Asthma in Children: What Concerned Parents Should Know
Published on: April 11, 2020
Asthma is the most common chronic disease in children and, in Thailand, exacerbated by air pollution. Dr. Karl explains what asthma is and its triggers, some symptoms to look out for, and how children are diagnosed.
By Dr. Karl Kalavantavanicha
Asthma is the most common chronic disease in children and a growing problem for kids all over the world. Here in Thailand, air pollution is one of the leading reasons we are seeing more children diagnosed with a wide range of allergic diseases — eczema, allergic rhinitis (hay fever), hives, and food allergies, in addition to asthma. Current research shows that more than 10% of children in Thailand have asthma (GAN Survey 2018).
For parents who suspect their child might have asthma, it is normal to be concerned about your child’s current and future health. The following five facts about children’s asthma should give a better understanding of the symptoms and triggers that may point to asthma, and help provide your child’s doctor with useful information for diagnosis.
Asthma is an allergic disease of the respiratory tract.
Asthma affects people of all ages but occurs more frequently in children than in adults; even infants and toddlers can develop asthma. When a person has asthma, the inside of the airways (bronchial tubes) that carry oxygen into and out of the lungs is swollen and irritated.
Asthma causes the airways to be highly sensitive to specific triggers. An asthma attack or flare-up results from exposure to a trigger, which causes the muscles around the inflamed airways to tighten and narrow, making breathing more difficult.
Pollution and dust mites are major triggers.
Unlike areas of the northern hemisphere, including the US, Western Europe, and Japan, Thailand’s proximity to the equator means it does not have much seasonal variation — there is no spring or fall, and no hay fever or pollen season. The most important asthma triggers in Thailand are dust (dust mites) and pollution. Other triggers include certain viruses and bacterial infections, cold air, exercise, cigarette smoke, and animal dander, which is fairly common in homes with cats or dogs.
Risk factors include environmental and genetic components.
What causes asthma is still not fully understood, but we do know that both environmental (exposure) and hereditary (genetic) factors can predispose a child to the disease. Having a parent with asthma or allergies puts a child at greater risk for asthma. Environmental and exposure risk factors include:
- Exposure during pregnancy to environmental tobacco smoke
- Postnatal exposure to environmental tobacco smoke
- Being born prematurely
- Having eczema or allergic rhinitis (hay fever)
- Frequent exposure to air pollution
- Heavy exposure to dust mites, typically at home
The most prevalent symptom is coughing.
Most children with asthma will show symptoms before the age of five. While symptoms can vary from one child to another, the most common symptom is a cough. The cough is distinctive; it tends to be a dry cough that comes and goes at certain times of the day, especially at night. The cough can become more severe when a viral infection or other illness is also present. Other symptoms may also include:
- Wheezing, rapid breathing or shortness of breath, often tied to exercise
- Tightness in the chest
- Frequent fatigue
- In infants, difficulty feeding or making grunting sounds while feeding
- Social withdrawal, reduced participation in sports and social activities
- Sleep interruptions resulting from coughing or breathing difficulty
Diagnosing a child’s asthma can be complicated.
There is no specific test to diagnose asthma, and children may not have symptoms during their doctor’s visit. Diagnosis typically begins with a physical examination, a review of the child’s medical and family history, and a discussion with the parents about the symptoms and triggers they may have observed. Questions could include:
- Does your child have food allergies?
- Are there any pets at home?
- What similarities have you noticed when a flare-up begins?
With some prompting from the doctor, parents often can recall events or situations that triggered a physical reaction in their child.
Your doctor may also recommend certain tests to help diagnose your child’s condition. Lung function testing, or spirometry, is used to measure the volume of air your child can exhale, and how quickly. With children, this and other tests are typically considered only beginning around the age of six, when they are mature enough to understand and follow directions required for accurate testing.
As with most chronic conditions, the earlier a child’s asthma is diagnosed and properly treated, the better the treatment outcome is likely to be. If you suspect that your child might have asthma, talk to your pediatrician.
About the Author
Dr. Karl Kalavantavanicha is a US-board-certified pediatrician specializing in pediatric allergies, immunology, and pulmonology medicine at Bumrungrad International Hospital.
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