How Early Can A Child Be Diagnosed With Asthma

The Impact Of Asthma On Daily Life

Asthma is often under-diagnosed and under-treated, particularly in low- and middle-income countries.

People with under-treated asthma can suffer sleep disturbance, tiredness during the day, and poor concentration. Asthma sufferers and their families may miss school and work, with financial impact on the family and wider community. If symptoms are severe, people with asthma may need to receive emergency health care and they may be admitted to hospital for treatment and monitoring. In the most severe cases, asthma can lead to death.

Medical And Home Treatments

According to Healthline treatments for asthma in babies is provided in inhaled forms. This includes medicines being given through a nebulizer or inhaler. With a nebulizer, the child wears a facemask and the liquid medicine is delivered through a mist that the child breathes in. The goal of the medicine is to open the airways and reduce inflammation so the child’s breathing returns to normal.

A common quick-relief drug is albuterol . Its one of a class of drugs known as bronchodilators. They help relax the airways to make breathing easier. Long-term medications include corticosteroids and leukotriene modifiers .

Parents can help their child experience fewer asthma symptoms by doing some simple things at home. Cover your child’s mattress with an allergy-proof casing to keep away dust and irritants. Also, wash bed linens and stuffed toys weekly and vacuum regularly to remove dust and dust mites. Also, using an air purifier at home will help reduce any dust or pet dander in the home. Should you have any pets, keep them out of the bedrooms. Likewise, keep your home clear from any smoke and keep your child away from any smokers away from home.

It is critical to seek a medical professional if your child is experiencing symptoms of asthma. There are successful treatment plans that will enable your child to remain healthy and symptom-free.

What Makes Yale Medicines Approach To Pediatric Asthma Unique

The Pediatric Asthma Program at Yale Medicine brings all aspects of a childs care team together, ensuring that each patient receives individualized attention and the best possible treatment. Patients are seen by specialists with extensive experience in asthma and related conditions, and also meet with registered nurses who are certified asthma educators. All details of the visit are communicated back to the childs primary care provider.

The nurse educators spend time with each family at the end of their visit and go through proper use of medications, show them how to use their inhalers, and give them advice on controlling environmental factors, Dr. Bazzy-Asaad says. If a child has certain allergies, for example, theyll talk about how to avoid those triggers.

Pediatricians working with the Asthma Program regularly collaborate with experts in other departments, too. If theres a situation that doesnt seem like straightforward asthma, its very easy for us to work with other specialists to get to the bottom of the problem more quickly, Dr. Bazzy-Asaad says.

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Asthma Patterns In Children

Every childs asthma is different. Some children have mild, occasional episodes of asthma or only show symptoms after exercising, or when they have a cold. Some experience daily symptoms, while others have symptoms continuously, which limit their level of activity.

Each pattern of asthma requires a different treatment approach. It is important to remember that children can still have a severe and even life-threatening attack, even if they generally have mild or occasional asthma.

Does Your Child Have Any Of These Symptoms

Wheezing and/or Chest TightnessSometimes this takes place only with exercise or with a cold.

A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:

• A parent has asthma.
• The child shows signs of allergies, including the allergic skin condition eczema.
• The child wheezes even when he or she doesn’t have a cold or other infection.

Frequent CoughMay be more common at night, and the child may or may not cough up mucus. You may notice your child is tired during the day, possibly due to lack of sleep.

Shortness of BreathThis is a feeling of not getting enough air into the lungs. It may occur only once in a while, or often. Shortness of breath can feel like tiredness or a decreased ability to do normal activities. Young children who are not yet verbal may experience feeding problems with shortness of breath while older children may describe tiredness, fatigue or just not being able to keep up with other kids their age.

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Why Are More Children Getting Asthma

No one really knows why more and more children are developing asthma. Suggestions include the following:

• Children are being exposed to more and more allergens such as dust, air pollution and second-hand smoke.
• Children aren’t exposed to enough childhood illnesses to build up their immune systems.
• Lower rates of breastfeeding have prevented important substances of the immune system from being passed on to babies.

Create An Asthma Action Plan

Both adults and children need to create an asthma action plan to outline what type of medicine they should take and when. It will also provide details for what to do when a persons asthma is dangerously out of control. These instructions will help you, your child, friends and relatives know when its time to change treatments or seek emergency care.

To make this plan, discuss your treatment options with your doctor. Plan what you should do in the event of an asthma flare-up. Define at what point you need to increase treatment measures to prevent or reduce an attack.

List what triggers can be avoided and the best ways to avoid them. Share this plan with friends, relatives, and any caregivers your children may have. Together, you will be able to successfully treat your or your childs asthma and avoid future complications.

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Early Life Risk Factors For Asthma At Age 22 Years

Univariate and multinomial analyses for the association between early life risk factors and asthma at age 22 years are shown in and , respectively. Newly diagnosed asthma was twice as likely to occur in females as in males. Parental asthma and both late onset and persistent wheezing during the first 6 years of life were associated with inactive, newly diagnosed and chronic asthma . In contrast, eczema by age 2 years and Alternaria sensitization at age 6 years were associated with inactive and chronic asthma but not with newly diagnosed asthma. Low V’maxFRC at age 6 years was associated with newly diagnosed and chronic asthma but not inactive asthma at age 22 years. There was a strong positive association between CA-BHR and both newly diagnosed asthma and chronic asthma . The population attributable risk of CA-BHR for newly diagnosed and chronic asthma was 33% and 26%, respectively. No significant association was found between inactive asthma at age 22 years and CA-BHR at age 6 years.

Can A Child Outgrow Asthma

Once someone gets sensitive airways, they stay that way for life. This is the case even though asthma symptoms can change over the years. As a child gets older, they may be able to handle airway inflammation and irritants better, so their symptoms may get better. About half of those children get asthma symptoms again when they are in their late 30s or early 40s. There is no way to know which children may have reduced symptoms as they get older. New triggers may set off symptoms at any time in people who have asthma. If your child has asthma, keep quick-relief medicines and their Asthma Action Plan on hand , even if symptoms dont happen often.

Medical Review September 2015.

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How To Diagnose Asthma In Young Children

Its often difficult to diagnose asthma in children under five years old, especially as they find breathing tests difficult. Doctors do not always choose to conduct a breathing test for children.

Your doctor will assess the symptoms and your explanation of your childs symptoms and may give your child asthma medicine to measure its effect.

This is called a treatment trial. Your doctor will monitor the effect this medicine has on your child and will use the results as part of their diagnostic process.

Spirometry tests

Allergy testing

Asthma is strongly linked with allergies.

Many people may have allergy tests as part of their diagnosis. These tests can be skin prick tests or blood tests and they detect allergen sensitivities.

Skin prick testing is usually done on the forearm. A drop of allergen is put on the skin and a small prick into the skin is made through the drop to allow a tiny amount of allergen to enter. If you are allergic, a small lump will appear over the next 15 to 20 minutes. Blood testing may be performed if skin testing is not possible, such as in cases of severe eczema. This test involves taking a sample of blood which is checked for antibodies to specific allergens.

A chest X-ray is not generally helpful in diagnosing or monitoring asthma, but you might have one if your doctor wants to rule out other problems such as pneumonia.

What Causes Asthma In Infants And Toddlers

We still do not know what causes some people to get asthma. If a child has a family history of asthma or allergies, a specific allergy or had a mother who smoked during pregnancy, they have a higher chance of getting asthma early in life.

A respiratory virus, an illness that occurs in the lungs, is one of the most common causes of asthma symptoms in children 5 years old and younger. Although both adults and children experience respiratory infections, children have more of them. Some preschool children get viral infections often. At least half of children with asthma show some sign of it before the age of 5. Viruses are the most common cause of acute asthma episodes in infants 6 months old or younger.

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How Is Asthma Treatment Different For Older Children

Sometimes when asthma is suspected, the doctor will put your child on a trial of asthma medication to see if it helps. If your child gets better while taking the medicine, it can be a signal that your childs symptoms are due to asthma. The medication will depend on how severe your childs symptoms are and how often they occur.

The goal of treatment for children include:

• Managing the childs environment to avoid triggers
• Treating the airway inflammation and bronchospasm with medication
• Keeping asthma in control so activity does not need to be limited
• Teaching the child about asthma, their medications and how to be as healthy as possible in a way they can understand

When administering medication to your child, make sure to follow the instructions given to you by your doctor and on the package insert.

What Are The Symptoms Of Asthma In Older Children

Symptoms of asthma in children who are 6 years of age or older can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies. Common symptoms include:

• Coughing, especially at night
• A wheezing or whistling sound, especially when breathing out
• Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly. Children with asthma may describe this like it feels like something is squeezing or sitting on their chest
• A lack of energy or feeling weak or tired
• Frequent colds that settle in the chest

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Diagnosis Of Asthma In Children

Diagnosing asthma in children younger than 5 years can be difficult because children cough or wheeze for many different reasons. Take your child to the doctor if:

• the wheezing happens more than once with or without an illness
• constant coughing or bouts of coughing become worse at night
• you are concerned about any breathing problems in your child.

Asthma Signs & Symptoms

People with asthma experience symptoms due to inflammation in the airways. They might only occur when you encounter an asthma trigger. Common symptoms that can lead to a diagnosis of asthma include:

• Persistent or recurring coughing: which often occurs at night or early in the morning, although it can happen at any time. Coughing is a major feature of asthma, especially in children and can sometimes be the only sign of asthma.
• Wheezing: is difficulty breathing accompanied by a whistling sound coming from your airways
• Shortness of breath: gives you the feeling that you cant get enough air into your lungs, and may even find it difficult to eat, sleep or speak
• Chest tightness: an unpleasant sensation of heaviness or pressure in the chest that can make it hard to breathe
• Increased mucus production: is characterized by high levels of thick fluid or phlegm accumulating in your airways
• Difficulty breathing while exercising: having trouble breathing while performing physical activities can be a sign of asthma
• Losing Sleep: Being unable to sleep through the night because of breathing troubles

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What Makes A Child More Likely To Develop Asthma

There are many risk factors for developing childhood asthma. These include:

• Allergies.
• Family history of asthma, allergies and atopy .
• Frequent respiratory infections.
• Being African American.
• Being raised in a low-income environment.

In children who are under five years of age, the most common cause of asthma symptoms is upper respiratory viral infections such as the common cold.

What Is Childhood Asthma

Childhood asthma is the same lung disease adults get, but kids often have different symptoms. Doctors also call this pediatric asthma.

If your child has asthma, their lungs and airways can easily get inflamed when they have a cold or are around things like pollen. The symptoms may make it hard for your child to do everyday activities or sleep. Sometimes, an asthma attack can result in a trip to the hospital.

Thereâs no cure for asthma in children, but you can work with your childâs doctor to treat it and prevent damage to their growing lungs.

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Assessment Of Asthma Control

Assess asthma control and risk factors for asthma attacks at the time of diagnosis, when creating/modifying a treatment plan and when monitoring treatment outcomes.

1. Asthma Symptom Control4, 8

0 points = well controlled asthma symptoms

1-2 points = partly controlled asthma symptoms

3 points = uncontrolled asthma symptoms

2. Risk of a Future Asthma Attack4, 8

Does the patient have any of the following risk factors:

• Uncontrolled asthma symptoms
• 1 severe attack in last year, previous intubation or intensive care unit admission for asthma
• Not prescribed or not taking an ICS properly
• Low FEV1
• Exposure to tobacco smoke
• Exposure to allergens that the patient is sensitized to
• Food allergy or past history of anaphylaxis

If the patient has any of these risk factors they are at risk for future asthma attacks. Consider strategies to eliminate modifiable risk factors .

Diagnosis And When To See A Doctor

Diagnosing asthma in babies can be challenging. A doctor cannot use the typical lung function tests because babies cannot exhale or inhale on command.

As a result, doctors do not typically diagnose asthma in babies. If a baby has asthma-like symptoms, the doctor may diagnose reactive airway disease and confirm an asthma diagnosis when the child is older and if the symptoms persist.

To check for the issue in a baby, a doctor may:

• Give medications to open the airways and see whether the symptoms improve.
• Give allergy tests to check for sensitivities to common triggers, such as dust mites, mold, pet dander, and pollen in an older baby or toddler.
• Order imaging studies, such as X-rays, to examine the lungs.

They may also make a referral to an allergy or lung specialist for further testing and treatment.

Asthma is a chronic condition with no cure. However, many babies with asthma-like symptoms, such as wheezing, do not go on to have asthma later in life.

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Can Asthma Be Cured

There is currently no known cure for asthma, but with proper diagnosis and asthma management it is fully possible for people with asthma to live healthy, active and symptom-free lives.

There is still much research that needs to be done to fully understand how to prevent, treat and cure asthma. Asthma Canadas National Research Program is committed to supporting leading asthma researchers and graduate student researchers working to expand our knowledge and one day, unlock a cure.

What Are The Treatments For Asthma In Children

IIf your child has asthma, you will work with their health care provider to create a treatment plan. The plan will include ways to manage your childs asthma symptoms and prevent asthma attacks, such as

• Strategies to avoid triggers. For example, if tobacco smoke is a trigger for your child, you should not allow anyone to smoke in your home or car.
• Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to have for your child at all times. It may also include other types of medicines which work quickly to help open your childs airways.
• Control medicines. They work by reducing airway inflammation and preventing narrowing of the airways. Not all children will take control medicines. Whether or not your child needs them depends on how severe the asthma is and how often your child has symptoms.

If your child has a severe attack and the short-term relief medicines do not work, get medical help right away.

Your child’s provider may adjust the treatment until the asthma symptoms are controlled.

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