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How old does a child need to be to be tested for asthma

Postby ChazBobBonz81 on Mon Apr 14, 2014 11:16 pm

Hello, my son is now four year old and the past two years, he has had seven horrible breathing episodes, where he wakes through the night gasping for air. I have tried not to panic, but it is hard when your child can not catch their breath. He has an inhaler now, but this does nothing for him at the time of an episode. He has been to a and e each time he has had an episode and all apart from one doctor who said that it could be asthma, have said that it is croup. Is is possible to get croup so bad that you cant breath? My son is healthy and well apart from these episodes. There is no history of asthma in my or my husbands family, yet his older brother has terrible eczema on his legs which also myself and my partner have never had before. Can somebody please tell me their thoughts on my four year old sons breathing episodes?

Thank you in advance.
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Re: How old does a child need to be to be tested for asthma

Postby Kathryn Dewdney on Fri Apr 18, 2014 10:08 pm

Hi,
Most children under the age of 5 years cannot perform spirometry or peak flow readings which are the tools used in diagnosing asthma; a diagnosis is therefore made on the probability of asthma on clinical assessment.
The following are clinical features that increase the probability of asthma, taken from the asthma guidelines:-
1. More than one of the following symptoms – wheeze, cough, difficulty breathing, chest tightness – particularly if these are frequent and recurrent; are worse at night and in the early morning; occur in response to, or are worse after, exercise or other triggers such as exposure to pets; cold or damp air, or with emotions or laughter; or occur apart from colds.
2. Personal history of atopic disorder
3. Family disorder of atopic disorder and/or asthma (you mention that a family member has bad eczema)
4. Widespread wheeze heard on auscultation - heard with a stethoscope.
5. History of improvement in symptoms or lung function in response to adequate therapy.

If asthma is suspected a trial of inhaled corticosteroid is advised. This has to be taken regularly to be effective.
You say that your son has been given an inhaler, but do not state which type. The corticosteroid inhaler (preventer) is usually brown and works by reducing the inflammation in the airways. It needs to be taken even when your son does not have symptoms for the duration of the trial; if his episodes of breathing difficulties improve this may indicate that he should be treated for asthma. The bronchodilator inhaler (reliever) is usually blue and works by relaxing the muscle in the airways, thus making the airways wider. The reliever inhaler is used when someone has symptoms. The aim of treating someone with asthma is for them to be symptom free, so if the person needs to use this inhaler on a frequent basis they should see the doctor/nurse to be reassessed.
Asthma and croup share many features and if the attacks are severe both can need urgent intervention.
Croup is caused by a viral infection which can cause inflammation on the inside lining of the breathing tube. There may also be a lot of thick mucus. A combination of these can cause narrowing of the breathing tube. The narrowed tube may cause noisy breathing (stridor). Breathing may become difficult if the narrowing becomes worse.
The cough in croup is usually harsh and barking, this is due to inflammation and swelling of the vocal cords in the larynx.
Other symptoms more specific to croup are a runny nose, hoarseness, and sore throat. Croup may follow a cold, but can also appear without any earlier illness. Other cold or flu-type symptoms may also occur, e.g. fever, feeling unwell, being off food, and general aches and pains.

Seven bad episodes and the fear of more in the future must be a worry for you. It is usual for either the hospital or the GP to follow up patients if they have attended A&E. I would certainly discuss the possibility of a corticosteroid inhaler trial with your GP if this has not already taken place.
I hope this has been helpful.
Kathryn Dewdney
Asthma Nurse
Alex Curtis Trust
Forum Moderator
talkhealth moderation team
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Re: How old does a child need to be to be tested for asthma

Postby jackedison on Wed May 07, 2014 11:48 am

There are chances that your son could be suffering from asthma, as croup is a condition that causes inflammation of upper airways and a sound occurs when the child struggles to breathe.Croup does not last for more then 6 days.Hope the doctor has done tests such as neck xray that would reveal it is croup.
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