These problems are called symptoms (sim-toms). About 8 of 10 children with asthma have the first symptoms before the age of 5.

What Happens During An Asthma Attack?

The lining of the airways becomes swollen. The airways produce a thick mucus. The muscles around the airways tighten and make the airways narrower. These changes block the flow of air, making it hard to breathe. It is important to treat even mild asthma so that you can keep it from getting worse. About half of children with asthma "outgrow" asthma and do not have it as an adult.

Why Does Asthma Happen?

A trigger makes a gun shoot. Triggers and allergies are things that sometimes "shoot off" or cause an asthma attack. Triggers and allergies can make your child's asthma worse. If your child stays away from triggers, the asthma will bother your child less of the time.

Common triggers are: dust, mold, pollen from trees and grasses, cold air, smoke, cats, dogs, some chemicals, and exercise.

How is Asthma Treated?

There are a lot of ways to treat asthma so that your child can be active without having asthma bother him or her. With asthma your child can still exercise, play sports, and sleep through the night without coughing. Your child does not need to feel sick from asthma medicine and he or she can cut down on the frequency and fierceness of attacks. But to keep asthma from bothering your child, you have to know what you are doing.

FOR MORE INFORMATION ABOUT TREATMENT, REENTER HOWSYOURHEALTH AND CHOOSE TO READ THE "ASTHMA AND BREATHING" SECTION FOR CHILDREN AND ADOLESCENTS AGED 9-19.

A typical child aged two through eight will have 8 "colds" a year and about 2 attacks of "wheezy" cough. Almost all of the time these colds and coughs are caused by viruses, a type of germ that antibiotics don't help cure. And more than eight out of every ten sore throats in children are caused by viruses.

The lungs, throat, ears, nose and sinuses have the same type of lining (inner skin).

That is why virus germs find it so easy to spread and cause a cough, runny nose, sore throat, and ear fullness at the same time. The medical term for all of these conditions is URI --"upper respiratory infection".

Viral sore throats and coughs get better on their own, and most ear infections do not cause long term damage. Some basic "Red Flags" can help parents identify the rare cases that may cause trouble.

What You Need To Watch for

Red Flags for More Serious Problems. Some clues for more serious problems possibly caused by bacteria germs are:

What You Need To Do

Parents seek care for these problems because they want their child to feel better fast.

However, a typical cold lasts about 7 days and the cough often lasts longer. Thick, green or yellow discharge from the nose (snot) is normal and also lasts a week or more. Antibiotics will not speed up recovery from virus germs. (When someone smokes cigarettes in the child's house, the problems can last longer).

1. Remember that:

2. Look for clues that the problem is not serious:

3. Use simple, inexpensive treatments while you wait for the problem to go away.

* Some children will always get a high fever with the colds and others will not. If your child is a "high fever child" give the acetaminophen early and regularly during the illness.

What About Antibiotics?

The use of antibiotics when not needed will not help colds, sore throats, cough, ear pain or sinus fullness caused by viruses.

Antibiotics cause:

Read the section above about colds. Most painful ears are NOT caused by bacteria that will be cured by antibiotics.

Numerous scientific studies have shown that pain medications (acetaminophen) is just as effective for ear pain as antibiotics. For frequent ear infections, studies are finding that surgically placing ear tubes is usually not helpful.

For the parent with a child who is crying with a painful ear, the best approach seems to be:

All children should be tested for hearing loss if they are having any difficulty speaking or doing well in school.

The most common cause for hearing problems is the "left over fluid" from an ear infection. Almost all of the time, this type of hearing loss cures itself.

New eye problems are seldom noticed in children aged 2-8. Before the age of 2 serious "lazy eyes" and very poor eyesight will be noticed. When a child is 2-3, a doctor will be able to have the child looks at distant objects and point to a nearby picture. Using this method, the child's vision may not test perfectly but both eyes should test the same. At about 8 years of age, some children will begin to develop near-sightedness --they will need glasses to see distant letters and objects.

Many children and adults develop "red eyes". This problem should clear up within a week and should not be painful when the child has to look at a bright light. It is usually caused by a virus that can be spread from person to person. Washing hands and any shared washcloth or towel is the best way to avoid spreading the virus.

Many children who do not appear sick may say they have pain. Most of the time these pains move from the head, to the arms or legs, or chest, or belly. For most children, the pains will go away quickly. The cause of the pain is never found. If the problem keeps coming back, stress or family problems may be the cause. As a general rule, if the child looks sick, or the pain lasts more than a few hours, a doctor should be contacted. Children with pain in the belly (abdomen) who are below normal weight should also have the cause of the pain investigated.

All headaches that begin in a child aged 2-8 should be checked by a doctor. By the time a child reaches school, he or she may have headaches: "migraine" (my grain), muscle tightness type, and "mixed" headaches which are the most common causes.

Migraine (vascular) headaches are often felt in the front and side of the head. They usually get very bad within 60 minutes and may make your child feel sick to their stomach, or want to avoid light. The child often feels a pulsing or throbbing. He or she may have about a twenty minute warning before the headache begins

Muscle Contraction Type headaches usually begin gradually and get worse by the end of the day. The pain feels aching and pulling and is usually worse around the entire head and in the neck.

Mixed headaches are a mixture of migraine and muscle contraction headaches.

The first treatment for all types of headaches is to find out if there is something that usually causes them. Then try to avoid it. The next best approach is to use a safe treatment to try to reduce the headache. Acetaminophen (Tylenol), ibuprofen, and naproxen are all effective medications that you can get without a prescription (avoid aspirin due to the risk of Reyes syndrome).

When a skin problem causes itching, wet and scaling patches on the face, neck, hands or where the elbows and knees bend, it is probably eczema. The skin may be very dry and the person who has eczema may also be bothered by hay fever and asthma. Some children have eczema caused by a skin reaction to things like dust, pet fur, or perfumes. For many others, the cause is not as obvious.

Usually, eczema responds very well to 1% hydrocortisone (steroid) cream and avoidance of things that obviously bother the skin. Placing dust free covers on bedding will help.

Hydrocortisone (which can be purchased without a prescription) is best if used at least twice a day. If the skin is usually very dry, mixing the hydrocortisone with Vaseline can help. Many children find that putting the cream on damp skin (after a shower) works very well.

Warts are very common in children. Warts are caused by viruses and occur most often on the hands and feet. Most warts go away on their own within two years. There are many methods to treat warts but the best treatment is usually to do nothing.

Many serious diseases can be spread by the bites of insects. A strong defense is the best approach. Always learn about dangerous insects in the environment in which you live and travel. Follow recommended approaches to avoid being bitten.

The strongest repellent for most flying insects is DEET. Children

should use DEET 30% or less. Skin-So-Soft; and citronella last about 30 minutes. Soybean oil products may also be effective.

The amount of skin wrinkling and skin cancers doctors find in older age can be reduced if kids protect themselves from the sun by:

•Not being in the sun from 10am-2pm

• Wearing wide brimmed hats and protecting as much skin as possible from the sun

• Protecting the skin and wearing at least UVA/UVB SPF15 sun block. Reapply sunscreen every two hours or after swimming or sweating. This will reduce some skin damage and some moles. HOWEVER, THIS MAY NOT PREVENT MELANOMA SKIN CANCER.

Sometimes children become infected with head and body lice. Body lice cause intense itching. Head lice may just cause crusting and scabbing. A fungus infection of the scalp may cause hair loss. Since these problems can be spread easily to other children, your doctor or the school nurse should be contacted as soon as possible.

Children aged 2-4 usually take naps for 1-2 hours a day. Naps are useful for children (and adults) of any age if the naps do not interfere with night time sleeping.

About one in ten four-year-old children awaken in the middle of the night or get up early.

For the child who normally awakens early, parents should make sure the bed is low to the ground, so the child can not be injured, and have available play things so that the child can keep busy.

If night time or early morning awakening is a problem, the family should keep a diary of when the child sleeps during the day an night. This diary should be kept for a week. The parents should look at the diary to see if there are any patterns - day time nap causes night time awakening, for example. Daytime activity is a very useful way to make sure that night time sleep occurs.

If the diary does not lead to obvious answers, the parents should talk to a doctor .