Will my child outgrow asthma?

This is a common question I’ve heard over the years. The answer is not quite so easy, but there are factors that may help predict the prognosis of toddlers who are wheezing around age 3 years old. The modified API (Asthma Predictive Index) is helpful. Doctors and parents have long known that infants and young children will wheeze more than older children and adults, and that sometimes this leads to asthma, but not always. It is challenging to know which toddlers will go on to have persistent asthma and which ones will “outgrow” it.

Modified API:

High risk children (under age 3 years) who have had 4 or more wheezing episodes in the past year that lasted more than 1 day, and affected sleep, are much more likely to have persistent asthma after the age of 5 years, if they ALSO have either of the following:

One major criteria:

• Parent with asthma

• Physician diagnosis of atopic dermatitis (eczema)

• Evidence of allergy to airborne allergens (i.e., positive skin or blood tests to trees, grasses, weeds, molds, or dust mites)

OR

Two minor criteria:

• Evidence of food allergies (especially milk, egg, or peanut)

• 4% or more eosinophilia on a blood test (Increased numbers of white blood cells called eosinophils are made by the body. They can collect in tissues and cause damage to the airways of the lung)

• Wheezing apart from colds

Children with positive modified API in the first 3 years of life have about a 65% chance of having persistent asthma by age 6 years. A negative modified API is about 95% accurate that the toddler won’t develop persistent asthma.

While there is no “crystal ball” to predict the outcome of asthma symptoms in infants and toddlers, there are certain factors that affect the risk.