When will my child outgrow his asthma?

In a recent article published in Lancet, researchers evaluated 880 patients with asthma and determined those with certain genetic predisposition were much more likely to have more severe asthma which lasted into adulthood.  An additional interesting finding was that this genetic predisposition was independent of family history of asthma.  So just because there is family history of severe asthma, it doesn’t mean that your child would have the same and vice versa.

James T C Li, M.D., Ph.D., answering a question for the Mayo Clinic about children outgrowing asthma, said, “In some children, asthma improves during adolescence and young adulthood. For others, symptoms go away only to return a few years later. Many children with asthma never outgrow it.”

Based on the debilitating effect of asthma, parents should take all the precautions to manage their child’s asthma and not count on them to outgrow it.  This generally means to follow an asthma action plan provided by your physician and track your asthma by using tools such as free AsthmaMD mobile app.

Q: Can Asthma make your child fail in school?

A: “Yes, if it is not well controlled” was the answer found by a new study at Brown University’s Alpert Medical School in Providence, R.I.  Researchers found the more asthma symptoms in a child, the lower his or her quality of schoolwork.  After measuring the children’s asthma severity using spirometry and following their peak flow measurements over time, they found that those who poorly managed the symptoms of asthma had lower grades than children who had their asthma under control.

When it came to sleep, children experiencing bad asthma symptoms couldn’t get enough sleep and their academics consequently suffered.

The frequent struggles with asthma were higher in urban children from low socioeconomic backgrounds primarily because they reside closer to risky environmental pollutants that may contribute to asthma and poor health. Children from these families are also at risk if they don’t visit parks for cleaner air.

The Natural Resources Defense Council found that pollutants such as smog, sulfur dioxide from burning coal, and diesel exhaust could trigger asthma.

The researchers hope that controlling asthma symptoms and gaining better sleep through interventions could significantly improve children’s school performances especially in these populations.

One of the easiest methods to track asthma symptoms and peak flow measurements is by using the FREE AsthmaMD mobile application and sharing your data with your physician for better asthma control and better school performance.

How do I know if my child or I suffer from Asthma?

Asthma is a chronic condition and can present itself at any age.  Initially it could be mistaken for other conditions such as bronchitis, recurrent colds, chronic cough, poor exercise tolerance, allergies, etc.  Here are some signs that should raise concerns about possibility of asthma for you to discuss with your physician:

1)   Recurrent nigh time coughing:  The body’s circadian rhythm (your body’s clock) at night releases less adrenaline and corticosteroids, which have protective effect against airway inflammation.  So if your cough is worse between 2-4am it may be nocturnal asthma.

2)   Feeling short of breath during exercise:  There are different triggers for asthma.  Exercise is one of the common triggers.  If you develop a cough while exercising it may be due to exercise-induced asthma.

3)   Recurrent Bronchitis:  Viral illnesses are another common trigger for asthma and are sometimes over treated with antibiotics.  If you have been diagnosed with recurrent bronchitis, ask you physician to do a pulmonary function test for you to determine your chance of having asthma, and hopefully avoid receiving unnecessary antibiotics.

4)   Coughing during the allergy season.  Seasonal allergies are a major trigger for both childhood and adult asthma.  If your symptoms are not controlled with allergy medicines alone, you may also have an underlying asthma diagnosis.

5)   Wheezing:  If you have felt short of breath, wheezing, and/or having retractions (pulling in of the skin between ribs when you breath), there is a strong possibility that you suffer from asthma.

If you or your child has any of the above signs and symptoms, be sure to discuss them with your physician.  There are tests, such as a pulmonary function test (PFT) that can be administered in the office to determine your risk of suffering from asthma.  Properly managed asthma should help avoid urgent visits to ER, and improve your quality of life.


Article written by Dr. Sam Pejham, director of Tri-Valley Pediatrics and Assistant Clinical Professor of UCSF School of Medicine, and the Co-Founder of AsthmaMD.

Traffic pollution may increase children’s risk of chronic asthma

BASEL, Switzerland, March 22 (UPI) — Fourteen percent of chronic childhood asthma is due to exposure to traffic pollution near busy roads, researchers in Europe say.

Lead author Dr. Laura Perez of the Swiss Tropical and Public Health Institute said until now, traffic pollution was assumed to only trigger asthma symptoms, but the research did not account for chronic asthma caused by the specific range of toxicants found near heavily used roads.

The researchers used data from existing epidemiological studies which found that children exposed to higher levels of near-road traffic-related pollution also had higher rates of asthma, even when taking into account a range of other relevant factors such as passive smoking or socioeconomic factors.

The study, published in the European Respiratory Journal, found 14 percent of asthma cases across the 10 European cities could be attributed to near-road traffic pollution.

“Air pollution has previously been seen to trigger symptoms but this is the first time we have estimated the percentage of cases that might not have occurred if Europeans had not been exposed to road traffic pollution,” Perez said in a statement.

Top 5 biggest mistakes parents make about their children’s asthma

 1)   My child does’t have asthma, he just coughs a lot at certain time of the year or wheezes when he gets a cold.   Parent’s have a negative connotation about what asthma means.  Today over 8 percent of the population in US has been diagnosed with asthma and that rate is higher among women and children.  If your child suffers from seasonal/allergic/viral illness related cough and feels short of breath, he may be suffering from asthma.  Proper diagnosis and treatment can make a big difference in their overall health and less missed school days.

2)  I don’t hear a wheeze.  So it can’t be asthma.  This is a common misconception among parents of asthmatic children and may delay start of treatment and increase chance of ER visits and hospital admissions.  For those with asthma, a cough is usually a sign to start their medication to help with their breathing.  Any delay in doing so may cause worsening of symptoms.

3)  My child won’t be able to play sports because of his asthma.  Currently there are numerous medications that should allow most asthmatics to play sports and/or do normal activities without feeling short of breath.  Your can take the asthma control test to see if your symptoms are well controlled.   If your symptoms are not well controlled, talk to your doctor to adjust your medication to achieve better symptom control.  Your physician would benefit from your asthma history if you can provide him with more detail about your symptoms.  There are free smart phone applications such as AsthmaMD which can be used at home to track your daily symptoms and allow you to share this information with your physician.

4)  I don’t want to give my child steroids.  Current inhaled corticosteroids (ICS) have  very little systemic side effects and there have been numerous studies to show that chronic use of ICS is safe for children.  Since Asthma is an inflammatory condition, according to NIH guidelines, any form of persistent asthma would benefit from use of anti-inflammatory medication such as ICS.  These medications play an important role to reverse and/or prevent an inflammation from starting, and may prevent future lung damage.

5)  My child hasn’t needed an inhaler for over 6 months. So he must have outgrown his asthma.  Data has shown that many asthma related ER visits can be avoided if the right medications are given early.  Many children improve their asthma at some age; however, just because they haven’t had an attack for a few months does not mean that they have  outgrown their condition.  Asthma usually has triggers which include, respiratory viruses, allergies, exercise, pollen, pollution, etc. which can cause an exacerbation of symptoms.  So it is best to have an inhaler ,which is not expired, readily available for emergencies even if you haven’t had an asthma attack for a long time.


Article written by Dr. Sam Pejham, director of Tri-Valley Pediatrics and Assistant Clinical Professor of UCSF School of Medicine, and the Co-Founder of AsthmaMD.

AsthmaMD at Health 2.0

Doug Evans, President, PresidioHealth & Sam Pejham, CEO, AsthmaMD

Doug, an ED doc, has been making applications since 2004 for workflow and charge capture for hospital-based physicians. Sam is a pediatrician with an iPhone app that helps parents and kids control asthma. What you’ll see today is a harbinger of Health 2.0’s future; information is shared by the physician with the patient’s AsthmaMD app, and then the patient’s records are reported back to Presidio. It’s cloud computing and API integration, creating healthcare savings and better care for patients.

Check out the video here: