Asthma is the most frequent chronic condition among children — affecting about 10 percent of kids — and it can be devilishly difficult to diagnose in youngsters under age 5.
“It’s a hard diagnosis,” says Kim D. Lu, MD, UCI Health pediatric pulmonologist and assistant professor of pediatrics. “There isn’t a gold standard test. So it is based on what we can see and hear, the child’s history and any family history of asthma or allergies”
Children who are age 5 or older can help a doctor by taking a lung function test. Younger ones usually aren’t able to blow into the machine correctly, making asthma even harder to diagnose, says Lu, whose patients are generally between ages 3 and 10 and have been referred by general pediatricians who suspect asthma.
What is asthma?
Asthma is a lung condition where there is inflammation of the airways, and it can result in wheezing, coughing and shortness of breath. It can be triggered by an allergies or infections, for example.
Lu explains it this way to parents: “Picture the lung as an upside down tree. The trunk is the breathing tube, or trachea, which expands into many, many branches that reach down into both lungs. Those branches — in younger kids especially — are so small that when they’re swollen or filled with mucus from infection or other triggers, it’s like breathing through a tiny straw instead of a big straw.”
Asthma can occur at any age, but it usually starts early in life. But everyone’s asthma is different in terms of triggers and severity. Most of the time, kids are fine, Lu says. But they can get very sick, very quickly if they’re around something that triggers their asthma. It can even be deadly.
What causes asthma?
Asthma is often hereditary and may appear in children who have skin conditions such as eczema or allergies to food or seasonal pollens.
There are many environmental triggers for asthma —trees, grasses, pets, second-hand smoke, air pollution. But the most common allergy in California is to dust mites. They’re little creatures that live in bedding, carpets, stuffed animals and the like.
Asthma signs to look out for
Lu, who sees patients at the pediatric subspecialty clinic in Orange, says parents should consider having their child evaluated for asthma if he or she has:
- A cold that lingers two weeks or more, especially if it is accompanied by a cough that begins to affect the child’s daily life
- Any trouble breathing, including a wheezing or whistling sound
- Been hospitalized for breathing problems
- Frequent colds that settle in the chest
- Problems with growing or gaining weight
Treating the condition
Children develop their lungs in the first few years of life, so any damage done early on can lead to longer term problems. But pulmonary specialists know how to treat asthma, which Lu says is completely manageable and often improves as kids grow.
It’s treated with medicines delivered through inhalers that use a spacer device to ensure the medication reaches the deepest part of the lungs that are most affected by asthma. It’s slightly tricky to inhale the medicine correctly, Lu says, but even babies can do it if parents are taught properly.
Some inhalers are used primarily for emergency attacks, while others are used more frequently to prevent problems.
How to prevent asthma attacks
There is no current cure or way to prevent asthma, but Lu recommends that parents ensure their children:
With the right medications, Lu says, children who suffer from asthma can and should participate fully in sports and other activities.