Doctors aren’t sure why some children develop asthma and others don’t, or why the disease increased so alarmingly during the last decades of the 20^th century. Research also shows that some groups  -- like boys, African-Americans, and kids who live in Northeastern cities  -- are more likely to get asthma, but again it does not tell us why. The primary risk factors for asthma are

• Heredity: Both a family history of asthma, particularly in parents, and a family history of allergies predispose children to asthma. If one parent has asthma, the chances are 1 in 3 that a child with develop asthma. If both parents have asthma, the chance rises to 7 in 10.

• Living in an urban area: Poor air quality and more exposure to indoor irritants may be the reason cities seem to have more children with asthma, but researchers aren’t sure – it could be the concentration of high-risk populations as well.

• Frequent respiratory infections, especially respiratory syncytial virus (RSV): Some infections, however, help children develop a healthy immune system, so it’s not necessary to take extreme steps to prevent illness. In fact, there is a theory, called the “hygiene hypothesis,” which suggests that overprotecting children from germs and other environmental factors can lead to increased rates of asthma.

• Regular exposure to secondhand smoke

• Regular exposure to chemicals used in agriculture, hairdressing or manufacturing

• Low birth weight (less than 5.5 pounds)

• Reflux or GERD (gastroesophageal reflux disease)

• Proximity to areas with a lot of vehicle traffic

• Being overweight

• Being African-American or Puerto Rican

• Being male: Though in adulthood, more women have the condition.

• Living in the Northeast: Asthma rates are highest here. Researchers aren’t sure if this is due to climate, urbanization, concentration of certain populations or all of the above.

• Poverty: Sub-par medical care, exposure to triggers, and less ability to modify the environment to make it healthier are some of the reasons experts think asthma has been linked to low income.

Triggers:

While the above factors may contribute to your child being at risk for asthma, the triggers below actually cause attacks. Asthma triggers differ from person to person -- if you have two kids with asthma, one may get an attack after petting a neighbor’s dog, while the other may instead start coughing on a cold, windy day. Common asthma triggers include:

• Airborne allergens: These includepollen, animal dander, mold, cockroach droppings, dust mites, mold

• Air pollutants: These include smoke (especially from cigarettes),air pollution like ozone and smog, chemicals (common household versions include paint fumes, cleaners, spray glues), hairspray

• Physical activity

• Cold air, wind, rain, sudden air changes

• Medications: These include beta blockers, aspirin and other non-steroidal anti-inflammatory drugs 

• Strong emotions and stress: Temper tantrums and crying can bring on an attack (as if they weren’t bad enough)

• Sulfites and preservatives in food: Artificial sweeteners like Aspartame andadditives likesulfites can trigger an attack

• Episodes of GERD, gastroesophegal reflux: Stomach acid backing into the throat

• Allergic reactions to food: This can include peanuts and shellfish, and even eggs and cow’s milk