Why can't i get confirmation from my doctor that my baby has asthma?

Difficult to diagnos: The diagnosis of asthma is best established with lung function tests that are not feasible in babies. However national guidelines from the nih do give some criteria: recurrent episodes of wheezing, troublesome cough at night, cough or wheeze after exercise cough, wheeze or chest tightness after exposure to airborne allergens or pollutants colds “go to the chest” or take more than 10 days to clear.

Too young: We don't like to label kids at such a young age. Most kids outgrow their R.A.D (reactive airway disease) which is basically a childhood asthma. If symptoms persist once older, maybe by 4-5 yo then asthma might be more mentioned.

Similar conditions: In a young child certain temporary conditions may look like asthma but either resolve over time or respond to different treatment. Bronchiolitis which is most ofter cause by RSV virus can result in repeated episodes of wheezing usually after upper respiratory which can persist for several winters. Gastroesophageal reflux may cause repeated wheezing which would respond to acid reducers.

Difficult diagnosis: Asthma is a difficult diagnosis to make in young children. Up to 40% will have occasional wheezing with respiratory infections that resolve as the child gets older. Many docs will avoid diagnosing asthma in young children for this reason. Also, spirometry or breathing tests cannot be performed accurately until about 4 years of age. Recurrent wheezing beyond age 6 is more likely to be asthma.

Confirmed over time: Usually, the diagnosis is confirmed over time. This is because "asthma" means a child has repeated episodes of asthma symptoms over time. So, doctors often don't want to label a child as being "asthmatic", if the child had only one mild episode of asthma symptoms.

May be it is not: Many infants have predisposing factors such as family history as well as a history of atopy or cows milk allergy. Some babies wheeze because they have reflux, others develop chronic wheezing problems secondary to infections such as rsv. Do not forget environmental factors such as second hand smoke and exposure to fumes. Yet it does not mean your child will be an asthmatic.