Dr. Alan Greene on Asthma Prevention

I have twin boys who developed asthma-like symptoms as they turned 2. Now they seem to get these symptoms almost every month. One of them always gets croup, too. How can I prevent this?

There is a set of guidelines put out by the NAEPP (National Asthma Education and Prevention Program) that includes step-by-step instructions for giving kids preventive medicines based upon their symptoms. These preventive meds might include a very gentle inhaler, such as cromolyn (which serves only as a protective barrier) or a small dose of an inhaled steroid.

Sometimes parents are advised to start their kids on short-term preventive asthma meds at the first sign of a cold or other respiratory infection. However, anyone who has asthma symptoms more than twice a week, or who has nighttime symptoms more than twice a month, tends to do better on one or more of the regular preventive medications. These include a leukotriene inhibitor (such as Singulair), an inhaled steroid (such as Flovent), or a long-acting beta-agonist (such as Serevent).

There have been no major demonstrated side effects from intermittent, short-term use of these medications. They can all slow growth (but of course ongoing asthma symptoms would have side effects and dangers of their own). It is not known whether this slightly slowed growth reduces final height, but it may.

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.