Asthma in infants and small children.

The wheezy young child is a particularly challenging patient to treat. This article focuses on a diagnostic approach and some of the treatment issues peculiar to this age group. Specifically addressed are (1) the problem of differentiating asthma from wheezy bronchitis in babies and the clinical implications of this; (2) general concepts of treating babies in whom many commonly used drugs are not FDA approved; (3) inhalation therapy, especially the use of metered-dose inhalers with spacers; (4) the standard asthma drugs and their beneficial and adverse effects, with particular reference to inhaled steroids; and (5) the nonpharmacologic management of asthma. A brief discussion of long-term outcome is also included.