Expert explains common myths about childhood asthma

A 7-year-old girl presented with a dry cough and wheezing of episodic nature for 2 years. She develops at least 3-4 such episodes in a year, and each lasts for a minimum of 10 days with nebulised medications. She has recently developed a dry cough at night, which disturbs her sleep. The child is diagnosed with asthma and told to take inhalers by the chest doctor for children. The parents can't believe it, but they reluctantly begin the treatment. Some family friends inform them, a few days later, that Inhalers should not be used as the child becomes dependent on inhalers. These parents are caught in a cycle of doubt, fear, and anxiety.

This is a very typical situation you will often experience in your everyday practice. Inhalers carry a great social stigma and innumerable misconceptions. This is a barrier to proper therapy of childhood asthma. So, now the myths concerning asthma are busted!

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Myth 1: If my child does not breathe hard, it can’t be asthma.

Fact: The airways of the lungs in asthma are narrowed and inflamed, preventing airflow. This may manifest as coughing, wheezing, tightness around the chest, or breathlessness during physical activity. All of these signs may not be present in all asthmatic children at all times.

Myth 2: My child was fine till the age of 4, how can he suddenly get Asthma?

Fact: Congenital and infantile asthma are seldom seen. Symptoms may manifest at any age during childhood or adolescence, and may also sometimes occur in adults.

Myth 3: Inhalers cause addiction

Fact: An inhaler is an instrument used to help asthma medication be inhaled into the lungs. Nebulizers and oral syrups also contain the same or similar formulations. There is no addictiveness to any of the pharmaceuticals employed in treating asthma. Some people feel that once they have started using inhalers, it is hard to stop. Not because having an inhaler is addictive, but because the condition it’s trying to mitigate is bad enough that you need drugs to control it.

Myth 4: If the child is well, they don’t need to take their inhaler

Fact: In general, symptoms are managed thanks to consistent use of inhaler medications. It’s also possible, given that doses may need to be titrated down (in case of flares), that sudden withdrawal might cause a flare, so simply stopping the treatment can land you back in a flare.

Myth 5: If the child takes their inhaler too much, then it stops working.

Fact: No tolerance develops for steroids over time. Symptomatic despite inhaled steroids is typically a result of either inconsistent use, poor technique, continued allergen or irritant exposure, or sensitization to some molds.

Myth 6: Inhalers with steroids will stunt my child’s growth

Fact: The amount of steroids in inhalers is measured in micrograms, but it is milligrams for oral steroids. In addition, inhaled steroids work predominantly in the airways and lungs with low absorption throughout the body. Because the dose is so tiny and targeted, there are no adverse effects on your child’s growth when using inhaled steroids. Instead, uncontrolled asthma can stunt your child's growth.

Myth 7: It is better to treat when symptomatic rather than regular use of medication.

Truth: The goal of asthma treatment is to tame the chronic inflammation in your airways, not just treat flare-ups. Uncontrolled inflammation can result in decreased lung function and very severe flare-ups that require hospital or ICU care, and treatment with oral steroids (which are much higher in dose than the ones from inhalers).

When properly used, there have been few side effects reported with asthma controller medications that are taken by inhalation, and they are the most effective and convenient way to go. Parents should be cautious and seek advice from a qualified medical professional, instead of relying on the web or social media, which can supply misleading information.


Dr. Anshula Tayal Bansal, Consultant, Pediatric Pulmonology, Manipal Hospital, Goa