Asthma: Why is my kiddo wheezing?
Most of the time a person’s lungs can fight off insults, such as viral infection or mild inflammation with time and supportive care but, sometimes, the lungs overreact causing too much mucous production and too much swelling around the smaller airways in the lungs. When that happens, a child can experience shortness of breath, wheezing, and coughing fits. This entity of overreactive lungs/airways is called Asthma.
Asthma usually runs in families. So, if you or your partner had asthma as a child, or still have asthma, your child has a higher likelihood to have asthma as well. Asthma often has a trigger that sets off this over exuberant inflammation process. Possible triggers are viral illnesses, like colds or bronchitis, allergies from pollens or animal hair, smoke or aerosol inhalation, or even exercise. We usually diagnose asthma after the age of 2, but kids can also show symptoms before the age of two. But because their airways are a lot smaller, even a small amount of inflammation can lead to that wheezing sound classically associated with Asthma. The process for diagnosing Asthma varies for each kiddo and their particular cough presentation. If there is a really good history of an identifiable trigger, patterned coughing and audible wheezing, often times pediatric pulmonologists will make the diagnosis based on that history alone and will further qualify their diagnosis with a trial of asthma specific medicines such as inhalers. The gold standard for diagnosis; however, is a test administered with the help of pulmonary function testing equipment, which involves the kiddo breathing into pulmonary function testing equipment before and after the administration of asthma medication. If the child’s lung function improves by 12% or more, they are diagnosed with asthma. This testing is usually reserved for kiddos with atypical presentation or kiddos with uncontrollable asthmatic symptoms even when on a usually effective asthma medication.
The good news is that as a child grows, their lungs get bigger and can often accommodate extra inflammation, so their asthma symptoms may go away over time. For instance, if you may have a friend whose child had viral induced asthma when they were little and needed asthma treatments when they had colds, but now they do not because they are in middle school and they no longer wheeze or have labored breathing in response to cold symptoms. As pediatricians, we often check in with our asthmatic kids every 3-6 months to see if they are, in fact, “growing out” of their asthma diagnosis by using standard questionnaires to collect data about how controlled or uncontrolled their asthma symptoms are on and off medication.