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Asthma in Kids Under 5

Posted Aug 24 2008 1:48pm
ELLEN CRAIN, MD: About 7 to 10% of children in the United States have asthma, and the rate of diagnosis of asthma has increased dramatically over the last 10 or 15 years.

ANNOUNCER: Research shows if a person is to develop asthma, he or she is likely to develop it quite early.

JAMES KEMP, MD: If you look at studies, it can show us that up to 80% of asthma does present itself before the child goes to school; in that sense, before five years of age. So physicians and parents have a very unique opportunity to recognize it early, and hopefully treat it earlier.

ANNOUNCER: But how's a parent to recognize asthma, especially when a child is very young?

ELLEN CRAIN, MD: Babies can't tell you that they're having difficulty breathing, so you often have to wait for symptoms to develop, and wheezing is not so obvious, sometimes, in young infants compared to older children.

ANNOUNCER: Parents may be quicker to recognize asthma symptoms if they understand that asthma runs in families.

JAMES KEMP, MD: Your genes are what you are, and it is quite clear that people who have asthma have one or more genes for asthma. That means they've inherited this tendency to have asthma from their parents.

ANNOUNCER: But even with an inherited tendency toward asthma, asthma symptoms require a trigger. For infants and toddlers, that's often a common cold.

NANCY OSTROM, MD: Very young children tend to have symptoms of asthma, particularly with infections. They get recurrent, frequent viruses as part of being a very young child. And that can often cause the symptoms of wheezing, coughing, difficulty breathing.

ANNOUNCER: So how are parents to know if it's a cold or asthma?

NANCY OSTROM, MD: All children get colds. They will all have cough with their colds or bronchitis. But if those symptoms last longer than a few days, are associated with coughing or tightness in the middle of the night, wheezing, tugging for breath. Those may all be indicative of asthma rather than just a routine bronchitis, and should be evaluated.

ANNOUNCER: When that evaluation leads to a diagnosis of asthma, doctors usually prescribe "reliever" medicines, to provide quick help if breathing becomes difficult.

But for persistent asthma, doctors usually also prescribe "controller" medicines. To improve day-to-day quality of life, and to help protect long-term health.

JAMES KEMP, MD: We do believe that recognizing asthma early and starting good preventative, or sometimes we call it controller therapies earlier may prevent the lung from losing some of its function.

ANNOUNCER: In children one to five, who have attacks at least twice a week, National Institutes of Health treatment guidelines call for daily or inhaled corticosteroids.

NANCY OSTROM, MD: The inhaled corticosteroid class of medications are now indicated by our national guidelines as the front line, first choice medications to help control the inflammation of any persistent asthma.

ANNOUNCER: In children over one, who have difficulty using inhaler pumps, a medication called budesonide can be given with a device called a "nebulizer," a simple machine that turns the medicine into a mist.

JAMES KEMP, MD: That type of therapy can be given to very, very young children, either as a mouthpiece where they can breathe in and out over a period of time, or as a face mask, where the mask, of course, is placed on the face snugly, and they are then just breathing in and out as, you know, they're watching something or playing.

ANNOUNCER: Doctors don't know why cases of asthma appear to be on the rise. But they say they can help the increasing number of children with breathing difficulties, even very young ones, lead normal lives.

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