Diagnosing babies and toddlers with asthma is challenging, because it's difficult to measure lung function in this young group. What makes diagnosis easier is knowing your child's symptoms. diagnosing asthma
Asthma is the most common chronic respiratory disease in children and affects more than 6 million U.S. children. Despite being common, diagnosing asthma in children can be difficult because "there is no one-size-fits-all set of symptoms," according to Dr. Harvey Leo, a pediatrics specialist who practices in Michigan.
A leading pediatrics group offers some tips for parents who suspect their infants or toddlers may have asthma or are having symptoms that could suggest another health condition.
If you're wondering whether your child may have asthma, here are some tips and tell-tale signs to look for.
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Talk with your child's doctor
"A solid, ongoing relationship with your child's health provider can help identify asthma risks and the best treatment for your child," he said in an American Academy of Pediatrics news release.
You should tell your child's doctor about any excessive cough, particularly a nighttime cough or a prolonged cough after a cold even if there is no wheezing. Coughing can be the only asthma symptom in some people. Share whether you have family members who have asthma, hay fever, eczema, recurrent bronchitis or sinus problems, the American Academy of Pediatrics (AAP) advises.
An unexplained frequent cough or daily cough in infants means you should have your child evaluated by a pediatrician or pediatric pulmonologist because it could be a sign of a serious disease.
When trying to diagnose what's causing the problem, your pediatrician will listen carefully to make sure that the sounds your baby is making are coming from the airways of the lungs, the AAP shares.
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Sometimes babies breathe noisily as a result of laryngotracheomalacia, a temporary weakness in the cartilage near the vocal cords. They grow out of this as the tissues become firmer. Unusual conditions related to airway development or prematurity can also cause wheezing in infants.
Your child's pediatrician isn't likely to recommend allergy testing unless the wheezing always happens after exposure to an animal or certain food. Food allergy is rarely a cause of asthma in infants and toddlers. It may be a trigger for eczema, the AAP notes.
Your doctor may order a chest radiography during the baby's first wheezing bout. If it's determined that your child has asthma, that won't likely be repeated because the bronchial tubes are not seen well in a radiograph.
If your baby is failing to grow or thrive, the doctor may test for other conditions, according to the AAP. Certain tests, including a sweat test to rule out cystic fibrosis, may be necessary when your doctor wants to be sure your baby's wheezing and chest symptoms are not caused by a condition with symptoms that are similar to asthma.
Conditions that resemble asthma
Parents need to be aware that there are many other conditions that can look like or worsen asthma in children, Leo adds. These include seasonal allergies, acid reflux, viral or bacterial infections, conditions related to a child's anatomy and heart issues.
Try asthma therapy
Sometimes the easiest and best way to diagnose asthma in a young child is to treat it with asthma therapy and see if the child improves. Medications for asthma usually only help asthma and not other conditions, the AAP notes. You can help the pediatrician by monitoring your child's symptoms carefully and providing feedback on whether the medications are helping.
Questions your child's doctor may ask
Key questions your child's doctor will need to know include:
- How often does your child cough or wheeze during the week?
- Do these symptoms affect their daily activity?
- Does your child's coughing or wheezing wake them up at night?
- What medicines have you tried and have they helped, including nutritional supplements or homeopathic therapies?
- Does anyone in the family have a history of asthma, environmental allergies or other respiratory conditions?
For children who are old enough (typically over 7 years of age), your doctor may order an asthma test. One of the most common is a lung function test (spirometry). The child breathes into a device that shows whether the child has some airway blockage, Leo explains.
Another test checks how much nitric oxide your child exhales, to assess levels of airway inflammation.
More complex lung function tests are also available and used for the diagnosis and follow-up management of asthma (such as imaging tests). There are also home respiratory monitors and medication reminder phone apps that can help manage a child's asthma.
"There are many tools that can help diagnose asthma, and treatment and medications that can help a child with asthma thrive. If you think your child may have asthma, talk with your pediatrician," Leo concludes.
