Bronchial asthma is not necessarily accompanied by choking, wheezing or shortness of breath. Diagnosing it can be quite difficult, as this disease does not have a universal set of symptoms. Together with experts from the American Academy of Pediatrics, we figure out how to understand that a child suffers from asthma.
Asthma affects people of all ages, but it is most common in children. According to WHO, bronchial asthma is one of the most common chronic respiratory diseases in childhood.
In order to recognize an attack in time and quickly take action, first of all, you need to be sure of the diagnosis. But diagnosing the disease is not always easy, because the manifestations of bronchial asthma can be confused with other respiratory diseases.
Asthma is a chronic inflammatory disease of the airways caused by abnormal immune responses. In this, it is similar to allergies, eczema or Crohn's disease, which are also associated with a malfunctioning immune system. The main manifestation of asthma is the narrowing of the lumen of the bronchi, which causes severe shortness of breath, coughing and suffocation.
Important!
Asthma symptoms are individual and can change from attack to attack. The most common symptoms are:
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Cough that persists for a long time. It is often the earliest and only symptom of the disease.
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The onset or worsening of coughing fits at night or after physical activity.
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Sleep disturbance, insomnia, feeling short of breath.
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General weakness, decreased activity of the child, complaints of fatigue.
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Rapid breathing and shortness of breath, accompanied by a feeling of tightness or pain in the chest.
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Characteristic wheezing and «whistling» breathing, manifested a specific whistling sound during inhalation or exhalation.
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Tension of the muscles of the neck and intercostal muscles during breathing, retraction of the abdomen when inhaling. In some cases, there is a rise and fall of the shoulders.
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In children under 1 year old, in addition to the aforementioned signs of bronchial asthma, there may be a loss of appetite or a characteristic «groaning» during feeding time.
What can help diagnose asthma
Pediatrician Harvey Leo, in a press release from the American Academy of Pediatrics, emphasizes that there are conditions that can aggravate asthma in children, and look exactly like asthmatic attacks. These conditions include seasonal allergies, acid reflux, viral or bacterial infections, and heart problems.
Answering these questions will help the doctor make a correct diagnosis:
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How often does the child cough or wheeze during weeks?
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Do these symptoms affect his daily activities?
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Does your child wake up with a cough or wheeze at night?
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What medications, including nutritional supplements or homeopathic treatments, did the child take. Did they help him?
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Does anyone in the family have a history of asthma, allergies, or other respiratory conditions?
For children older than 7 years, the doctor may prescribe various tests for asthma. Most often, this is spirometry — a study of lung function. During the procedure, the child breathes into a device that shows if they have an airway blockage. Another test assesses the level of inflammation in the airways, recording how much nitric oxide the baby exhales.
Read all about bronchial asthma in children in the Encyclopedia on the Medportal.
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Asthma predictive index
In addition to the above methods, doctors and parents have a tool that helps to predict quite accurately whether a baby will develop asthma or simply outgrow the unpleasant symptoms. This is the asthma predictive index (API).
The API determines which children are likely to develop asthma at an older age. For example, according to this index, a three-year-old child who has had four or more episodes of wheezing in the last year is much more likely to develop lifelong asthma if the following conditions are met:
There must be one main decisive factor:
- parent with asthma,
- diagnosed eczema or atopic dermatitis,
- sensitivity to airborne allergens. Determined by a doctor with positive skin tests or blood tests for allergens — trees, grasses, weeds, mold or dust mites.
Or two minor deciding factors:
- food allergies,
- more than 4% of eosinophils in the blood (a type of white blood cell often seen in allergic diseases),
- wheezing, except in case of a cold.
Api index is based on combinations of major and minor criteria. It was developed after observing almost a thousand children under the age of 13. It turned out that a wheezing child with a positive API at the age of 2 to 3 years with an 80 percent probability will go to the first grade with a diagnosis of «bronchial asthma«.
Using this criterion, doctors and parents can more closely monitor developing asthma symptoms and more quickly connect medication therapy.
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