Pediatric breathing problems
Alan Adler, MD, is a pediatric pulmonologist with Banner Children’s Medical Group at Banner Thunderbird Children’s Center.
Question: Does my child have asthma?
Answer: Many infants and young children have wheezing—a high-pitched whistling sound—when they have a cold. Although this could be a sign of asthma, most infants (about 65 percent ) who have “wheezing” don’t have asthma and will usually stop wheezing by the age of 5 years. The diagnosis of asthma is more likely when someone else in the family, either the mother, father or a sibling, has asthma or the child has had eczema, a recurrent red scaly rash of the neck, elbows, arms or knees. Of course, anytime your child's breathing seems abnormal to you, you should consult with your doctor.
Question: What is RSV? Will it hurt my baby?
Answer: Respiratory Syncytial Virus (RSV) is an extremely common infection which comes around every winter. Everybody has been exposed to RSV by 2 years of age. In most of us, RSV simply causes a cold. In infants and young children, RSV can cause a form of pneumonia known as bronchiolitis because children have smaller bronchial tubes that are easily blocked. It has often been said that if a child has RSV during infancy, the child will be destined to get asthma later on. This has been debated for years and nobody really knows the answer. It is a case of the chicken and the egg. Which came first, the RSV infection or the predisposition to have asthma or wheezing? Some children do have wheezing and asthma after an RSV infection, but many other children never wheeze again, and remember, 2/3 of all infants who wheeze grow out of it by the time they’re 5 or so.
Question: My child often sounds congested or noisy but doesn’t seem to be sick. What should I do?
Answer: There are many reasons for a child to have congested-sounding breathing: a stuffy nose and large tonsils are two of the most common reasons but there are many more. You should be concerned if the congestion is chronic, that is, if it occurs even when your child isn’t sick or if the congestion interferes with sleep (either theirs or yours), eating, or the child’s ability to speak clearly. If your child always seems to breathe through their mouth or requires more effort for each breath than you think they should, you should discuss this with their doctor.