Is It Just a Cough -- Or Childhood Asthma?

Jeffrey Lobas, MD, EdD

A cough here, a wheeze there. Most children have respiratory illnesses every now and then. But for one in 12 kids, these symptoms are a sign of something more significant: childhood asthma.

Unlike short-term bugs, asthma is a chronic inflammatory condition. In children who have it, their airways swell and narrow from time to time, making breathing difficult. While the condition typically lasts a lifetime, Jeffrey Lobas, MD, EdD, a pediatric pulmonologist at UH Rainbow Babies & Children’s Hospital, notes that a third of affected children will grow out of the disease by age 10, another third may only be affected seasonally, and the last third will require year-round support with medication and other therapies.

Is My Child at Risk?

Scientists are still untangling asthma’s causes. In most cases, it seems to start when the body is exposed to an allergen – for instance, ragweed or pet dander. However, other causes include viral illnesses, exercise or even cold air. Some people’s immune systems react strongly to certain allergens and go into overdrive, causing the lining of the airways to swell and the muscles around them to tighten.

Kids may be at higher risk for asthma if they:

• Have a parent or other family member with asthma or allergies
• Have allergies themselves, including skin reactions or food allergies
• Have frequent respiratory infections
• Were exposed to secondhand smoke before and/or after birth

Pick Up The Patterns

What’s one way to tell the difference between asthma and other illnesses? Monitor your child’s symptoms over time.

“When symptoms such as coughing, wheezing and shortness of breath are linked to asthma, they usually follow a pattern,” Dr. Lobas says. He says symptoms tend to flare up:

• At night, causing trouble sleeping
• Early in the morning
• During exercise
• After exertion, laughing or crying
• In cold air

Often, kids with asthma develop symptoms before age 5. But the condition can be difficult to diagnose, in part because kids can’t explain how they’re feeling. So information from parents becomes critical. “If you notice troublesome trends, tell your child’s pediatrician or an allergist/immunologist,” Dr. Lobas says. “Either can diagnose and treat the disease.”

As part of the exam, the health care provider will test your child’s airway function. This may involve blowing in and out through a tube. Since babies and toddlers can’t always do this, the provider may instead start asthma treatment to see how your child responds.

“Asthma can’t be cured. But with medication and careful planning, it can be managed. Doing so can help your child breathe easier today and prevent long-term lung damage and other complications in the future,” Dr. Lobas says.

Related links

Learn about the new national asthma treatment guidelines that are helping patients better control symptoms, or call 216-278-7485 for an appointment with a Rainbow asthma expert.