Parents have a lot of misconceptions about asthma. We clear them up.


Breathing is such an innate reflex that you probably haven't given much thought to your child's ability to inhale and exhale. But breathing is a struggle for the 7 million kids diagnosed with asthma. This chronic life-threatening disease constricts airways into the lungs. It's the third-leading cause of childhood hospitalizations and a top reason that kids miss school. Even though asthma is the most common chronic childhood disease, parents still have many misperceptions about its signs, risk factors, and treatments. Take a look at these six facts you need to know about asthma.

child with asthma
Credit: Bryan McCay

You can't always tell when a child has asthma. Shortness of breath and wheezing are classic signs. But some kids have only a persistent cough that worsens at bedtime. Although asthma symptoms usually appear before age 5, they're often mistaken for a respiratory illness such as a cold, reflux, croup, or bronchitis. Adding to the diagnostic challenge is the fact that episodes can be sporadic. "There isn't a perfect test that definitively detects when a child has asthma," says Stan Szefler, M.D., head of pediatric clinical pharmacology at National Jewish Health in Denver. Your pediatrician may refer you to an asthma specialist, typically someone with special training in pulmonology or allergy and immunology. This doctor may conduct a breathing test called spirometry to measure how much air is coming in to and out of your child's lungs. A child's medical history, along with a family history of asthma or allergies, is factored into a diagnosis.

Allergies can play a role. Allergens--such as dust mites, pollen, mold, and pet dander--often trigger asthma attacks. In fact, up to 80 percent of children with asthma also suffer from allergies. Environmental allergens typically are to blame, but up to 70 percent of children with eczema, a skin allergy, develop the disease. Although rare, food allergens have been known to trigger an asthmatic episode.

Gender and genetics increase your child's asthma risk. Experts aren't sure why some kids develop asthma, but there's a 30 percent chance that your child will have it if one parent has the condition. Those odds more than double to 70 percent if both parents have the disease. For unknown reasons, more boys than girls are diagnosed with asthma.

Asthma is a lifelong condition. Asthma is a chronic health condition that never really goes away. The possibility of an asthma episode always exists even when symptoms subside. Still, a 2013 Pediatrics study found that as many as 1 in 5 kids may go into remission (no wheezing or need for inhalers) by age 19. Doctors aren't sure why, but remission is less likely in children who develop allergies to cats, dogs, horses, and birch trees before age 8.

Your child's size may affect breathing. Overweight and obese kids are more likely to develop asthma than normal-weight kids are, according to a 2013 study in the American Journal of Epidemiology. That risk grows as body mass increases. The study also found that heavier children with asthma see the doctor more frequently and use their inhalers more often. Researchers believe the additional weight on a child's chest may affect the severity of the illness. Inflammation caused by body fat may also play a role.

Back-to-school time can mean trouble. Viral infections such as colds and influenza cause more than 80 percent of asthma attacks in children. A child's risk of catching a virus increases significantly when he's in the close quarters of a classroom with sneezing and coughing classmates. Up to one quarter of all children hospitalized for an asthma attack are admitted in September, a phenomenon known as the "September epidemic." Your child's doctor should provide the school with an asthma action plan that will cover the medications to be kept on site, a list of things that exacerbate your child's asthma, and emergency contact phone numbers.

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