By Scott Schroeder, MD, Tufts Medical Center
My 2-year-old has battled asthma-like conditions since he was a baby. Colds and viruses tend to settle in his chest, and we spend a lot of quality time with the nebulizer over the winter months, especially. Our pediatrician advises us not to worry, saying most children "outgrow" this condition by the time they reach 5. Do you find this true in many cases, and how does a child "outgrow" asthma?
Every parent knows what it is to hear their child lying in bed, coughing at night -- it is awful -- especially when you feel like there is no way to "fix" it.
Good news? The circumstances you are describing are very, very common. Most often, what you are describing is called "Reactive Airway Disease" (RAD) and, yes, many babies and children will outgrow it. And if it is any consolation: five U.S. Presidents had asthma.
If your child was born full-term with no eczema or allergies, but has repeated colds resulting in the symptoms you have described, it is RAD, rather than asthma. RAD is responsible for these exact symptoms that occur in babies and children under the age of 5. Boys often suffer from RAD more than girls, because for the most part boys are born with smaller airways than girls. When they get colds, their smaller airways fill up with fluid that causes coughing and wheezing. As they get older, the airways increase in size and capacity -- literally outgrowing the problem.
This is not to say that these symptoms may not also be an indication of asthma for some, though it is far less likely. Family history and the child's own health history can help determine if they are more likely to be suffering from asthma. And we want to always do whatever we can to avoid a child developing asthma, which is why medicines are given to children to help prevent them developing it.
For some children, the problem is more than RAD, and some early symptoms to pay attention to can help when talking with your child's pediatrician. For many children, the symptoms worsen at night --and your child's doctor is not able to witness the issues firsthand. If your child has a significant cough at night that wakes them up repeatedly, is not drinking normally, has belly breathing (a rocking motion when they breathe), or breathing faster than normal -- these can be indications of something else, including asthma, and will help your doctor in making determinations about the root cause.
If you are concerned about asthma, it is also important to pay attention to your child's breathing and coughing between colds. Colds usually last 7-10 days, but for a child with asthma or RAD, colds can last up to 14 days or longer. In between colds, their breathing should be normal and they should not be coughing or wheezing at night. Conversely, if symptoms seem to abate during the summer, that is always a good indication.
You know your child best. If they are presenting symptoms that concern you, it is always best to talk with their pediatrician about their individual situation and symptoms.
Dr. Scott Schroeder, MD, is Chief, Division of Pediatric Pulmonology & Allergy, at Tufts Medical Center. He specializes in childhood asthma, cystic fibrosis, chronic lung disease of infancy, and pulmonary problems in children with primary immunodeficiencies.