This is a condition in which a child, usually under 1 year old, has a chronic, persistent or intermittent wheeze, heard without a stethoscope, but is happy and smiling, not at all distressed.
It is probably true that these children do have asthma, and the problem is one of therapy, especially given the limited efficacy of asthma medications in children of less than 18 months. It is thought that inflammation and oedema account for a more significant part of the airway obstruction in the very young child and hence bronchodilators are less effective.
The diagnosis "Happy wheezer" is thus for the most part a psychological reassurance, both for the parents and the physician. However, there is debate as to what the smiling actually means and whether is important to monitor oxygen levels in this apparently benign condition.
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