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February 10, 2012

Asthma in Children

Asthma is the leading cause of chronic illness in children. It affects as many as 10%-12% of children in the U.S. and, for unknown reasons, is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.

Doctor to Patient

Asthma Risk - Who & Why?

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

Get statistics on young children with asthma.One of the more frequent questions my patients ask me concerns the relative risk of their child developing allergies or 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?


Asthma Resources from Medscape and eMedicine

Doctor to Patient

What makes a child more likely to develop asthma?

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

  • Presence of allergies


  • Family history of asthma and/or allergies


  • Frequent respiratory infections


  • Low birth weight


  • Exposure to tobacco smoke before and/or after birth


  • Being male


  • Being black


  • Being raised in a low-income environment

Why are more children getting asthma?

No one really knows why more and more children are developing asthma. Some experts suggest that children are being exposed to more and more allergens such as dust, air pollution, and second-hand smoke. These factors all are triggers of asthma. Others suspect that children are not exposed to enough childhood illnesses to build up their immune system. It appears that a disorder of the immune system where the body fails to make enough protective antibodies may play a role in causing asthma.

And still others suggest that decreasing rates of breastfeeding have prevented important substances of the immune system from being passed on to babies.

How can I tell if my child has asthma?

Signs and symptoms to look for include:

  • Frequent coughing spells, which may occur during play, at night, or while laughing. It is important to know that cough may be the only symptom present.


  • Less energy during play


  • Rapid breathing


  • Complaint of chest tightness or chest "hurting"


  • Whistling sound (wheezing) when breathing in or out


  • See-saw motions (retractions) in the chest from labored breathing


  • Shortness of breath, loss of breath


  • Tightened neck and chest muscles


  • Feelings of weakness or tiredness


  • Dark circles under the eyes


  • Frequent headaches


  • Loss of appetite

Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from asthma episode to the next episode in the same child. Also note that not all wheezing or coughing is caused by asthma.

In kids under 5 years of age, the most common cause of asthma-like symptoms is upper respiratory viral infections such as the common cold.

If your child has problem breathing, take him or her to the doctor immediately for an evaluation.



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Asthma in Children

Long-Term Control Asthma Medications

Doctors and asthma specialists recognize that asthma has two main components: airway inflammation and acute bronchoconstriction (constriction of the airways). Research has shown that reducing and preventing further inflammation is the key to preventing asthma attacks, hospitalizations, and death from asthma.

Long-term control asthma medications are taken daily over an extended period of time to achieve and maintain control of persistent asthma (asthma that causes symptoms more than twice a week and frequent attacks that affect activity).

The most effective long-term control asthma medications are those that stop airway inflammation (anti-inflammatory drugs), but there are others that are often used along with anti-inflammatory drugs to enhance their effect.

Long-term control asthma medications include:

  • Corticosteroids (The inhaled form is the anti-inflammatory dru...

Read the Asthma Medications article »






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