This article was co-written by Dr. Robert Chilcote, Imperial Valley Child Asthma Program consultant

Asthma is the leading cause of chronic illness in children. It affects as many as 10%-12% of
children in the U.S. and, for unknown reasons, is steadily increasing. It can begin at any age, but
most children have their first symptoms by age 5.

What Makes a Child More Likely to Develop Asthma?

There are many risk factors for developing childhood asthma. These include:

• Presence of allergies
• Family history of asthma and/or allergies
• Frequent Viral respiratory infections
• Low birth weight
• Exposure to tobacco smoke before and/or after birth
• Being male
• Being raised in a low-income environment

Why Are More Children Getting Asthma?

No one really knows why more and more children are developing asthma. Some experts suggest
that children are being exposed to more and more allergens such as dust, air pollution, and
second-hand smoke. These factors all are triggers of asthma. Others suspect that children are not
exposed to enough childhood illnesses to build up their immune system. It appears that a disorder
of the immune system where the body fails to make enough protective antibodies may play a role
in causing asthma.
And still others suggest that decreasing rates of breastfeeding have prevented important
substances of the immune system from being passed on to babies.

How Can I Tell If My Child Has Asthma?

Signs and symptoms to look for include:

• Frequent coughing spells, which may occur during play, at night, or while laughing. It is
• important to know that cough may be the only symptom present.
• Less energy during play
• Rapid breathing
• Complaint of chest tightness or chest "hurting"
• Whistling sound (wheezing) when breathing in or out
• See-saw motions (retractions) in the chest from labored breathing
• Shortness of breath, loss of breath
• Tightened neck and chest muscles
• Feelings of weakness or tiredness

Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary
from asthma episode to the next episode in the same child. Also note that not all wheezing or
coughing is caused by asthma. In kids under 5 years of age, the most common cause of asthma-like symptoms is upper
respiratory viral infections such as the common cold. If your child has problem breathing, take him or her to the doctor immediately for an evaluation.

How Is Asthma Diagnosed In Children?

Asthma is often difficult to diagnose in infants. However, in older children the disease can often be
diagnosed based on your child's medical history, symptoms, and physical exam.

• Medical history and symptom description. Your child's doctor will be interested in any historyof breathing problems you or your child may have had, as well as a family history of asthma, allergies, a skin condition called eczema, or other lung disease. It is important that you describe your child's symptoms -- cough, wheezing, shortness of breath, chest pain or tightness -- in detail, including when and how often these symptoms have been occurring.
• Physical exam. During the physical examination, the doctor will listen to your child's heart and lungs.
• Tests. Many children will also have a chest X-ray and pulmonary function tests. Also called lung function tests, these tests measure the amount of air in the lungs and how fast it can be exhaled. The results help the doctor determine how severe the asthma is. Generally, children younger than 5 are unable to perform pulmonary function tests. Thus doctors rely heavily on history, symptoms and examination in making the diagnosis.
• Response to medication: children with cough and wheezing that respond well to asthma medications, such as albuterol, likely have asthma. Other tests may also be ordered to help identify particular asthma triggers. These tests may include allergy skin testing, blood tests and X-rays to determine if sinus infections or gastroesophageal reflux disease (a gastrointestinal condition that causes reflux of acid stomach contents into the esophagus or even into the lungs) is complicating asthma.