Asthma is the most common chronic childhood disease, affecting more than 6 million children in the United States. Asthma can cause coughing, shortness of breath, wheezing and a tight feeling in the chest.
Asthma is often underdiagnosed, particularly in very young children. One reason is that physicians and parents hesitate to label children with a chronic disease. As a practicing pediatrician, I frequently hear statements such as: “No, my son does not have asthma; he just wheezes when he has a cold.” In fact, this is a classic description of asthma. A child with a propensity to wheeze has asthma. Likewise, a child who has needed albuterol treatments during three separate wheezing episodes probably has asthma.
Although being diagnosed with a chronic disease is not ideal, there are some benefits of correctly diagnosing asthma. Children with asthma receive priority for influenza vaccination and are often expedited in the emergency department. Physicians generally dedicate time during each physical exam to review how to manage asthma and maximize lung function and breathing.
Parents and medical professionals should work together to advocate for children with asthma so that they get the medical attention and specialty care they deserve. Denying the “label” of asthma denies children their best shot at staying healthy.
If your child has asthma, the key to maximizing lung function is first to prevent, then to aggressively treat, asthma symptoms.
My first goal for patients with asthma is to eliminate asthma symptoms during most days and evenings. One of the best ways is to avoid things that trigger the symptoms, including allergens (pollen, mold, dust and animal dander), irritants (perfumes, pollution and cigarette smoke), chemicals (sulfur dioxide and sulfites in preserved foods and drinks) and most especially smoking. It can be more difficult or even impossible to avoid other triggers, such as respiratory infections, extreme emotions and seasonal changes.
Children with asthma should see their doctors regularly. It’s important to discuss the frequency of asthma symptoms at each visit. To this end, keep a journal to help monitor your child’s symptoms and determine whether it is well controlled. Be prepared to answer questions about your child’s frequency of daytime symptoms, nighttime symptoms and rescue-inhaler use, and about your child’s ability to perform normal activities and exercise. This will help your doctor create a unique asthma action plan addressing how to avoid and treat symptoms.
A child with asthma, as well as all other family members, should understand how to follow the asthma action plan. Post it in a visible place at home and provide a copy for anyone who cares for your child. It may also help to attend an asthma education course offered through your health-care provider.
Asthma is a chronic disease, but it doesn’t have to be a debilitating one. You can help your child manage the disease and lead a more healthful lifestyle each and every day.
Dr. Natasha Leman is a pediatrician at the Palo Alto Medical Foundation’s Redwood City Center.
The Palo Alto Medical Foundation and column editor Arian Dasmalchi provide this monthly column.