Asthma is the most common serious chronic disease of childhood, affecting nearly 5 million children in the United States. Characterized by coughing, chest tightness, shortness of breath and wheezing, asthma is the cause of almost 3 million physician visits and 200,000 hospitalizations each year. In infants and children, asthma may appear as cough, rapid or noisy breathing in and out, or chest congestion, without the other symptoms seen in adults.
Children with recurrent cough, wheezing, chest tightness or shortness of breath may have one or more forms of asthma. Left untreated, asthmatic children often have less stamina than other children, or avoid physical activities to prevent coughing or wheezing. Sometimes they will complain that their “chest hurts” or that they can not “catch their breath.” Colds may “go straight to their chest.” They may cough when sick, particularly at night.
Asthma has multiple causes, and it is not uncommon for two or more different causes to be present in one child. Asthma is not just “wheezing.” Coughing, recurrent bronchitis and shortness of breath, especially when exercising, are also ways that asthma appears.
Diagnosis
Diagnosing the precise cause of asthma is sometimes difficult because two or more causes may be present in one child. Unfortunately, there is not a single test that provides all the answers. An allergist/immunologist, often referred to as an allergist, has specialized training and experience to determine if your child has asthma, what is causing it and develop a treatment plan.
Your child’s allergist will want to learn how often episodes of wheezing/coughing/other symptoms occur, and how bad they are. It is important to understand what triggers your child’s symptoms, and what (including medications) makes them go away. An understanding of your family history and environment (smoking, pets, etc) is useful, so your physician may ask.
Infants may need extra attention during the diagnostic process because asthma symptoms can be caused by many things in this age group, some of which need very different therapies. When an infant has asthma symptoms, it is sometimes called “reactive airway disease.”
The two most common triggers of asthma in children are colds and allergens. After infancy, allergies become particularly important, and therefore asthmatic children should have an allergy evaluation to help diagnose and manage their asthma. Avoiding the allergens to which your child is allergic may help improve his or her asthma.
If your child is older than 5 years, he or she may be asked to perform pulmonary function testing to learn how air flows in his or her lungs. Other tests that your physician may discuss with you include measures of inflammation, a chest x-ray and tests for some of the less common causes of asthma-like symptoms.
Management
The most important part of managing asthma is for you and your child to be very knowledgeable about how and when asthma causes problems, how some of the triggers can be avoided and how to use medications. The causes of asthma and best treatment for it in your child may be quite different than for another child.
Your allergist will help you develop an asthma management plan, and it is wise to share it with other caregivers. This plan outlines what medications to take, and when and how to increase the doses or add more medication if needed. It also includes advice about when to call your physician. An asthma management plan puts you in control for detection and early treatment of symptoms.
Inhaled medications come as metered dose inhalers (sometimes called pumps), nebulizer solutions (delivered as a mist by a machine) and dry powder inhalers. It is important to learn how to use the type of medications prescribed for your child, or they might not work well. Another brochure in this series, Inhaled Asthma Medications, offers helpful information.
Asthma medications include inhaled rescue medications (quick relievers) to treat symptoms and long-term controller medicines (inhaled as well as oral) to control inflammation that commonly causes the asthma. If your child’s asthma is more than a rare minor problem, a controller medication will probably be prescribed.
Our knowledge about asthma and its therapy is constantly changing. An ongoing relationship with your child’s physician is key to determining what will work best for your child, now and throughout childhood.
Answers to Commonly Asked Questions
Will my child outgrow his/her asthma?
Many babies who wheeze with viral respiratory illnesses will stop wheezing as they grow older. If your child has atopic dermatitis (eczema), allergies or if there is smoking in the home or a strong family history of allergies or asthma, there is a greater chance that asthma symptoms will persist.
Can asthma be cured?
Not yet. However, for most children and adults, asthma can be controlled throughout life with appropriate diagnosis, education and treatment.
Should my child exercise?
Once a child’s asthma is controlled, (usually with the help of proper medications) exercise should become part of his or her daily activities. Children with asthma certainly can and do excel in athletics. Many Olympic athletes have asthma. How can symptoms be controlled at school?
You, your family, physician and school personnel can work together to prevent and/or control asthma. Share your child’s asthma management plan with the school nurse and any coaches who oversee your child. With the approval of physicians and parents, school-age children with asthma should be allowed to carry metered dose inhalers with them and use them as appropriate.
Healthy Tips
- Asthma is not just “wheezing.” Coughing, recurrent bronchitis and shortness of breath, especially when exercising, are also ways that asthma appears.
- The two most common triggers of asthma in children are colds and allergens.
- Diagnosing the precise cause of asthma is sometimes difficult because two or more causes may be present in one child.
- The most important part of managing asthma is for you and your child to be very knowledgeable about how and when asthma causes problems and how to use medications.
- An allergist has specialized training and experience to determine if your child has asthma, what is causing it and develop a treatment plan.
