4 August: Q&A with Dr Steven Conway

I am worried that my four year old may be developing asthma. It doesn’t run in the family so I am not over familiar with the symptoms. He coughs a lot, particularly at night and if he is running around during the day, he quickly becomes short of breath and wheezes.

Do you think this could be asthma and if so, is he likely to need any treatment? Would it be something he could grow out of?

Dr Steven Conway, Consultant Paediatric Surgeon replies:

Asthma may first present in pre-school age children. There is often a family history of eczema, hay fever, or asthma but absence of these does not exclude the diagnosis.

Night time cough and shortness of breath with wheezing on exercise are symptoms of asthma but also occur in other respiratory illnesses. It is therefore important that your child is assessed by your general practitioner. A detailed history of your child’s symptoms is the best way to make the diagnosis. If there are concerns simple investigations such as a chest x-ray can be requested.

 If asthma is thought to be the most likely diagnosis your GP may proceed with a trial of anti-asthma treatment. This will usually be simple inhalation of aerosol medication designed to increase the airway diameter and reduce airway inflammation. If your child’s symptoms settle with this treatment the diagnosis of asthma is supported.

Asthma is certainly the most likely diagnosis if your child is well between the coughing/wheezing episodes. Most children will grow out of mild asthma symptoms, although intermittent symptoms can recur later in life.

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