Hearing a child wheeze can frighten even the most calm and collected parents.

Between 25 and 30 percent of all children will experience wheezing as an infant, a number that increases to about 40 percent by the toddler years and to nearly 50 percent by age six, according to the American Academy of Family Physicians.

The most common cause of wheezing in children is an upper respiratory infection, which affects breathing, says Dr. Grady Adkins, a family physician with Tidelands Health. Often, children will contract a cold and develop associated wheezing that dissipates with the cold.

If your child is wheezing slightly but seems OK otherwise, there is generally little cause for concern, Dr. Adkins says. However, if the child is struggling to catch their breath and moving their shoulders up and down to breathe – and if the wheezing is very audible – seek prompt medical attention.

“The best way to put it is, if it looks like the way a track athlete looks after running a 100-yard dash but the child hasn’t been exerting himself, then it needs to be checked,” says Dr. Adkins, who practices at Tidelands Health Family Medicine at Hemingway and Georgetown.

How do you know if your child’s wheezing is an indication of asthma? Chances are if the wheezing disappeared after a respiratory infection, it isn’t from asthma, Dr. Adkins says. Acid reflux, which can cause irritation to the trachea, can also cause wheezing.

Alarm bells should ring if it appears the child’s wheezing is associated with allergies or occurs without any relationship to sickness, Dr. Adkins says. That could indicate the child has asthma and needs to be evaluated further.

Children can be tested for allergies to help determine what may trigger an asthma attack, he said, and some may need medication to help control the condition. If you have any concerns, the best approach is to contact your physician for an evaluation.