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Special Topic:Asthma and Children

Can I catch asthma from my child?

Asthma is not an infectious condition. It cannot be transmitted from person to person, nor can it spread between people. That said, it has been noted for many years that the tendency to develop asthma tends to run in families. There is an inherited component to the development of asthma and allergy. If one parent has asthma or certain allergies, a child has a greater chance of developing asthma and/or allergies than does a child of unaffected parents. The chance of a child developing asthma increases further when both parents have asthma. The inheritance of asthma is poorly understood and is far from “the whole story.” Current thinking also attributes a large role to environmental factors in the development of asthma.

Do more boys than girls have asthma?

Yes, but only as children. In young children, boys are almost twice as likely as girls to develop asthma. Interestingly, the pattern is reversed when looking at asthma in older age groups. An article published in the medical journal Chest in October 2003 found that 62% of children with asthma (asthma patients younger than 18 years of age) were male, while 68% of the adult patients with asthma were female. In studies of severe asthma, the preponderance of boys is notable as well: 2 of 3 children with severe asthma are boys. But, among adults with severe asthma, women account for two thirds of those affected. The gender-based differences are not understood. Theories suggest the influence of female hormones, as well as the difference in size between male and female lungs as they grow into adulthood.

If my 7-year-old daughter wheezes, does it mean that she has asthma?

Maybe not, but asthma is very likely. Repeated bouts of cough and wheezing in school-age children — boys as well as girls — are almost always due to asthma. Children may catch many colds each year, especially when school is in session. Asthma is often underdiagnosed, especially in children, so it is important to distinguish between repeated infections such as bronchitis or pneumonia, and asthma. Don’t assume that your child is experiencing a “bad winter” if she seems to suffer from multiple chest colds. It may be that she has asthma. If so, make sure you get appropriate medical care, establish the correct diagnosis, and allow your daughter to receive asthma treatment if required.

how-to-manage-asthma-in-kids

Should I take my young child to a physician who specializes in asthma?

Gemma’s comment:

Yes! The focused attention of both physician and patient is all-important. During her early years, my daughters allergies and asthma symptoms were repeatedly overlooked by the busy pediatricians who saw her only for a few overbooked minutes in a crowded office full of crying babies and frazzled moms.

You should take your child to an asthma specialist if your child’s asthma is active for most days, if there are frequent night-time asthma symptoms that interfere with sleep and rest, if your child is absent from school because of asthma symptoms, or if your child requires hospital emergency room visits for asthma. You should also consider seeking a consultation with an asthma expert if you or your child believe that asthma symptoms are not controllable, or if you do not understand how to take care of those symptoms. You might seek consultation from a pediatric pulmonologist or from a pediatric allergist. After your child has undergone the appropriate evaluation, you and the specialist can decide whether the child requires continuing ongoing care from an asthma specialist or if your pediatrician can resume caring for your child’s asthma.

The most recent 2002 update of the NAEPP’s Expert Panel Report addresses of when infants and children 5 years of age or younger should be referred to an asthma specialist. Consultation with an asthma specialist is recommended for all young children with moderate or severe persistent asthma. Similarly, referral to an asthma specialist should be considered for infants and young children with mild persistent asthma.

Will my child outgrow his or her asthma?

Yes, and no. Yes — because symptoms and the requirement for medication seem to disappear during adolescence in some children who have mild asthma. No — because research indicates that asthma is lifelong and is never truly outgrown. A child with physician-diagnosed asthma is viewed as having a lifelong condition. The state of baseline hyperactivity that defines asthma never disappears.

That said, it has long been observed that many children appear to “grow out” of their asthma. Contemporary medical thinking views the phenomenon of “disappearing” asthma as a state of prolonged asthma remission. Typically, adults in their late 20s or 30s who develops asthmatic symptoms will recall having had mild asthma as a child and are surprised that they continue to have asthma in adulthood.

Should my child be excused from physical education classes since he’s been diagnosed with asthma?

No, absolutely not. Your child’s asthma should be brought under good control, and then he should be encouraged to participate fully in all aspects of school life, including fitness and sports. A diagnosis of asthma should never automatically lead to curtailed physical activity. Participation in physical education and in team sports is an important component of the healthy lifestyle advocated for all persons with asthma. Having your child excused from physical education class not only robs him of the benefits associated with exercise, but also stigmatizes him, and sends the message that asthma is a physical impairment rather than a lung disease.

How can Intake sure that my child’s school staff can cope with his or her asthma? What about summer camp staff?

The best way to make sure that your child’s school or camp is in a position to cope with your child’s asthma is to teach your child about asthma and to establish good communication with the school and camp administration. Even though asthma is a very common condition throughout childhood and adolescence, it is still a good idea to make sure that school and camp staff know that your child carries a diagnosis of asthma. Several measures are helpful to ensure that your child’s asthma remains well-controlled at school or camp. Familiarize yourself with the school or camp policy (if any) regarding asthma in general, and inhaler use in particular. For example, some schools allow a student to carry a “rescue” inhaler at all times; others require that it be left in the school nurse’s office. Discuss any concerns you may have with your child’s doctor in advance of the start of camp or school. A good time might be when the physician fills out the required pre-enrollment health forms. Make sure your child knows how to measure peak flow and is aware of his or her asthma action plan. The school and camp should be given a written copy of the plan, as well as a copy of your child’s medication list. Make sure that your child learns when to use the “rescue” inhaler and how to use the metered-dose inhaler with a spacer. Finally, there are a number of useful, patient-centered asthma Web sites that you can review for additional pointers.

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