When a child's cough could mean asthma

Although asthma is a lifelong condition, it can be well-managed with the proper medications used at the right times. — Positive Parenting

My granddaughter had a cough that went on for three months. At first, we thought she was having a prolonged respiratory infection. We took her to the GP (general practitioner) and she was given antibiotics. But the cough didn’t go away. We didn’t let her drink anything cold. Finally, we took her to a child specialist (paediatrician), who said she has asthma. I thought asthma was associated with wheezing?

Asthma can present with different symptoms from child to child.

Even for the same child, the symptoms can differ from one episode to another.

Coughing is actually a very common symptom of childhood asthma. It is also often the only symptom.

It can occur when the child is exerting themselves, such as when they are playing or laughing.

It can occur at night, and also just after waking up.

Naturally, other symptoms include shortness of breath and wheezing.

The child may experience a tight chest, or even chest pain.

You may even observe the child trying very hard to breathe by the obvious in-and-out movements of the area between his ribs and neck.

In addition, the child may be tired, irritable, or have trouble eating.

Most children who develop asthma get it by the age of five years.

So my grandchild is having an asthma attack every time she coughs?

An acute exacerbation of asthma is also called an asthmatic attack.

Your grandchild is only having an attack if the symptoms get a lot worse.

This is occurring when she has a sudden fit of severe coughing, rapidly increasing shortness of breath, trouble speaking, or even turning pale or blue in the face.

Your grandchild then needs medical intervention, such as a reliever inhaler.

If the attack is severe, you may even need to rush her to the accident and emergency department.

What causes childhood asthma? Her parents don’t have asthma. Neither do I.

No one knows exactly why some children have asthma, but it has something to do with their developing immune system.

Asthma does run in families, but it is not always the case.

There may also be certain things in the environment that change the way your child’s lungs develop and their immune system.

For example, when the haze occurs, there are typically a lot more asthmatic attacks.

Similarly, children who live in urban areas with a lot of smog and pollution are at greater risk of getting asthma than children who live in less polluted rural areas.

Children who get frequent respiratory infections are more likely to get asthma.

Such infections can also exacerbate attacks for children who already have asthma.

Allergies also tend go together with asthma.

In addition, there is a higher risk of asthma if the child is frequently exposed to tobacco smoke.

What causes the coughing and wheezing in asthma?

When a child has asthma, the walls of their bronchial airways are inflamed and swollen.

This narrows the airways, which causes the wheezing sound.

At the same time, the membranes may secrete a lot of mucus to try to clear any pollutants in the lungs.

The child may cough to try to clear this mucus out.

How will I know if my grandchild has asthma and not some respiratory infection?

Asthma is a chronic illness, so it is a cough or wheeze that persists beyond a few days or weeks.

A respiratory infection is acute and will usually subside after a few days or weeks.

A wheeze is more characteristic of asthma than an infection.

You will need to go to the doctor – preferably a paediatrician – and get a diagnosis.

Your grandchild will likely have to undergo some tests, such as a lung function test to measure the airflow in her lungs, a skin test for allergens, and a chest X-ray to rule out pneumonia and other causes.

Is childhood asthma a lifelong condition?

Yes.

The good news is that half of children who have asthma will experience a decrease in their symptoms by the time they become adolescents.

So childhood asthma can be outgrown.

However, it can return in adulthood for some people.

Even if you have asthma, you can control it and live as normal a life as possible.

What medicines are available to treat it?Asthma symptoms, like wheezing, are controlled by short-term relief medications such as short-acting beta-2 agonists or anticholinergics.

Steroids are also given to reduce inflammation.

Sometimes, your child needs to take these by nebuliser.

Then there are longer control medications, such as steroids, leukotriene modifiers and long-acting beta-2 agonists.

Will long-term steroids stunt my child’s growth?It has been shown that children who take long-term inhaled steroids may be half an inch shorter than children who don’t.

So yes, steroids do affect growth, but not that much. It is not as bad as people used to think in the past.

Contrast this to the ill effects of an asthma attack, which is possibly life-threatening, and you can evaluate the risk-benefit ratio.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.