Could your child have asthma
By Darcy Lewis
It’s no secret that pediatric asthma—chronic inflammation of a child’s airways—has reached epidemic proportions. According to the American Lung Association, asthma affects more than 7.7 million children under age 18. And the Centers for Disease Control and Prevention found that asthma rates in children under age 5 increased more than 160 percent between 1980 and 1994, making it the most common chronic illness among children and adolescents .Once asthma is diagnosed, the good news is that attacks can be prevented. You can identify what triggers asthma in your child and stop attacks before they happen. But asthma can be difficult to pinpoint because some asthmatic children don’t have symptoms. And when they do, the symptoms look a lot like other respiratory infections. So, is it asthma or a late-winter virus? Is it asthma or an early spring allergy? Signs of trouble Here are some signs to help you recognize when it is asthma and when to take your child to the doctor. • Wheezing: The whistling sound of air being forced through swollen airways is the most distinctive asthma symptom. "True wheezing comes from the lungs," says Dr. Jeff Mjaanes, a pediatrician at Rush Children’s Hospital in Chicago. "It’s not whistling from phlegm in the throat or a stuffy nose." Wheezing warrants a call to the doctor. "A wheezing child should definitely be evaluated," says Mjaanes. "Many parents think wheezing automatically means an asthma diagnosis, but that’s not always the case." Other possible reasons for wheezing include infection, pneumonia, gastroesophageal reflux disease or even something lodged in an airway, he says. • Shortness of breath or rapid breathing: If your child says his chest feels "tight" or "funny," take his complaint seriously. "Young children often can’t articulate what shortness of breath feels like," says Dr. Michael Flais, an allergist with Associated Allergists in Flossmoor. "But once I ask, ‘Do you feel like you’re breathing through a straw?’ most kids respond right away." •Fatigue: Does your child often stop during a soccer game when everyone else keeps running? "If your child looks winded, isn’t keeping up with the others or has a decreased tolerance for exercise, I would want to hear about it," says Dr. Jacqueline Moran, an allergist at DuPage Medical Group in Glen Ellyn. • Frequent chest colds: It’s normal for children to get multiple colds each winter, but if they result in frequent bronchitis, this may indicate asthma. "If a parent tells me a child’s cold always moves straight to her chest, that’s a red flag," says Moran. •Cough: This is the stealth symptom of asthma and the one most likely to be confused. "There are plenty of children who have what we call cough-variant asthma," says Moran. "They might never hear themselves wheeze, but we treat them with asthma meds and the cough disappears right away." You should suspect asthma if your child’s cough typically lingers long after other cold symptoms fade and if your child’s cough outlasts the cold by two weeks or more. "Also be suspicious if your child is fine by day but coughs at night," says Moran. "Any cough that consistently wakes up a child or the parents in the absence of a cold should be noted." An asthmatic cough tends to be dry and hacking but can also produce yellow phlegm. "Listen for a distinctive squeezing sound," says Mjaanes. "It’s a cough combined with a wheeze, especially toward the end." But Flais cautions that many other conditions can cause coughs, including postnasal drip, upper respiratory infection, acid reflux and even secondhand smoke exposure. •Genes and environment: Asthma, allergies or eczema can be genetic and when someone in the family has any of these conditions be particularly watchful of the children. Also, environmental factors may trigger asthma in previously undiagnosed children. Some of the most common triggers include upper respiratory infections, cold air, exercise and smoke. Can asthma be prevented? With the number of asthma cases surging, researchers are focusing on ways to prevent the disease, not just the attacks. "The jury is still out on anything that provides effective primary prevention," says Dr. Sandra Thomas, the Chicago Department of Public Health’s epidemiology director. But some research indicates prevention can start at birth. "Many well-designed studies have shown that breastfeeding for at least six to 12 months will reduce or prevent later cases of nasal allergies, asthma and eczema," says Mjaanes. "These studies give very strong encouragement for mothers who start nursing to continue breastfeeding." Most people with asthma also have nasal allergy symptoms, so other theories indicate that untreated allergies can trigger asthma in people who are predisposed by genetics or environment. "When nasal allergy symptoms are controlled, asthma can be controlled or even prevented," says Flais. "It’s now very common for allergists to start kids with allergies on allergy shots in the hope of preventing asthma." However, this technique does not work for everyone. So, even though the true "silver bullet" for asthma prevention lies in the future, recognizing your child’s asthma symptoms early can ensure prompt diagnosis and treatment, which is the next best thing.
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