Asthma in Children

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What is asthma in children?

Asthma is a chronic inflammatory disorder of the airways, characterized by recurrent, reversible, airway obstruction. Airway inflammation leads to airway hyperreactivity, which causes the airways to narrow in response to various stimuli, including allergens, exercise, and cold air.

How common is asthma in children?

Asthma is the most common chronic disease of childhood. The prevalence of asthma is increasing. This is also the case with other allergy conditions, including eczema (atopic dermatitis), hay fever (allergic rhinitis), and food allergies. According to recent CDC data, asthma affects approximately 8.5% of the pediatric population in the U.S., or more than 7 million children. Asthma accounts for more school absences and more hospitalizations than any other chronic condition in this country.

What are the signs and symptoms of asthma in children?

The most common symptoms of childhood asthma are coughing and wheezing.

  1. Coughing is typically non-productive and can frequently be the only symptom. When it is the only symptom, this is termed cough-variant asthma.
  2. Wheezing is a high-pitched whistling sound produced by turbulent airflow through narrowed airways.

Other common symptoms include:

  1. Difficulty breathing
  2. Chest tightness
  3. Poor exercise endurance

Symptoms are often worse with exertion or during the night. Night cough is also common. Symptoms are also typically exacerbated by viral upper respiratory infections, and these viral symptoms can linger for weeks in children with asthma, whereas age-controlled counterparts tend to recover much sooner. Symptoms can also have a seasonal variation, which can be due to environmental allergies. Tobacco smoke commonly aggravates symptoms, and secondhand tobacco smoke is not only a risk factor for developing childhood asthma, but also complicates asthma control. Children with asthma often have a history of recurrent bronchitis or even a recurrent croup-like cough.

The physical exam in asthma is often completely normal. Occasionally, wheezing is present. In an asthma exacerbation, the respiratory rate increases, the heart rate increases, and children can look as if breathing is much more difficult. They may require accessory muscles to breath, and retractions of the chest wall adjacent to the ribs are common. Younger children may become lethargic and less interested in feeding. It is important to note that blood oxygen levels typically remain fairly normal even in the midst of a significant asthma exacerbation.

Medically Reviewed by a Doctor on 9/26/2013

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Asthma Risk - Who & Why?

Medical Author: Alan Szeftel, MD, FCCP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

One of the more frequent questions my patients ask me concerns the relative risk of their child developing allergiesor asthma. In previous Doctors' Views, I have raised issues relating the environment to the development of allergies or asthma. However, both a genetic predisposition and environmental/lifestyle factors are necessary for these conditions to develop.

The incidence of asthma has risen dramatically in the past 20 years—a period too short to reflect any significant changes in the gene pool. This supports the important role that environmental influences (allergy, infection, lifestyle, and diet) have on the development of asthma.

What role then does genetics (heredity) play in asthma? A genetic link in asthma has long been suspected primarily due to "clustering" of cases within families and in identical twins. This does not prove a genetic cause, since it may also reflect shared environmental exposures. Several studies conclude that heredity increases your chances of developing asthma, particularly if allergies or other allergic conditions are present. Moreover, you may pass this tendency to asthma to the next generation. So, what are the chances that your child will develop asthma?