Management of infant asthma presents some unique problems. Infants have proportionately less smooth muscle around their airways resulting in less support for the airway, but also less spasm of the airway. As a result, infants also have less response to the bronchodilator medicines which open up the airways and provide older asthmatics such quick relief. Toddlers present a diagnostic challenge because wheezing occurs mostly as the air is coming out and so does crying. Since most toddlers cry when being examined by a physician, their crying obscures the wheezing.
Parents can help to make the examination successful in several ways.
First, remove your child's shirt and undershirt as soon as you enter the examining room. Children often start to cry when they are undressed for an examination because they have some idea what will happen. If the child's shirt is off when the physician enters the room, it provides the physician with an opportunity to observe the child's breathing while he is quiet. Even if he starts to cry when the doctor enters the room, the baby can usually be calmed faster if he doesn't first have to be undressed. The examination should be carried out with the toddler held by a parent, either in the parent's arms or in her lap.