Wheezing
In its classic form, asthma will be suspected when your child has repeated episodes of wheezing that are reversible with treatment. I always ask what parents mean when they say their child is wheezing. Parents often mean that their child has noisy breathing or has croup or is congested. It is important to understand that "wheezing" has very particular characteristics. Wheezing is a high-pitched, whistling kind of noise that comes from the lower airways in the chest, not from the nose or neck. It is usually worse when your child breathes out (expiration) rather than when he/she breathes in (inspiration), although in severe cases it can occur at both times. Parents may confuse noisy breathing or congestion with wheezing, though these are separate entities. Another important thing to understand is that not all people with asthma have wheezing. In its mildest form, there is only a lengthening of the breathing out phase that requires a stethoscope to hear.
Other signs and symptoms
Some patients do nothing but cough. Their cold symptoms, particularly their coughing, last for weeks without responding to cough medicine or antibiotics. This is especially true of younger children in whom mild asthma symptoms are commonly misdiagnosed as "bronchitis" and treated with repeated courses of antibiotics. In my opinion, a child with multiple episodes of "bronchitis" and "pneumonia" is often an undiagnosed asthmatic who is not being treated for his underlying problem. Some people only have asthma symptoms in very specific settings, such as after exercise or when exposed to irritants such as cigarette smoke, chemical fumes or animals.
