SmartParents asked family physician Dr Lim Kai Hung of Lifescan Medical what he thought about the possibility of a child’s cold actually turning out to be asthma in disguise.
He said: “Diagnosis of asthma in a young child less than 5 years old would be difficult as children have respiratory symptoms such as wheezing and cough commonly — even though they have no asthma. It is also difficult to perform a spirometry test to confirm asthma in these children as they are unable to follow instructions.
“However, diagnosis of asthma can be made by observing recurrent symptoms and a detailed family history (including parents) and physical examination of the child.”
He told us that symptoms to look out for include:
- Cough that gets worse at night.
- Recurrent wheezing.
- Recurrent complaints of chest tightness.
- Recurrent shortness of breath.
- Symptoms worsening with exercise, dust, viral infections, smoke or in the presence of carpets and pets.
- Associated eczema or allergic rhinitis.
So if your child has several or all of the above symptoms, and you or your spouse has a family history of atopy (eczema, asthma or allergic rhinitis), then you should bring your child for a check-up.
The doctor would then look out for things that include allergenic shiners (darkness around the eyes), eczema and allergic rhinitis.
If the decision is that your child needs to be treated for asthma, you will need to:
- Treat the symptoms with nebulisers (these gadgets produce a mist that your child needs to breathe in because your child may not be able to coordinate to do the squirt-and-breathe) or using a spacer with medicines like short-acting bronchodilators (Ventolin) that helps solve the coordination problem; and/or taking oral Singulair and antihistamines.
- If it is a recurrent problem, you and your doctor should discuss possibly putting your child onto trials of treatment with inhaled glucocorticosteroids (Beclotide, Flixotide, Seretide etc) for two to three months and monitoring to see if symptoms clear up.
- Get rid of triggers in the environment. This may mean cleaning your carpets, regularly performing maintainence on your aircon, cleaning bedsheets and linens rigorously and often, making sure your child has an environment free of second-hand smoke and — this may be hard — removing all that is furry, which could mean restricting or giving away your pets.
- Once your child’s breathing is relatively free of symptoms, then encourage regular exercise because that will support your child’s future health.
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