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Does my child have hyper-reactive airway disease?

Q: My daughter is 15 months old and has been wheezing for several months. We have taken her to the doctor many times for this in addition to other symptoms such as fever, coughing, runny nose, loss of appetite, poor sleep and ear infections. These mostly seem like cold symptoms but we are very concerned about her wheezing. There seem to be no real answers about it. We also got her tested for cystic fibrosis, she is normal. We are also taking her to an allergist. She was born 2 weeks premature. I was hospitalised two weeks earlier--and was given steroids to help her lungs develop--she was in ICU for about a week until her breathing improved and she began to eat. She is normally a very happy baby but this still continues. She is suffering from chronic cold, just when she gets over an ear infection or cold it seems to return. About two months ago she was diagnosed with eczema as well. With elidel and orapred she seemed to do a lot better. We have heard the term reactive airway disease being mentioned but we don't know much about it. Can you tell us about it?Is this a possibility with my daughter? What other things can we do as concerned parents? Where can we find information about the disease?

A:Your diagnosis is perfect. Your baby has Hyper-reactive airway disease. Which means the airways to your babies lungs are hyper sensitive and they tend to go in spasm either spontaneously or get precipitated by various aggravating factors like changing climate, exposure to dust smoke or viral infections. This results in inflammation or swelling of the airways. There may be a genetic predisposition to this condition especially if there is a family history of asthma and allergic disorders. This condition tends to be more common in babies who have had respiratory problems in the newborn period. This condition is also referred to as Childhood Asthma. But the good thing about this is many of these children outgrow this as they get older. We don't have a permanent cure for this but, as I said, with each year it may become better. The best treatment option is put the child on some form of inhaled medications bronchodilators and preventors (which are steroids). Inhaled steroids are better, safer with fewer side effects, but with severe episodes one may have to short courses of oral steroids. You should see a pediatric pulmonologist (chest specialist) who should be able to sort out your child's problems. To get the information you should look for Hyper reactive airway disease on any of the search engines like Google.

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