Reactive Airway Disease Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 14, 2020

What is Reactive Airway Disease?

Reactive airway disease refers to wheezing that occurs in small children triggered by a viral infection. Wheezing happens when a child’s lower airways are inflamed or narrowed.

It is not uncommon for children to wheeze when they’re sick and does not always mean they have asthma. Children that wheeze frequently, however, especially if they have allergies, eczema or a family history of asthma, should be further evaluated for a diagnosis of asthma.

How to Treat Reactive Airway Disease

For infrequent episodes of wheezing in which the child does not have difficulty breathing, then albuterol should be used. Albuterol works by reversing the inflammation and narrowing of the airways. It can be administered through an inhaler or using a mask and a nebulizer. 

Antibiotics are not needed for reactive airway disease. Oral steroids can be used if wheezing becomes severe or your child is working harder to breath. If this is the case, then further evaluation for asthma should be pursued.

Does my child have asthma?

No. Not every child that wheezes when they’re young, especially under the age of 5, has asthma. In fact, most don’t and will grow out of it. 

However, in the following circumstances, further evaluation for a true diagnosis of asthma is warranted:

  • Your child wheezes more than 4 times per year
  • Your child experiences difficulty breathing with wheezing episodes
  • Your child has eczema and seasonal or environmental allergies
  • Your child has a dry, nighttime cough that wakes them up frequently
  • There is a strong family history of asthma
  • Your child needs albuterol frequently
  • Your child gets tired, wheezes or coughs with exercise and albuterol helps
  • Your child wheezes with triggers other than viruses

Check in with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

  • Wheezing does not improve with albuterol 
  • Wheezing happens with triggers other than viruses
  • Albuterol is needed frequently
  • Your child is working harder to breath but does not seem to be in distress
  • You want to further evaluate your child for asthma
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.