Diagnosing asthma in infants and toddlers can be difficult as many children wheeze and suffer recurrent colds, especially if they go to a crèche or day mother where they’re exposed to other children’s colds and coughs.
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In most cases wheezing in children is a strong indicator of asthma, but not all wheezes are caused by asthma.
Wheezing in young children may also be caused by:
bronchiolitis (a contagious viral infection of the small airways);
cystic fibrosis;
congenital heart disease;
congenital lung disease;
allergies.
Some children also have naturally smaller airways. This may be a result of inherited factors, smoking by the mother during pregnancy, maternal viral illness during pregnancy or if the child is born prematurely.
Research shows that not all children who wheeze go on to develop asthma but, if your child has recurrent bronchitis or cough especially at night or during the early morning, then be on the alert.
Other clues to look out for include:
coughing or wheezing after physical activity, especially running;
symptoms that flare up when exposed to irritants or allergens such as cat dander, perfume or tobacco smoke;
symptoms that seem to be season specific and always occur at the same time each year;
a persistent dry cough starting in the early hours of the morning (2 am).
In older children, performing a lung function test is a good way to measure air flow and lung volumes. If done properly, these measurements provide a reliable and objective way of assessing the diagnosis and treatment of asthma. But it’s difficult to do lung function tests in children until they’re five or six so, if there’s any doubt about whether or not your infant or toddler has asthma, a trial of asthma medication may be helpful. A good response to the medication will suggest that your child is asthmatic.
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