Please reference this document as follows:
From the Global Strategy for the Diagnosis and Management of Asthma in Children 5 Years and Younger, Global Initiative for Asthma (GINA) 2009. Available from: http://www.ginasthma.org.

Each year, the Global Initiative for Asthma (GINA) updates its guidelines for treatment of asthma, the Global Strategy for Asthma Management and Prevention, and makes it available via the GINA Website at www.ginasthma.org. That guideline document provides a unified text and a source document for other GINA documents and resources. Each chapter contains, where relevant, details and management advice for specific age groups including children 5 years and younger, children older than 5 years, adolescents, adults, and the elderly. Most of the differences between these age groups relate to natural history and co-morbidities, but there are also important differences in the approach to diagnosis, measures for assessing severity and monitoring control, responses to different classes of medications, techniques for engaging with the patient and his/her family in establishing and maintaining a treatment plan, and the psychosocial challenges presented at different stages of life.

In January 2008, the GINA Executive Committee convened a panel of pediatric experts* to prepare a conceptual framework for the diagnosis and management of asthma in children 5 years and younger. In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in health care access and delivery. Patients in this age group are often managed by pediatricians and general practitioners who are routinely faced with a wide variety of issues related to childhood diseases. While this report highlights a number of issues specific to the under-5 age group, the reader is referred to the Global Strategy for Asthma Management and Prevention for fuller background on asthma pathology, pathophysiology, and medications. Recommendations in this report are made based on the best evidence currently available, and are intended to serve as an initial reference point with the recognition that some recommendations may need to be modified to adapt to the population characteristics and health care resources present in different clinical practice settings.

Eric Bateman, MD
Chair, GINA Executive Committee