PATIENT EDUCATION

From asthma to immunization, find out more about what the American Academy of Pediatrics recommends for your child’s health. You’ll gain access to a wide variety of information on developmental stages, safety and advocacy for babies, children, teens, and adolescents from the AAP.

Well-Child Visits: Parent and Patient Education

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CDC.gov is your online source for credible health information and is the official website of the Centers for Disease Control and Prevention (CDC). CDC is committed to achieving true improvements in people's health. CDC applies research and findings to improve people's daily lives and responds to health emergencies—something that distinguishes CDC from its peer agencies. Working with states and other partners, CDC provides a system of health surveillance to monitor and prevent disease outbreaks (including bioterrorism), implement disease prevention strategies, and maintain national health statistics. CDC also guards against international disease transmission, with personnel stationed in more than 25 foreign countries.

CDC.gov provides parents with credible, reliable health information on:

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Visit CDC.gov for more information

We understand many women may be apprehensive or unsure at first about breastfeeding vs. bottle-feeding their baby. It’s normal to have many questions related to breastfeeding. Our doctors and lactation consultants are here to support you.

Immunizations have been one of the single greatest advances in preventive medicine and an essential part of well-child care. Our practice follows the immunization guidelines recommended by the American Academy of Pediatrics (AAP).

For information about these vaccines, the diseases they protect against, immunization schedules, vaccine safety and other important information, please visit the AAP immunization page.

To learn more about Phoenix Children’s position regarding vaccines, please click here.

As a parent, it is your job to protect your child when riding in a vehicle. Using car seats properly helps keep children safe. But with so many different types of car seats on the market, understanding how to use them correctly can be overwhelming for parents.

Visit the AAP Car Seat Safety Information page for guidance on choosing the most appropriate car safety seat for your child.

Child products, such as cribs and toys, are sometimes recalled due to a defect or hazard. It’s important to pay close attention to recalled consumer goods to protect your child from dangerous items.

Visit the following site frequently to ensure that the products your child is using have not been recalled by their manufacturer or the federal government: Consumer Product Safety

Traveling with children requires special planning and preparation, especially when traveling abroad. There are many things parents should consider when traveling with children of any age.

Visit the CDC Traveling with Children page for helpful resources, including:

• Safe food and water precautions, diarrhea management and insect protection when traveling abroad
• Modifying the immunization schedule
• Traveling while pregnant
• Travel and breastfeeding
• International adoptions

By Dr. Michael Perlstein

Asthma is a term we all have heard used in common conversation, so it seems so familiar. However, the specifics of the medical condition are vague, if not confusing to most of us. The following outlines what you need to know about asthma, then delves deeper into a subtype of asthma called exercise-induced bronchospasm (EIB).

Common asthma symptoms and triggers

Asthma is an inflammatory condition of the airways of the lung. It is diagnosed as both a recurrent and reversible condition, meaning a patient may have multiple respiratory events over time, which are treatable with medications that quickly ease symptoms. Classic subtle symptoms for asthma tend to be coughing during physical activity or play and coughing or shortness of breath during rest periods or at night. In addition to coughing, other common symptoms of asthma include:

• Shortness of breath
• Audible wheezing
• Low oxygen levels
• Disrupted sleep due to coughing
• Poor exercise tolerance

In general, a patient must be predisposed to asthma. Put another way, a patient may have reactive airways. This means that the lungs are waiting for an excuse to be triggered — and there must always be a trigger. Common triggers include:

• Upper respiratory illness (common cold)
• Environmental allergies
• Food allergies
• Inhaled irritants (i.e., smoke, ozone or pollution)
• Cold air
• Heartburn
• Exercise

Each asthmatic patient is truly unique — from the type of trigger that flares symptoms … to the type, combination, frequency and severity of symptoms they experience. A consultation with a primary care provider can narrow down key triggers and determine how best to manage symptoms.

Exercise-induced bronchospasm (EIB), a common form of asthma

One of the more common forms of asthma is exercise-induced bronchospasm (EIB), more commonly referred to as exercise-induced or exercise-triggered asthma. A bronchospasm is a tightening of the muscles that line the airways (bronchi) of the lungs. EIB causes coughing, shortness of breath and reduced exercise tolerance specifically when a person is engaged in physical activity. It’s quite possible for a person with EIB to experience asthmatic symptoms only during physical activity (i.e., exercise is their only asthma trigger).

In addition to asthma occurring during strenuous activity, symptoms can worsen at times when other common asthma triggers are present. For example, if someone with EIB exercises during high allergy season or while overcoming a cold or flu, their symptoms may flare up more than usual.

EIB, more common in adolescents and young adults

I have met many children over the years who were very active in competitive sports, but something always seemed to be holding them back. They were described as “very athletic” but couldn’t run as hard or as long as their peers. Once these young athletes were evaluated and diagnosed with EIB, they underwent medical therapy, and both the patients and their families were amazed at their recovery — with many of them enjoying higher performance levels in their chosen sport.

Testing and treating EIB

Most people at all ages experience some shortness of breath when exercising, especially early on during physical conditioning. It can be difficult to differentiate between the normal “being-out-of-shape” shortness of breath, and the pathologic exercise-induced cough and shortness of breath.

There are specific test protocols that can be done to determine or rule out EIB, which is most commonly evaluated by a pulmonary or allergy specialist. There are also medications that can be prescribed to treat EIB, both to treat acute symptoms as they occur and help prevent future symptom flare-ups.

To be clear, not all coughing or shortness of breath during exercise will be related to EIB. However, if these symptoms seem to ring true for your child, speaking with a pediatrician may help uncover possible treatable asthma symptoms hiding beneath the surface.

About Dr. Michael A. Perlstein

Michael A. Perlstein, MD, is a pediatrician, providing comprehensive pediatric primary care for children of all ages at Phoenix Children’s Pediatrics – Palo Verde, in Gilbert, Arizona.

Dr. Perlstein received his medical degree from the University of Arizona College of Medicine in Tucson, and completed his residency at the University of Minnesota.

He has served 10 years on the Arizona Chapter of the American Academy of Pediatrics board. Working closely with the families, he hopes to help shape a child's development, instilling a strong sense of self-confidence and self-esteem.

When not providing patient care, Dr. Perlstein loves spending time with his wife, three kids and numerous pets. He is also a soccer coach and has a passion for movies.