By: Harvey Leo, MD, FAAP, FAAAAI
Asthma is the most common chronic respiratory disease in children. It affects more than 6 million U.S. children and leads to over 13 million missed days of school each year. Yet as common as it is, asthma can be challenging to diagnose in children. There is no one-size-fits-all set of symptoms. A solid, ongoing relationship with your child's health provider can help identify asthma risks and the best treatment for your child.
Questions to ask
Pediatricians have many tools to help identify and support a child who might have asthma. The most important tool of all is the child's medical history. Depending on their age, some children will not have wheezing during an asthma flare, but rather a chronic cough that lasts for days or appears during illness or activity. Here are some key questions your child's doctor will need to know:
How often does your child cough or wheeze during the week?
Do these symptoms affect their daily activity?
Does your child's coughing or wheezing wake them up at night?
What medicines have your tried and have they helped, including nutritional supplements or homeopathic therapies?
Does anyone in the family have a history of asthma, environmental allergies, or other respiratory conditions?
If a child is old enough, usually over age 7 years, your health care provider may request an asthma test. One of the most common ones uses spiromety to check lung function. For this test, the child breathes into a device that will show whether your child has some airway blockage.
Another test developed over the past decade checks how much nitric oxide your child exhales. This measures how much inflammation there is in the airway. Pediatric specialty centers may also offer more complex lung function testing, imaging tests and techniques such as methacholine provocative challenges, which gauges how "reactive" a child's lungs are. These tests may be used for the diagnosis and follow-up management of asthma. Additional resources such as home respiratory monitors and medication reminder phone apps can also be help manage a child's asthma.
Conditions that can look like asthma
Keep in mind, there are many other conditions that can look like or worsen asthma in children. Some of these include seasonal allergies, acid
reflux, viral or bacterial infections, conditions related to a child's anatomy, and cardiovascular issues.
There are many tools that can help diagnose asthma, and treatment and medications that can help a child with asthma thrive. If you think your child may have asthma, talk with your pediatrician.
About Dr. Leo
Harvey Leo, MD, FAAP, FAAAAI, who practices in Michigan, is a member of the American Academy of Pediatrics Section on Allergy and Immunology.