Baby Asthma Basics

Asthma is on the rise in children -- rates have increased by 160 percent in kids 4 and younger since 1980, and by 75 percent in the general population. It's the most common chronic condition among children, affecting about 5 million kids in the U.S., almost half of whom have symptoms before age 1. No one is exactly sure why asthma rates are increasing, but it may be a combination of more pollutants in the environment, earlier exposure to a wide range of allergy triggers (called allergens) in foods and in the environment, and better methods of diagnosis.

Asthma is a chronic disease in which the airways to the lungs become inflamed, leading to episodes of breathing difficulty. The condition is caused by an immune reaction to a variety of irritants (allergens such as dust, pollen, and mold), and environmental pollutants (such as tobacco smoke). In fact, there's a strong connection between allergies and asthma. Sixty percent of asthmatics suffer from allergies, usually hay fever. And babies with allergies -- experienced in infancy as eczema or a food allergy -- are at a greater risk for asthma. Asthma attacks can also be brought on by upper respiratory infections and even cold air.

An asthmatic episode occurs when the airways are exposed to irritants, setting off an allergic response that causes them to swell, spasm, and produce excess mucus. This causes the airways to constrict, resulting in a high-pitched whistling sound as the person exhales, known as wheezing.

In infants, whose airways are already very small, it takes only a little bit of swelling to make it harder for them to breathe. As a result, wheezing is common before age 1 and can be caused by simple cold viruses as well as asthma. For example, respiratory syncytial virus (RSV) often causes a type of pneumonia called bronchiolitis in young children. RSV usually begins as a regular cold, with coughing and congestion, but it can progress to difficulty breathing, a worsening cough, and wheezing.

Other conditions that can cause wheezing in infants include:

• "Floppy" airways that narrow easily (a condition children usually outgrow by age 2)
• A bit of food or a small object lodged in the airway
• Bronchitis
• Croup (a cold virus that causes a barking cough)
• Stomach acids that get into the lungs as a result of chronic reflux

If your infant is wheezing, you should always call your doctor, even if the baby seems alert and comfortable. Your baby requires immediate attention if you notice any of the following:

• Breathing that's faster than normal
• Flaring of the nostrils
• Sucking in of the stomach or pulling in between the ribs
• Bluish color around the lips