Asthma in Infants and Children
Asthma is a disease that affects over 5% of Americans, many of which are infants and young children. This entry will discuss asthma and wheeze in children, how asthma is diagnosed in kids, and overview its impact and prognosis.
Asthma over a lifetime
Asthma affects people of all ages, but it has a typical pattern of development in the population. This pattern is similar to that of peoples’ allergies, as discussed in an earlier entry.
Most people with asthma as adults had asthma as a child, and may have had a small break in severity in their teens. Some adults did not have asthma as a child and developed it as an adult, even up to age 50 or more. And there are many people who remember wheezing as a child with colds or during hayfever season but ‘growing out of it’, as they ‘grew out’ of their allergies. There is no real way of knowing how each person’s asthma will change over time. We do know that asthma tends to run in families, so can say that some children have a greater chance than others of developing asthma.
Wheezing and asthma in infants
Many infants under a year old (about 30%) will wheeze at one point, usually associated with an upper respiratory infection (a cold from a virus). The majority of these children will not go on to develop asthma, but may wheeze occasionally whenever they have a cold; this stops occurring later in childhood. Whether these children technically have asthma is a matter of considerable debate, but the wheezing is treated the same regardless. Some infants, usually older than six months, will have wheeze or unexplained cough between colds or triggered by other factors. These kids will more likely be diagnosed with asthma, and may benefit from controller medications, such as leukotriene modifiers (e.g. montelukast (Singulair)) or inhaled steroids (e.g. budesonide (Pulmicort)). These medications are prescribed for children with asthma to minimize severity and persistence of wheeze or cough, in addition to quick relief medication (e.g. albuterol (Proventil, others)). The correct combination of medications for your child should be determined in consultation with your doctor.
Diagnosing asthma in children
Asthma in young children is usually diagnosed by the presence of wheeze or cough that is typically triggered by colds, exercise or allergies and improves with asthma medication. Older infants and children can have tests performed (such as pulmonary function testing or peak flow monitoring) to help diagnose asthma. Whether these tests are useful depends a lot on how well a child can perform the maneuvers of the test. In most cases specific testing is not necessary; this should be determined with your doctor.
As noted above, the majority of children with wheeze during infancy will not develop persistent asthma. Those that do can be well controlled with medication so that they can have an otherwise normal childhood, playing games and sports as well as other activities.
The key to good asthma control is compliance with medications, especially controller medicines. It can be a challenge to convince a small child to take medicine regularly, particularly if they are not wheezing or short of breath. As in adults, the key is to help the child understand that the reason they are feeling well is because they are taking their medicines. Your doctor can help both recommend the right combination of medicines for your child and give some tips on helping your child ‘buy in’, so he or she can have the best possible asthma control.
Published On: July 17, 2006