According to the Centers for Disease Control and Prevention (CDC), asthma is the most common chronic condition affecting children in the United States. In 2009, an estimated 10.2 million U.S. children — almost 10 percent of Americans under 18 years of age — have been diagnosed with asthma.
And it is increasing at an alarming rate; up 75 percent from 1980. A rise in asthma cases among infants and toddlers accounts for a large part of the overall increase. One of the difficulties of diagnosing asthma in this group is that it is difficult to safely measure lung function at that age.
In the past, many infants and toddlers with asthma did not get the treatment they needed because they were wrongly diagnosed with chronic bronchitis, wheezy bronchitis, reactive airway disease, recurrent pneumonia or recurrent upper respiratory infections. Doctors were cautious about labeling the symptoms of wheezing and coughing as asthma until they ruled out other possibilities.
But now, the American Academy of Pediatrics (AAP) has developed an Asthma Predictive Index (API), which helps parents recognize the probability of asthma in infants. Most wheezing in infants and toddlers is related to viral respiratory infections. The symptoms of these infections may be difficult to differentiate from early asthma, making diagnosis difficult. The Merriam-Webster Dictionary defines the verb “wheeze” as “to breathe with difficulty usually with a whistling sound.”
The API serves as a guide to determine which infants and toddlers will develop asthma and which will not. According to this diagnostic tool, infants and toddlers who have had four or more persistent wheezing episodes in a 12- month period will have asthma if:
- They have at least one parent with asthma
- They have a clinical diagnosis of asthma (atopic dermatitis)
- They have a sensitivity to allergens in the air, as diagnosed through positive skin or blood tests
Other factors indicating asthma are food allergies, greater than four percent blood eosinophils, and wheezing separate from colds.
The AAP followed almost 1,000 infants and toddlers to age 13; eighty percent of those with a positive API were later diagnosed with asthma. Using the API, parents can be alerted to a higher probability of asthma, so that medication and other treatments will begin at a younger age; this allows asthma symptoms to be controlled better.
If your infant or toddler has a positive API, there are ways to reduce asthma symptoms by controlling allergy triggers in his or her environment. Cover furnishings and bedding in the child’s bedroom, especially pillows and comforters, with allergen-proof casings. Wash all bed spreads, linens and even stuffed animals weekly in hot water (over 130 deg. F). Employ a high-efficiency particulate air filter (a HEPA filter).
The National Asthma Council in Australia has outlined several steps to reduce the risk of asthma in infants and toddlers. Breastfeeding is highly encouraged, as it has unequaled nutritional benefits for your baby and will strengthen his or her immune system. If not breastfeeding, hydrolyzed milk formulas should be used, as they’re associated with fewer incidences of asthma.
Supplements like omega 3 fatty acids and probiotics do not increase asthma incidences. And contrary to what many believe, the presence of pets in the home does not cause asthma. However, children who are allergic to certain animals (such as cats and dogs) may develop allergy symptoms not related to asthma — an estimated 20 to 30 percent of people who have asthma also have pet allergies.
By Eirian Hallinan