“Why do I have this?”
The kids tend to ask, “Why do I have this?” almost in a “What’s wrong with me?” kind of way. I very clearly say tell them that it is not their fault, and that there is nothing wrong with them. I explain that asthma is something that we know tends to be hereditary and is something they inherit, just like they inherit their eye color and hair color. I also try and point out that although they don’t have control over the hereditary part of asthma, there are things about it that they do have control over, like their environments, how they manage their asthma, how they take the medicines. All these things play roles in helping them understand why they have it or how sick they get with it. I really try to point out that there are some kids who do have significant asthma but with having all the education and knowledge about how to manage it they don’t really have to be sick at all. They can be at a point where no one will ever really know that they have asthma because they seem fine.

Shari Nethersole, MD, Pediatrician

 

Genes can skip generations
Sometimes it’s confuses parents how they could have contributed genes for asthma to their child if they don’t have asthma and the other parent doesn’t have asthma. I often explain how genes can skip generations and even if you yourself don’t have asthma, you can still carry the gene that predisposes to asthma and can pass that gene down to your child. In combination with certain other genes from the other parent, your child can wind up with a genetic tendency to get asthma. The environmental part is easier for people to grasp, because there is sometimes tangible evidence of what causes an asthma attack– a kid goes over to Grandma’s house with the cat and starts wheezing or coughing, for example. People can really appreciate that environmental changes can make symptoms better or worse.

Hans Oettgen, MD, PhD, Associate Chief, Division of Immunology

 

Parents often want to know why their kid got asthma
The answer that I generally give to that question is there are two big reasons. The first is that asthma is genetic, which means your child inherited genes which came from you and the other parent which predisposed him or her to asthma. The second big contribution to asthma is the environment, so a child who has a genetic predisposition for asthma usually doesn’t instantly have asthma when they’re born, but through gradual exposure to things which we call allergens, which come from the environment and through allergic responses, develops inflammation in the airways which then causes asthma. So if a child who has two parents with bad asthma grows up in urban Boston in a home with lots of dust mites and cockroaches he or she is probably going to have asthma, and a kid who has no allergy history in the family and who lives in Denver, Colorado in the mountains with no mice or dust mites is probably not going to get asthma. Those are two extreme examples that I use to help explain the genetic and the environmental components of asthma to parents.

Hans Oettgen, MD, PhD, Associate Chief, Division of Immunology