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Asthma in toddlers with infants

Asthma in toddlers while wheezing infant has confused health professionals for years. Many physician training programs taught that a child should not be diagnosed as having asthma before the age of two or, in some instances, age four. Other terms such as “reactive airways disease,” “chronic bronchitis,” or “recurrent bronchiolitis” were used to describe infants and toddlers with recurring cough, wheezing, or labored breathing.

Asthma in toddlers  and infants using method online quotes

The current definition of asthma does not exclude any age group. In fact, guidelines from the National Institutes of Health make specific mention of the asthma in toddlers with asthma in infants. The diagnosis of asthma is based not on age but on a child’s medical history and physical examination. If an infant or toddler meets the criteria and other possible diseases are excluded, the child is diagnosed with asthma. Yet there are some differences between infants and toddlers with asthma and older children and adults with asthma. Parents need to understand the special considerations for this youngest age group.

Asthma in toddlers and infants using method online quotes
Asthma in toddlers and infants using method online quotes

The cold connection

Many different types of triggers can cause an asthma flare in older children and adults. In infants and toddlers, however, the most common trigger is a cold caused by a respiratory virus, known as a “viral upper respiratory tract infection,” or URI. The usual pattern for an infant with asthma starts with a cold, then the cough gets worse, and finally labored breathing and wheezing begin. In young children whose asthma is not well controlled, other nonspecific irritants such as smoke or fumes can also trigger asthma symptoms and asthma in toddlers. Allergies play a smaller role in these early years, although some children show allergic tendencies quite early in life.
Studies of the development of asthma have followed a large group of children from birth. These studies suggest that babies and toddlers with asthma fall into two categories:

Group One

The first group has asthma symptoms until age four or so and then no longer shows any symptoms. These infants and toddlers have asthma symptoms only with colds and have none when they are well. Parents of children in this group tend not to have asthma in toddlers. Children in this group usually don’t have any signs of allergies, such as eczema. This is the only group that seems to “outgrow” asthma. Young children who have asthma symptoms only with colds might be treated with asthma medicines from the first sign of a cold until the last symptom is gone, and they may not need to take controller medicines in between asthma in toddlers and asthma in infants. Consider this child’s situation:
Brenda got her first cold when she was two months old. The first day she had a runny nose, then she started coughing. The next day the runny nose disappeared, but the cough grew worse in severity and occurred during sleep. She also developed a “rattle” in her chest. Her cough continued for two weeks despite cough medicine and then gradually went away. She caught another cold a month later and almost immediately developed a hacking cough and chest congestion. Her pediatrician heard wheezing and prescribed albuterol by nebulizer. The albuterol helped temporarily, but her symptoms returned four hours later. These symptoms hung on for two weeks before disappearing. This pattern continued through a few more colds with asthma in toddlers.
During a well-baby visit, Brenda’s pediatrician prescribed an inhaled steroid to go along with the albuterol and advised her parents to start the medicines at the first sign of a cold. A month later, they began giving her medicines the first day her nose started running. This time her cough only lasted three days and seemed less severe. This plan was used for each cold, and the cough and wheezing were easily controlled.
In the spring following Brenda’s third birthday, her doctor recommended stopping this plan. Brenda had several minor colds over the next few years, but the harsh cough and wheezing never returned while using asthma in toddlers.

In youngsters like Brenda, asthma symptoms appear only with colds. Using a quick-relief medicine alone (albuterol) decreases the symptoms for the moment, but they return over two weeks. Adding an anti inflammatory medicine (the inhaled steroid) to the albuterol at the first sign of a cold controls symptoms so they are not as severe and do not last long. This plan may work in some cases, but in other cases a child may need to take an anti inflammatory medicine every day even when well to prevent asthma symptoms during colds with asthma in toddlers.

Asthma in infants easy using guidelines

Asthma in toddlers in the second category, Asthma in infants and toddlers have symptoms not only during colds but also in between colds. Parents of children in this group usually have a history of asthma, and these children are more likely to show some form of allergic disease. They do not outgrow their asthma, although there may be periods of remission later in life. Some children in this group also experience a decline in lung function.

Asthma in infants easy using guidelines
Asthma in infants easy using guidelines

Young children who have symptoms in between colds benefit from daily controller therapy to guard against the inflammation that causes symptoms. Children in this group tend to have asthma in toddlers symptoms that are more severe and more difficult to control. Daily controller medicines may also guard against loss of lung function. Compare Brenda’s case with Michael’s below:

Four-month-old Michael developed a hacking cough, wheezing, and labored breathing after getting his first cold. His mother, who has had asthma all of her life, recognized the symptoms immediately and took her son to the doctor’s office. Michael was admitted to the hospital with “bronchiolitis” and treated with nebulized albuterol and oral prednisone. He was discharged with a nebulizer, and his parents were given instructions to give albuterol by nebulizer if the wheezing returned.

In the months following the hospitalization, Michael had several wheezing episodes. The albuterol made the wheezing disappear for a time. He also developed eczema. With the next cold, Michael had severe labored breathing despite several albuterol treatments and was hospitalized again. This time, he was diagnosed with Asthma in toddlers, and a daily inhaled steroid was prescribed as maintenance therapy. Two weeks later, the episodic wheezing stopped.
With each cold, he experienced three to five days of harsh coughing and wheezing, but these symptoms were easily relieved with albuterol. Throughout his school-age and teen years, Michael continued to have brief, mild bouts of wheezing in response to a variety of triggers, and his symptoms got worse whenever the daily medicines were withdrawn Asthma in toddlers.

His mother’s history of asthma, the appearance of eczema, and his wheezing in between colds suggested that Michael would have persistent asthma beyond infancy. Children like Michael need daily anti inflammatory therapy to decrease asthma in toddlers, prevent asthma flares, and maintain good lung function.

When your infant or toddler is diagnosed as having asthma, keep in mind that he has about a fifty-fifty chance of “outgrowing” asthma in toddlers. The chances of outgrowing it are better if all of the following are true:

  • Your child only wheezes with colds.
  • Neither parent has asthma (diagnosed by a physician).
  • Your child does not have eczema (diagnosed by a physician).
  • Your child does not have other signs of allergies.

No matter which group your child is in, he may need daily controller therapy with an anti inflammatory medicine. You must also have an asthma management plan to use when your child has Asthma in toddlers, even if daily medicine is not prescribed. You should be able to evaluate your young child for wheezing or labored breathing, because infants and toddlers cannot tell you how they feel or describe their Asthma in toddlers.

Remember: a wheeze is a continuous musical noise when a child breathes out. Signs of labored breathing include breathing fast, flaring nostrils, and when the skin in between the ribs and underneath the rib cage seems to get sucked in, a sign called retractions. Review these signs with your child’s doctor or nurse practitioner so you can recognize them early and act promptly.

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