Home Health DR. DAVID WONG: Not easy to tell if a young child has asthma

DR. DAVID WONG: Not easy to tell if a young child has asthma

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Dear Dr. Wong: Our daughter is 15 months old. For the past few months, I have been sick since I started going to daycare. Each time she started with a cold, which invariably developed into a bad cough that lasted for weeks, she finally got better, then she caught a cold and got sick again.

I was thinking of taking her to the emergency room because she coughed so much at the end that she was coughing up mucus and was lethargic. Luckily, I was able to get in touch with the Nurse Practitioner. He suggested she might be somewhat dehydrated from her vomiting and advised me to nurse her for longer.After a few hours of feeding, she was fine. and gradually recovered.

I grew up with pretty severe asthma and her cough reminded me of coughing when I was younger. Much better now but still have exercise induced asthma and use an inhaler occasionally How can I tell if my daughter has asthma?

answer: I am very happy that your daughter is getting better with more milk from you. When she was sick and coughing, she was breathing rapidly and coughing up her mucus, all of which contributed to her dehydration which made her lethargic. There is a possibility. I got good advice from my nurse practitioner.

Due to the COVID-19 pandemic, many children were at home and had little contact with other children. As pandemic rules eased, children started attending schools and daycares. Respiratory viruses include exposure and immunity to common respiratory viruses such as the common cold-causing rhinovirus, influenza virus, and respiratory syncytial virus (RSV), not to mention the COVID-19 virus. It circulates naturally among almost no children.

When your daughter was exposed to one of these viruses, she developed cold-like symptoms such as stuffy or runny nose, sore throat, fever and cough. I get sick for days, but the cough is usually not that bad. Some people develop complications such as ear infections, sinus infections, and pneumonia.

It can be difficult to tell if a young child has asthma. As you may already know, asthma is a genetic disease. One or both parents usually have a history of asthma. Adults can have pulmonary function tests. People with asthma have narrowed bronchi. These bronchi can be relaxed after taking a bronchodilator inhaler. However, this test is very difficult to do in young children. Some centers can perform modified pulmonary function tests in young children for research purposes only.

Symptoms of asthma in young children include a long, hard cough when they catch a cold. Very often, cold symptoms can last for weeks and may include coughing and spitting up mucus. A wheezing sound may be heard when the parent breathes. In severe cases, these children can breathe very quickly and parents may see their chest sucked in between their ribs or under their ribcage.

Although not uncommon, doctors may not be able to determine if a child has asthma at an early age. Listening to chest sounds with a stethoscope may not tell you anything. Doctors may have to rely on the pattern of coughing when sick, and the frequency and duration of these episodes. A course of steroids may be prescribed.

Since you have a history of asthma, it is possible that your daughter will develop asthma. You may want to eliminate common indoor triggers such as ticks, mold, and certain household pets. Asthma symptoms are more common in spring and autumn.

In the meantime, if you have not yet been vaccinated against influenza or COVID-19, you should consider getting vaccinated against these viruses. Whether she has asthma or not, both can make her quite ill.

Dr. David Wong is a retired Summerside pediatrician and recipient of the Canadian Academy of Pediatrics’ 2012 Distinguished Community Pediatrician Award. His column is published in The Guardian on the last Tuesday of each month. A collection of his previous columns can be found at his URL below. askdrwong.caIf you have any questions for Dr. Wong, please mail them to Prince County Hospital, 65 Roy Boates Ave., Summerside, PEI, C1N 2A9.

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