel de santé.