PEDIATRICIAN DR.PAUL Answers: Asthma has three main symptoms. The first two, a lot of people are aware of: wheezing a whistling noise while one exhales and difficulty breathing, The third symptom is a frequent or persistent cough. In fact the definition of asthma is repetitive episodes or periods of wheezing and/or shortness of breath and/or cough, in the absence of any lung disease or problem.

In other words, the child is well otherwise. Using this definition then, your son may have asthma. Note that asthma is not the only cause of a persistent cough. However, it is known that 5% of asthmatic children have "Cough Manifest Asthma", where the only symptom is cough. In this case the chest is usually clear and there is no history of difficulty breathing.

In children less than 6 years of age, the diagnosis is made based on history, such as in your child's case. In older children, there are specific breathing tests that can prove whether or not a child has asthma or not. These are called histamine or methacholine challenges.

Another clue in helping confirm the diagnosis of asthma is a history of eczema or other allergies. Generally, asthma occurs in children with an atopic history. Atopy means an allergic tendency. The allergic or atopic tendencies are inherited together and these include eczema, food and respiratory allergies and asthma. Additionally, in the family, a positive history of atopy is also helpful as we know allergic or atopic tendencies are inherited.

Once the diagnosis is made, the treatment is the same as for the other forms of asthma ... either a bronchodilator alone or with an anti-inflammatory medication. However, in my mind, one of the most important things one can do in terms of treatment is to make sure that there is nothing in the child's environment that is triggering these symptoms.

Second hand cigarette smoke is a very common irritant. When parents stop smoking in the house and in the car, often asthma symptoms improve dramatically, and in some cases stop all together.

Similarly, dust mites that live in carpets, mattresses, pillows and stuffed toys can also be making symptoms worse and should be eliminated. Pets, most often cats, can also make a things worse. If a child is allergic to a certain pet, then this particular pet is making the symptoms worse or even causing them in the first place.

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