Asthma in Infants

Few things are as unsettling as a sick baby, struggling to breathe – especially when it's yours! And, figuring out the source of the problem can be a bit of a puzzle, particularly if your infant has asthma.  That's because asthma in infants can have many faces. Babies with asthma often have sudden, severe wheezing and trouble breathing, just as older children do. But asthma in infants may also show up as chronic coughing, noisy breathing, or "chest colds."

            Asthma is a chronic lung disease. It makes the airways swell, tighten, and produce too much mucus. Severe asthma attacks can require a trip to the emergency room. And, uncontrolled asthma can damage the lungs over time. So, this is not something to ignore. If your baby has unexplained respiratory symptoms, stay alert and in communication with the pediatrician. Be prepared to tell the doctor how and when symptoms get worse. This can help rule out problems and confirm a diagnosis of asthma.

            If anti-asthma medications relieve any wheezing and coughing, the diagnosis is pretty clear. But in some cases, other asthma mimics need to be ruled out. These include viral infections or congenital conditions or diseases such as cystic fibrosis. If it turns out your baby does have asthma, you may be wondering what caused it and what to do next! Although no one really knows the cause, your genes may play a role. Other factors may also come into play. Some doctors think breastfeeding the first year can help prevent asthma, but the evidence doesn't yet support this.  

            Keeping your baby away from common asthma triggers such as cigarette smoke, aerosol sprays, pet dander, and dust mites may lessen symptoms of asthma. If you suspect a certain food is causing an allergic reaction, this could also trigger asthma. Remove the food from your baby's diet, and then reintroduce it, to see what happens. However, it's hard to do very much about other common triggers, such as crying, respiratory infections, and weather changes.

            Prescription anti-inflammatory medications are the other mainstay of asthma treatment for infants. Your baby may need a combination of different types of medications. Be clear about whether you should give medication continuously or only when symptoms appear. A nebulizer uses forced air to send out a mist of medication that your baby can breathe through a mask. Don't be alarmed if it takes a little while for your baby to get used to this. If your child is a toddler, it may be possible to use an inhaler with a spacer (a small tube).

            Are you concerned about trying these medications in such a small child? Remember that, along with your child's pediatrician, I can help guide you in their safe and effective use. But whatever you do, don't put off seeking care – even if you think your child may "outgrow" this problem. Some kids' asthma does get better with time, but the best results come with adequate treatment.