Coughing — Is it a Sign of Asthma in Your Child?

Asthma and its resulting symptoms are one of the most common reasons that parents bring their children in to see a pediatrician. Approximately 5-7% of children are thought to be asthmatic or have asthma-like symptoms at some time during their childhood. However, the ability of the doctor to diagnose asthma may at times be difficult, or require persistence by both the parents and physician. It is, therefore, important for parents to recognize some of the warning signs and indications that their child may have asthma or be at risk for developing the condition.

Asthma is a disease that causes swelling and tightening of the airways. Usually children have recurrent episodes of wheezing and coughing, especially at night or in the early morning. Parents may notice that a child always coughs for days after getting a cold, or always coughs during and after exercise. Some children cough at night for weeks at a time. A child with repetitive episodes of bronchitis or pneumonia may actually have asthma.

A child with nasal allergies or eczema, close relatives with asthma or severe allergies, a history of exposure to cigarette smoke, a viral infection of the airways called bronchiolitis during the first year of life, or a history of prematurity is at risk of developing asthma.

The appropriate diagnosis of asthma by a physician can be made based on the history, physical exam, and absence of alternative problems that can sometimes mimic asthma (such as vocal cord problems, foreign bodies in the airways, other lung diseases, heart disease, blood vessel abnormalities, or a chronic heartburn). Once the diagnosis is made, a treatment plan should be initiated by the doctor. This plan may include lung function studies, use of inhalers to open the bronchial tubes and/or decrease mucus plugging and swelling of the airways, medications by mouth to decrease inflammation, and evaluation of lifestyle issues which may trigger asthma. Allergies to animals, plants, molds or dust may require treatment and evaluation. Eliminating cigarette exposure is an important step in controlling asthma. Any significant psychiatric or family problems that interfere with asthma therapy may require referral to a mental health professional.

A partnership between the physician, parent, and child should be established to address the family’s concerns, agree on goals of asthma therapy, and agree on an action plan for patient and parent self-management. Parent and patient education should continue on a regular basis, with emphasis on the goals of asthma therapy that include:

• preventing symptoms during the day and night with no sleep disruption, no missed school, no or minimal need for emergency room visits or hospitalization
• maintaining normal activity levels to include exercise
• having normal or near normal lung function
• patient/parent satisfaction with the asthma care received
• having no or minimal side effects while receiving the best medical regimen

Robin Schaten, M.D., is a board certified pediatrician. She joined Longmont Clinic in July 1986.