Your child’s pediatrician may suspect asthma if your child has frequent episodes of coughing or wheezing, especially if there is a family history of asthma. Children with asthma also are more likely to have eczema (allergic dermatitis) and nasal allergy (allergic rhinitis or hay fever). Children younger than 3 often wheeze and cough with respiratory illnesses, and some of these children do have asthma. But the diagnosis of asthma is more reliable after the age of 2 or 3.
There is no one single test for asthma. Your doctor may diagnose asthma by clinical examination, especially if it is very obvious. The doctor may order pulmonary function testing (spirometry), in which your child breathes into a tube connected to a computerized analyzer. In general, spirometry can be done only on children around 4 years or older.
A chest X-ray may be in order in some situations, to be sure that there is no pneumonia or other cause for the coughing and wheezing. If the asthma is severe, your pediatrician may measure the blood-oxygen saturation to be sure your child’s lungs are able to exchange air normally.
Allergy testing can help identify what specific allergens the asthmatic child may have.
How is asthma treated?
It is imperative that children with asthma are not exposed at all to tobacco smoke. Parents of children with asthma are very strongly encouraged to stop smoking completely; if smoking continues, it must be done outdoors and never in a car when a child is present.
If allergens like animal hair, dust and pollens are identified, your pediatrician or allergist will have specific suggestions on ways to minimize your child’s exposure to these. Allergy shots (immunotherapy) have been shown to be very helpful for some asthmatic patients.
The mainstay of asthma treatment is medications, which are often given by inhalation. Bronchodilators like albuterol are given in metered-dose inhalers or by a nebulizer machine once to several times daily, for asthma episodes, and also to control mild or intermittent asthma, or exercise-induced asthma.
Inhaled corticosteroids (such as flunisolide, beclomethasone, fluticasone, triamcinolone) given two or three times a day help reduce the inflammation of asthma and are very helpful in preventing future episodes.
New asthma medications, taken orally or by inhaler, are very effective for asthma that is difficult to control. Excellent asthma treatment is available and easy to give, and it can make the difference between a child who coughs and wheezes often, misses school, and needs frequent doctor visits and hospital stays, and one who rarely has difficulties with asthma. Your pediatrician will help you tailor an asthma treatment regimen that works best for your child and your family.