Is It Just a Cough – Or Childhood Asthma?

A cough here, a wheeze there. Most children have respiratory illnesses every now and then. But for one in 12 kids, these symptoms are a sign of something more significant: childhood asthma.

Unlike short-term bugs, asthma is a chronic inflammatory condition. In children who have it, their airways swell and narrow from time to time, making breathing difficult. While the condition typically lasts a lifetime, Joao Pedro Matias Lopes, MD, a pediatric allergist/immunologist at UH Rainbow Babies & Children’s, notes that around a third of affected children will grow out of the disease by early teenage year, another third may only be affected seasonally, and the last third will require year-round support with medication and other therapies.

Is My Child at Risk?

Scientists are still untangling asthma’s causes. In most cases, it seems to start when the body is exposed to an allergen – for instance, tree, grass, or weed pollens, or pet dander. However, other causes include viral illnesses, exercise or even cold air. Some people’s immune systems react strongly to certain allergens and go into overdrive, causing the lining of the airways to swell and the muscles around them to tighten.

Kids may be at higher risk for asthma if they:

• Have a parent or other family member with asthma or allergies
• Have allergies themselves, including environmental allergies or food allergies
• Have frequent respiratory infections
• Were/are exposed to secondhand smoke before and/or after birth

Pick Up the Patterns

What’s one way to tell the difference between asthma and other illnesses? Monitor your child’s symptoms over time.

“When symptoms such as coughing, wheezing and shortness of breath are linked to asthma, they usually follow a pattern,” Dr. Lopes says symptoms tend to flare up:

• At night, causing trouble sleeping
• Early in the morning
• During exercise
• After exertion, laughing or crying
• In cold air

Often, kids with asthma develop symptoms before age 5. But the condition can be difficult to diagnose, in part because kids can’t explain how they’re feeling. So information from parents becomes critical. “If you notice troublesome trends, tell your child’s pediatrician or see an allergist/immunologist or a pediatric pulmonary doctor,” Dr. Lopes says. “Either of those doctors can diagnose and treat the disease, and keep in mind the diagnosis is mainly clinical, so it is not mandatory to get pulmonary function tests to get to a diagnosis or to attempt treatment.”

As part of the exam, the healthcare provider may test your child’s airway function. This may involve blowing in and out through a tube. Since babies and toddlers can’t always do this, the provider may instead start asthma treatment to see how your child responds.

“Asthma may be difficult to fully cure as you would cure an infection, but it can be appropriately managed, with medication and careful planning, and there are a lot of new medications that have become available in the last decade that can help control asthma that would be very difficult to manage in the past. Doing so can help your child breathe easier today and prevent long-term lung damage and other complications in the future,” Dr. Lopes says.

Related links

Learn about the new national asthma treatment guidelines that are helping patients better control symptoms, or call 440-613-1172 for an appointment with a Rainbow asthma expert.