Wheeze is an increasingly common symptom in preschool children. In Leicestershire, the proportion of children aged less than 5 years who had ever wheezed rose from 16% in 1990 to 29% in 1998.1 Wheezing illness is therefore a common source of anxiety to parents and professionals involved in the care of young children, all of whom would like an accurate diagnosis and prognosis. In the accompanying study, Frank and colleagues report the long term outcome of 628 children with and without preschool wheeze, including factors that predict asthma in later life.2

Many different wheeze phenotypes have been described in this age group.3 4 Most children will eventually turn out to have been “transient early wheezers.” These children do not usually have a family history or personal history of atopy, and the wheeze tends to settle by the age of 3 years. A second group of children with transient symptoms consists of “non-atopic wheezers,” most …