A common misconception that asthma is a disease of adults has been completely disproved in recent years. If there is convincing evidence in the form of clinical data and examination results, the doctor can make such a diagnosis to a baby who has not yet turned 2 years old. However in every age bronchial asthma It has its own characteristics, which pediatricians are necessarily aware of. What kind of symptoms can be the reason to suspect this disease in children?
Children of the first 2 years of life
In babies of the first two years of life, the most common debut of bronchial asthma is recurrent broncho-obstructive conditions that develop on the background of acute respiratory viral disease. In most cases, the cause is a respiratory syncytial infection, parainfluenza or influenza. In this case, the child experiences respiratory insufficiency of varying severity: shortness of breath during exercise or at rest, dry unproductive cough, wheezing during expiration, he can see cyanosis of the nasolabial triangle, intercostal spaces drawn in during expiration, etc. These symptoms quickly and effectively stop inhaled bronchodilators (Berodual, Atrovent and etc.).
Outside of a viral infection, the child often does not have any respiratory symptoms, bronchial obstructions do not develop. However, any cold provokes worsening and as a result, the baby suffers obstructive bronchitis 3-6 times over the course of a year.
Often such children have heredity (usually on the maternal line), food allergies, intolerance of dairy products and gluten, aggravated by allergic diseases. In tests, they have elevated levels of eosinophils, immunoglobulin E, and positive allergy tests for various provoking factors can be detected. Very often, asthma appears in babies suffering from atopic dermatitis, allergic rhinitis or conjunctivitis.
Children aged 2 to 5 years
In children from 2 to 5 years, the debut of the disease can also occur in the form of recurrent obstructive bronchitis. Formally, the diagnosis of bronchial asthma can be made if the baby has suffered this disease 3 or more times in the last year. However, as the condition progresses, attacks of bronchial obstruction may develop outside the context of viral infection. They can be triggered by the inhalation of polluted air, tobacco smoke, contact with animals or exercise. Sometimes it can be a long night dry cough with the addition of wheezing on the exhale, while during the day these symptoms are often absent.
These children also often suffer from other allergic diseases (atopic dermatitis, allergic rhinitis or conjunctivitis), and have a poor heredity. Often their mothers smoked, and long before the onset of pregnancy. Such babies, as a rule, are harder to tolerate physical activity, asking for hands after a few minutes of running. After crying or laughing, you may experience shortness of breath or deep, noisy breathing.
Sometimes the diagnostic criterion is a significant improvement after a trial course of inhaled corticosteroids within 2-3 months. The frequency of episodes of bronchial obstruction is significantly reduced, and exercise tolerance improves.
Child aged 6 to 12 years
Doctors often see the following situation: in the first year of life, the baby had atopic dermatitis, at the age of 1 to 3 years allergic rhinitis and conjunctivitis joined him, and from 6-7 years asthma also complements them. This triad of diseases has the name “atopic march” and is an extremely common phenomenon in pediatrics.
In this case, bouts of bronchial obstruction develop in a child upon contact with a very specific allergen (plant pollen, animal fur and epidermis, house dust, etc.). Catarrhal diseases can be more severe, with the possibility of wheezing, choking, shortness of breath and dry cough, but the provocative factor in the form of an allergen comes first.
If the child is promptly started basic therapy, it will minimize the forced restriction of physical activity and he will be able to play sports. However, it is necessary to direct all your strength to identify the causative allergen and the complete elimination of contact with it, the maximum possible enhancement of immunity to combat viral infections.
Bronchial asthma in adolescents
Sometimes it happens that the debut of asthma occurs in adolescence. This is an extremely difficult situation, since adherence to treatment in such patients is not the best. Hormonal restructuring, the appearance of the first menstruation in girls is often the impetus for the appearance of attacks of bronchial obstruction. It becomes harder for such adolescents to endure physical exertion, while running, active walking during classes at school they have to constantly stop to recover their breath.
Treating asthma in adolescents is not an easy task. Often they are ashamed to inhale for fear of ridicule from their peers, they miss doses, which worsen their condition. Often, it is at this age that they begin to smoke, which has a very negative effect on the course of asthma. Going to a doctor with a teenager is a difficult task, as he will avoid this event in every possible way.
Bronchial asthma in a child is permanent. headache for his parents. However, with proper diet, compliance with certain living conditions (especially the child’s room), identification of the causative allergen, exclusion of contact with it and implementation of all medical recommendations, such children are no different from healthy ones. They can attend regular school, sports, music sections, lead an active lifestyle, because the state of long and sustained remission is quite within the reach of most of them. However, the main condition for success is the early detection of asthma and the adequate acceptance of this disease in a child by his parents.