3 things you might not know about childhood asthma

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Asthma is one of most common chronic diseases of childhood; almost 9% of children in the United States suffer from it. And yet I find it's a disease that lots of people don't understand — even parents of children with asthma.

Lungs are made up of lots of little tubes that lead into bigger tubes; they look almost like sponges. In asthma, the tubes get irritated and narrowed, making it hard for air to get in and out. Lots of different things can cause that irritation, such as allergies, cold air, chemicals in the air, exercise, the common cold, or even stress.

As a pediatrician, I see children with asthma almost every day — and have lots of conversations with their families. Over the years, I've found that there are lots of misunderstandings about asthma, and those misunderstandings can cause real problems for children with asthma.

Here are three things you might not know about childhood asthma.

1. The symptoms can come and go

Many times, I've had parents tell me that their child doesn't have asthma because they hardly ever wheeze. It's certainly possible — common, even — to have some wheezing with a bad cold or lung infection and not have asthma. But if that has happened a couple of times or more, then we generally call that asthma.

It's understandable to want to dodge the diagnosis — who wants their child to have a chronic disease? But it's actually really helpful to make the diagnosis, because that way we can be watchful and figure out what triggers a child's symptoms. Once we know the triggers, and know the signs that an asthma attack is beginning, there is so much we can do to help the child. We can avoid triggers, like by staying away from cats, or doing lots of hand washing to avoid illness. We can manage the triggers, like by wearing a scarf over the mouth and nose in cold weather, or by using an inhaler before vigorous exercise. We can be sure they get a flu shot, as influenza can make children with asthma very sick.

The goal is always to help children with asthma lead the healthiest, most normal lives possible. We can't even begin to do that if we don't make the diagnosis.

2. You can have asthma without hearing a wheeze

The wheeze is often not at all obvious; you may need a stethoscope and trained ears to hear it. Also, some children with asthma don't wheeze at all: they just cough. Coughing is the main symptom of asthma in most children. It's how the body tries to get and keep those airway tubes open.

Now, of course there are plenty of other reasons that children might cough. The common cold and postnasal drip from allergies are the most common. But if your child coughs often at night or after exercise, has a frequent nagging dry cough, or gets a really bad, lingering cough with colds, you should talk to your doctor because it could be asthma.

3. Asthma is really treatable

As I said above, what we most want is for children with asthma to lead healthy, normal lives. And here's the thing: we can make that happen. Not only can we work to avoid and manage triggers, and not only can we use medications to relieve the symptoms; there are medications we can use that can prevent them. A steroid inhaler or other preventative medication, used every day or during periods when asthma is worse or might get worse, can make all the difference. While some parents get nervous about using steroids, the dose is very low — and while some families find daily medications challenging, there are all sorts of strategies to make it work. It's worth it. For some children, preventative medication can be the difference between wheezing all the time and not wheezing at all.

Which, you have to admit, is pretty great. So if your child has asthma, or you think they might have asthma, talk to your doctor and get your child started on the healthy, happy life they deserve.