How to diagnose asthma in children

Asthma in children under the age of 5 is a matter of concern. It is not a rare disease and early diagnosis is important. Common signs of asthma in children are:

1. Recurring bronchitis
2. Wheezing
3. Discomfort in the chest
4. Coughing
5. Trouble breathing

While some children have persistent yet mild symptoms, some children have severe attacks at times. Seasonal allergies and smoke make the symptoms worse.

What to notice?
While feeding an infant, if you notice that your child is facing shortness of breath, it might be a symptom of asthma. In a toddler, if your notice a decreased desire to run and play, or easy fatigue, then this could be a symptom of asthma. Asthma attacks for many children under the age of 5 are worsened when they catch cold or have any other respiratory infections. All these, if noticed should not be ignored and your child's pediatrician should be consulted.

The above mentioned symptoms were mild. Some children have it worse and the attacks can be life-threatening, needing immediate treatment. If your child is under the age of 5 and you see them doing one of the following, contact emergency services immediately:

1. Trouble in speaking because they have restricted breathing
2. When they are breathing in, the effort is so much that the abdomen is getting sucked in
3. Gasping for air.

Diagnosing asthma in a child can be tricky as symptoms like coughing, wheezing, etc can be for other conditions also. Once a child is a little older and if the symptoms persist, breathing and lung function tests are taken to gauge the situation. 

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How To Diagnose Asthma In Children, Before It Attacks?

If you have noticed your child to be restless and anxious all the time, it might look cute as the child is highly energetic, but it could be a cause for concern at the same time. It is not normal and the child could be having ADHD that is attention deficit hyperactivity disorder. As the name suggests, it is a disorder with deficiency of attention and in which the child is always hyperactive.

ADHD is a disorder in which the symptoms usually show up before the age of seven. It is characterized by a group of behavioral symptoms that include inattentiveness, hyperactivity and impulsiveness. The impact of these symptoms is felt extensively where his overall self-esteem is affected, be it at home, preschool or school, academics or extracurricular activities and in interpersonal relationships.

The most common symptoms, which are almost diagnostic of ADHD are:
1. Inability to hold attention: The child's attention span is very short and it is very difficult to keep them engaged on one particular thing.
2. Increased restlessness: The child would be extremely restless and gets distracted easily.
3. Fidgeting: The child would be seen constantly fidgeting with his fingers.

The following are the less common ones:
1. Learning disability is rare, but can happen. However, the good news is that it does not affect the child's intelligence.
2. Sleep disorders
3. Difficulty in following directions
4. Poor executive functioning skills
5. Disorganization, which can lead to poor motor coordination and impaired movements
6. ADHD kids tend to forget things very easily and need help with coordinating movements
7. The child suffering from ADHD could easily tire and/or feel lethargic with very low energy levels. This can lead to the child procrastinating things and not wanting to do things on priority basis
8. These children also have difficulties with fine motor and cognitive skills and so there is delay in their overall participation in games.

While these are the pressing symptoms of ADHD, occupational therapy can play a significant role in managing the child in the following ways. As a first step, the caregiver should have a detailed discussion with the school staff and any other people with whom the child interacts significantly. This will help identify areas that need support from an Occupational Therapy, which are the following:

1. Support with gross and/or fine motor skills
2. Support with improving handwriting
3. Support with engaging in playing sports and games
4. Support in engaging in social activities
5. Improving sensory processing difficulties
6. Improving visual perception
7. Support in adapting to the environment
8. Teaching strategies to participate in various social and academic activities

So, while an ADHD child is definitely a cause for concern, proper support from family can help manage the condition.

Symptoms of ADHD

Has your child been coughing frequently? Is the cough chronic in nature, making your child breathe rapidly and does he/she complain about a tightened chest? These symptoms signify that your child is having asthma. Asthma is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. It is common in children and an affected child experiences difficulty in breathing, and a whizzing sound is produced, especially during expiration. Asthma may lead to severe health complications and needs immediate diagnosis and treatment.

Diagnosis: The diagnosis of asthma is based on the symptoms, medical history and a physical examination of the child.

The different modes of asthma diagnosis are as follows:

    Medical history and symptoms: You must tell the doctor about any history of breathing trouble with your child or whether there are chances of other inherited health conditions. You must explain your child's symptoms properly, which may include coughing, wheezing, chest pain or tightness and others if observed.
    Physical examination: A physical exam will be carried out in your child where the doctor will listen to his heart and lungs, and look for eye or nose allergies.
    Medical tests: A chest X-ray of the child has to be carried out, along with a simple lung function test known as spirometry. This test measures the amount of air present in the lungs and determines how fast it can be exhaled. Spirometry enables a doctor to determine the severity of the asthma. Some other tests are also carried out for the identification of asthma triggers. They include allergy skin testing, blood tests and X-rays to know if sinus infections are affecting the asthma. An asthma test determines the amount of nitric oxide in your child's breath.

Treatment: Based on your child's severity of asthma symptoms and his medical history, the doctor will provide you with an action plan to treat the same. This action plan explains all the medications your child requires, the dosage and schedule of the medicines. The plan also includes points on what to do when the asthma worsens and when an emergency treatment is required. Anti-inflammatory drugs are prescribed to children who require bronchodilator medication. All asthma medicines used by adults can be used in case of children but in lower dosages.

You should give the asthma medications to your child using a home nebulizer or a breathing machine. A nebulizer delivers asthma drugs by transforming them from liquid to a mist. The child gets the drug by breathing it via a face mask.

In order to control and manage asthma in children, they must avoid the triggers and should keep away from any source of smoke. A doctor must be consulted to know about the best diagnosis and treatment methods.

Asthma in Children: Diagnosis and Treatment

High fever is common in kids and a common worry for parents as well. If you are a parent, you need to know when the fever is serious, and when you should worry about it. Fever is a defence mechanism of the body. Body temperature rises if any foreign body (or antigen) attacks your body. As a defence, body temperature rises making it an unfavourable condition for the antigen. Fever means 100.4 degree Fahrenheit. Normally for kids, thermometer is placed under the armpit to record the temperature. You need to add an extra degree for accuracy. Paediatricians recommend treatment for fever if it's more than 101 degree F.

When to Call a Doctor

If the kid is less than 4 months old and has a fever of 100.4 degree F with other mentioned symptoms as highlighted, one must see the doctor as an emergency situation.
If a kid has 104 degree F fever, rush to the doctor. Such a high fever in children could lead to seizers.

You must call a doctor if the kid has a fever along with the following symptoms:

    Looks very dizzy
    Has a deteriorated immune system or even any other medical condition
    Has a seizure
    Has symptoms such as rashes, painful throat, annoyance, rigid neck or ear pain

Medication Side Effects:

At times, if you treat your children with some medication that does not suit them, it may lead to high fever. In case fever in a kid aged less than 2 years lasts for more than one day, it's time to see a doctor. And lastly, remember that normal body temperature is 98.6 degree F.

High Fever: When It Should Raise Alarm for Parents

Growth is the most important aspect of childhood, one that distinguishes children from adults. Growth is affected by a number of diseases and growth failure is often the first sign of a serious disease. Unfortunately children with growth failure present very late when no help is possible. 

Why to worry?

Growth is the best marker of health and growth failure may be caused by a seious disease. Moreover children with short stature have lower self esteem. 

When to worry? 

Plot the height of your child in the growth chart and if it is below the lower limit visit a doctor. Alternatively if your child's height is less than the formula (Height = Age in years x 6 + 77 cm) it may be a cause of concern. Growth stops at the age of 14 years in girls and 16 years in boys. Hence the child should be reviewed latest by 10 years for girls and 12 years for boys. 

What causes growth failure? 

Growth failure can be due to a number of causes including poor nutrition, lack of physical activities and low genetic potential with parents being short. Short stature can also be caused by a number of diseases like thyroid problems, growth hormone deifiency and celiac disease (wheat allergy). 

How can I improve my child's growth?

Please encourage your child to play for atleast 1 hour a day. It is important to restrict screen time including television, computer, tablets and mobiles to less than an hour. Increased protein and calcium intake with more milk, pulses and vegetables also helps in improving growth. Growth hormone is produced during sleep. Sleeping for at least eight hours a day is therefore essential for a child to achieve good growth. 

What can be done if my child is very short? 

Please consut a doctor to identify the cause of short stature. Most conditions are readily treatable. Children with growth hormone deficiency respond dramatically to growth hormone. Growth hormone is also being used now in children with turner syndrome, familial short staure, small size at birth and kidney disease. 

Time is important- act now if your child is short. 

Is My Child Short? 

Being a mother is the greatest gift to womankind. With the most amazing feeling of being a mother, comes big challenges and responsibilities. The first and foremost being, keeping the baby safe and healthy. Providing babies their best start begins with breastfeeding. Doctors around the world recommend exclusive breastfeeding to begin within the first hour of a baby s life and continue until six months.

A mother s milk has no substitute. It is packed with amazing nutritional benefits, the absence of which can lead children at risk of malnutrition and various diseases. Breast milk is often being termed as complete food with added antibodies, enzymes, hormones and fatty acids extremely vital for a delicate immune system of an infant. Babies build their immunity in the first few years of their life and breast milk is critical to developing immunity.
UNICEF working on child s rights and well-being world over promotes breastfeeding schemes across many countries. 

According to UNICEF reports, a non-breast fed child is 14 times likely to die within first six months than an exclusively breastfed child. An estimated 8,20,000 children under the age of five could be saved each year with increased breastfeeding. However, Only 38% of infants globally are breastfed. Looking at India s state, Malnutrition continues to be one of the greatest challenges. One cost effective, safe and smart intervention to curb malnutrition and decrease infant mortality is breastfeeding.

Let s now look at the benefits of breast milk for infants and mothers:

Breast milk is found to reduce the risk of respiratory tract infections, diarrhea, asthma, food allergies, leukemia, diabetes and celiac disease.
Psychologists have long established the positive effects of mother s touch in the emotional development of babies. In addition to this, breastfeed has positive effects on child s cognitive development.
Breastfeeding has amazing benefits for mothers. It is found to aid weight loss post pregnancy. It promotes better uterus shrinkage and delays menstruation. Lactating mothers naturally avoid pregnancy till they breastfeed. It reduces the risk of breast cancer, cardiovascular disease and rheumatoid arthritis later in life.
Considering the benefits of this super natural milk, many countries have now adopted an international code of marketing of breast-milk substitutes. The code promotes breastfeeding and restricts marketing of infant formula milk. India along with many other countries signed it.
India has also begun with a baby friendly hospital initiative where hospitals educate new mothers regarding breast feeding and strictly discourage infant formulas wherever possible. The myth of feeding newborn babies with honey, water, sugar does more harm than good. Thus, it is vital to exclusively breastfeed the baby at least for six months before introducing other foods. 

Ensure your child s right to a healthy life through breastfeeding!

Breastfeeding - Its Benefits for both Mother and Baby

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