Asthma

Asthma is a lung condition that affects 23 million Americans, including 6 million kids. People with asthma may cough, wheeze, or have trouble breathing.

Is Your Child’s Asthma Under Control? Take Our Assessment

If your child has asthma, it can seem like you’re fighting an invisible enemy. Youngsters with asthma often seem perfectly healthy, just like any other kid. But things most children can shrug off—a simple cold or a bout of exercise—can land the asthmatic child in the hospital if the respiratory disease is not well controlled by medication.

What’s so maddening, as a parent, is not knowing if you have a lid on asthma. When that trigger comes—be it mold, pollen, dust, a cold, or pet cat—will your child’s asthma escalate out of control?

The bottom line is, it’s hard to tell—but not impossible. Your child may be coughing at night, but there are ways to tell how much coughing is too much. And, sure, your child may need to use a rescue inhaler, but if he or she needs it too often, it’s an indicator that he or she could be edging into the danger zone.

If your child is ages 5 to 11, you can use this assessment tool to help determine if his or her asthma is under control. (This tool, which was adapted from asthma guidelines issued by the National Heart, Lung, and Blood Institute, in 2007, is not designed to replace a consultation with a doctor. Nor should it be used for children under age 5 or 12 and older.)

1 .  My child has asthma symptoms such as coughing or wheezing:
A. No more than two days each week and never more than once a day (+1 point)
B. Several times a day on at least two days a week, or more than two days each week (+2 points)
C. Throughout the day (+3 points)

2 .  My child has coughing or has wheezing that wakes him or her up at night:
A. Once a month or less (+1 point)
B. Twice a month or more (+2 points)
C. Twice a week or more (+3 points)

3 .  My child needs to use his or her rescue inhaler or nebulizer:
A. Two days a week or less (+1 point)
B. More than two days each week (+2 points)
C. Several times per day (+3 points)

4 .  When it comes to my child’s daily life, asthma symptoms:
A. Never limit his or her activities (+1 point)
B. Cause some limitation (+2 points)
C. Extremely limit activity (+3 points)

5 .  My child has had asthma symptoms so severe he or she needs a course of oral corticosteroids:
A. One time per year or not at all (+1 point)
B. More than twice per year (+3 points)

If your score is 5 points:

Based on symptoms alone, experts would consider your child’s asthma to be under control. You should make sure your child continues to take medication carefully and correctly, and be sure to see your doctor within one to six months.   Another way to measure asthma control is to check peak flow, which can be done at home with a peak flow meter. If peak flow is more than 80% of your child’s personal best, asthma is under control. If it’s 80% or less, asthma is not well controlled.

If your score is 6 points or more:

Based on symptoms alone, your score suggests that your child’s asthma is not as well controlled as it could be. Talk with your doctor as soon as possible to see if your child is taking the right amount and type of medication.   Another way to measure asthma control is to check peak flow, which can be done at home with a peak flow meter. If peak flow is more than 80% of your child’s personal best, asthma is under control. If it’s 80% or less, asthma is not well controlled.

Why You Need to Take Asthma Medicine, Even If You Feel Fine

Carolyn M. Kercsmar, MD, the director of the asthma center at Cincinnati Children’s Hospital Medical Center, recently had a 10-year-old patient who decided, on his own, to stop taking his asthma medicine—crucial maintenance steroids he was supposed to take regularly.

His reasoning: He felt fine and hadn’t had any asthma attacks for a while, so why bother? Dr. Kercsmar performed a series of tests, and it was clear his lung function was compromised, even though he didn’t have any coughing, wheezing, shortness of breath, or other signs of asthma. She made sure he knew that he needed to start his asthma medication again.

“We were to come into pollen season, which could have triggered his asthma symptoms, possibly leading to an emergency room visit or hospitalization,” she says.

Generally, asthma can be categorized into two classes: intermittent asthma, in which symptoms occur less than three times a week, and chronic asthma.

People with intermittent asthma can often get by using only a short-acting or “rescue” inhaler when symptoms develop. Those with more chronic asthma and more frequent flare-ups (like Dr. Kercsmar’s 10-year-old patient) need to take a maintenance medication to reduce inflammation between attacks. “The goal of asthma treatment is to prevent, prevent, prevent,” Dr. Kercsmar says.

Unfortunately, patients failing to take their maintenance medication is an all-too-common scenario. People may take medication incorrectly, in an erratic stop-and-start fashion, or just flat out skip it. It’s not that people with asthma are trying to dupe their doc. Asthma can be a sneaky foe. Most people feel perfectly fine, until they very quickly don’t. All it takes is a rise in pollen counts, a common cold, a chance encounter with a cat, a change in temperature, or a bout of exercise to send a patient into the danger zone. The problem? It’s hard to predict when that will happen.

“It can be hours, days, weeks, or months, so it’s pretty easy for patients to be lulled into a false sense of security,” says Dr. Kercsmar. “It’s an incredibly variable disease that can be punctuated by flare-ups, but the time between flare-ups can be variable.”

Asthma Symptoms

While asthma symptoms seem straightforward—coughing, wheezing, and shortness of breath—it’s not always easy for doctors to definitively diagnose the condition. It can be hard to determine if a chronic cough is asthma, a lingering respiratory ailment, or something else. Symptoms like wheezing can come and go, or coughing may only occur at specific times, such as at night or with exposure to pollen or other triggers.

To learn more about the symptoms of asthma in children, check out the following information from our A–Z Health Library. Asthma symptoms in adults are very similar to those in children.