Childhood Asthma - What Is It?

The faces of childhood asthma are many:
Your child who complains about shortness of breath after running. Your infant with her fourth episode of "bronchitis" this season. The child who always seems to be coughing and whose colds seem to last forever. Your 7-year-old brought to the doctor's office just as it opens, having been up all night gasping for breath. The 2am trip to the emergency room with your child who is having severe breathing troubles and will need to be admitted to the hospital...AGAIN!

Childhood asthma, always a common problem, seems to be the disease of the new millennium. More and more children are diagnosed and they seem to be getting sicker, despite a whole new arsenal of treatments and an improved understanding of the disease. No one really knows why this is happening. Speculation ranges from exposure to environmental toxins such as cigarette smoke to allergies related to insects to an increasing genetic predisposition to the disease.

Whatever the cause, the results are clear. Asthma is a major problem for our children that must be aggressively treated. Treatment of childhood asthma cannot be successful unless parents become involved and educated about the causes, classification and treatment options for this chronic disease.

What's in a Name?
Before we can talk about this illness, we must decide just what to call it. This is not as easy as it may sound. The word "asthma" means different things to different people. It can be a frightening label to place on a child.


As a result, doctors are now trying to avoid using the word "asthma" in favor of another name: reactive airway disease. Doctors like this name since it more accurately describes what is happening in our young patients. The problem, in my experience, is that when I tell parents that their child has reactive airway disease, they have no idea what I'm talking about. The word asthma, however, seems to be clear to everyone.

No matter what words are used, it is of the utmost importance that the child and his/her parents understand the disease and its ramifications. Patient education is the key to the successful treatment of asthma. Unfortunately, this education can be complicated and it takes time, a commodity often in short supply in many pediatric offices.

Does My Child Have Asthma Or Not?
This is a simple question with a not-so-simple answer. Making the diagnosis of asthma can be very easy in a child with repeated classic episodes of wheezing that respond to standard treatment and a strong family history of asthma. But what about children without a family history who only have occasional, mild and/or less obvious symptoms? Unfortunately, in these cases the diagnosis of asthma is not always easy and can be missed.

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