Your Child's Asthma: First Office Visit

Health history

Before starting the exam, your child’s healthcare provider will ask for background information. The more details you can give, the better. Be ready to talk about:

• Your child’s symptoms, including when they first appeared, how often they happen, how bad they get, what makes them better, and what makes them worse

• How the symptoms affect your child. For example, if the symptoms limit physical activity, interfere with sleep, happen at night, or cause your child to miss school.

• Any family history of asthma or allergies

Physical exam

The healthcare provider will listen to your child’s lungs with a stethoscope. Asthma often produces unique breathing sounds, such as wheezing. But if your child is not currently having symptoms, the lungs may sound normal. This does not necessarily mean your child does not have asthma. In addition, the provider may look for signs of allergies, such as skin rashes, swelling inside the nose, and nasal discharge. If your child has never wheezed before, your provider may want to do a chest X-ray of the lungs.

Spirometry testing

Spirometry is a quick and easy test used to assess how well your child’s lungs are working. It's a very important part of diagnosing asthma. Here’s how it works:

• Your child breathes in deeply and then blows forcefully into a tube that is attached to the spirometer. The spirometer calculates the amount of air the lungs can hold and how fast it is breathed out.

• Next, your child breathes in a dose of asthma medicine. Then he or she blows into the tube again. An increase in airflow suggests that asthma medicine may be helpful.

• Finally, the provider might ask your child to do some physical activity. The test is repeated to see how the activity affects your child’s breathing and symptoms.

Spirometry is a useful test. But children younger than age 5 may not be able to do the test accurately.

Always discuss with your child's healthcare provider the correct way to use an inhaler in children. Young children should always wear a face mask and spacer when using an inhaler.

Allergy testing

Most children with asthma have allergies that make their breathing problems worse. Your child's healthcare provider may order tests to check for allergies. If allergies are found, you can take steps to limit your child’s exposure to those allergens. To get allergy testing, you may need a referral to a specialist.