Breathe Deeply Caring for children with complex asthma

Difficult-to-treat asthma can be a major contributor to school absenteeism, inability to engage in physical activity, and emergency department visits and hospital admissions.  In some cases, what presents itself as recurrent pneumonia or frequent respiratory infections can actually be traced back to an underlying asthma diagnosis.

The C.S. Mott Children’s Hospital Asthma Wellness Program is specifically designed for high-risk pediatric asthma patients.CIC-breathedeeply

“We’ve crafted our program around the needs of children 3 years of age and older who have had at least two emergency room visits or an inpatient admission for asthma,” says Marc Hershenson, MD, chief of the division of pediatric pulmonology at C.S. Mott Children’s Hospital.

The Mott team works closely with the child’s family and primary care providers to manage complex asthma through a robust year-long protocol utilizing intensive education and case management.  Emphasis is focused on decreased emergency department visits and admissions. Each child in the program is seen by a pediatric pulmonologist, nurse educator, respiratory therapist and social worker.

“We take a collaborative, multidisciplinary approach to treating children with complex asthma,” says Dr. Hershenson. “We’ve found that to be the best way to help minimize the complications of asthma for these children.  Causes of poor asthma control can range from failure to use an inhaler correctly to co-morbidities such as gastroesophageal reflux or fungal sensitization.   On the other hand, some referrals for difficult-to-treat asthma turn out to have other diseases like primary ciliary dyskinesia or recurrent aspiration.  Our multidisciplinary model allows us to provide accurate, comprehensive, multi-faceted care for each child.”


The U-M pediatric pulmonology team – including 11 pediatric pulmonologists – offers expertise in pulmonary conditions ranging from common breathing disorders to rare conditions:

  • Wheezing
  • Chronic cough
  • Recurrent respiratory infections and pneumonia
  • Asthma
  • Cystic fibrosis
  • Lung diseases of premature infants including bronchopulmonary dysplasia
  • Sleep-disordered breathing including central and obstructive apnea
  • Respiratory insufficiency requiring ventilator assistance
  • Aerodigestive disorders
  • Congenital abnormalities of airway and lung development including tracheobronchomalacia

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