Asthma is the most common childhood lung disease, impacting more than 6 million children nationwide, but symptoms are easy to overlook, especially when it comes to young children. As the season changes, asthma attacks are more common. Health Reporter Erin Billups takes a look at how to prevent asthma symptoms.
“The first day I learned how to do a two-wheeler, it just took 10 minutes,” said Daana Raman, an asthma patient.
These days, five-year-old Daana is an experienced bicyclist, but as a toddler she had less opportunity to play because she often had trouble breathing.
“You sit in the shower with the steam and all of that and it's a painful process. But most of all, you look at your kid and you're like, 'How can I make this better?'” said Sri Raman, her father.
Daana began having frequent asthma attacks when she was one. Her mother, Vindya Bhat, recalls that “The cough just wouldn't go away.”
Mount Sinai Pediatric Pulmonologist Alfin Vicencio says parents, and sometimes even general pediatricians, mistake persistent coughing in young children as viral infections, especially as seasons change and germs are ever-present.
“But because they don't have other classic symptoms that people associate with asthma, such as wheezing, then it doesn't really register for a lot of people,” Vicencio said.
A serious symptom of breathing difficulty is called retractions. “Where you can sort of see the ribs -- or sometimes up here below the neck -- the skin pull in when they're breathing," Vicencio said.
It is a sign the asthma attack is worsening and a child may need immediate medical attention. The problem is that the go-to response for many families is a trip to the emergency room, where they are given a large dose of steroids to open their airways.
A 2018 study in the Journal Pediatrics found that 20 percent of children admitted for asthma attacks return within a year. “She was getting it like three to four times a year,” Bhat said.
But experts say a more effective asthma treatment is daily puffs of low-dose corticosteroids, which often make parents who are weary of steroids, balk.
But Vicencio says the small doses are actually very safe.
"Using a daily preventative inhaled corticosteroid," Vicencio said. "six months-worth of that is probably equivalent to one course of steroids, probably much, much less."
Since Daana's been on her daily dose of medication, she has not needed the high powered steroid treatments given in emergency situations.
“When I'm at school, I take it every day," she said. "it's because I don't want to get sick."
And she rarely has attacks, so she is not missing school and her parents aren't missing work to care for her.
“We're really happy about her progress," Bhat said. "We're hopeful that maybe someday she may not require daily medication."