Welcome to

Respiratory and Sleep Medicine


Pediatric Asthma Center

The Division of Respiratory and Sleep Medicine at The Children's Hospital at Montefiore (CHAM) houses a specialized Pediatric Asthma Center, where we treat what is the most common chronic disease of childhood, as well as the number one cause of pediatric hospital admissions. The Bronx has one of the highest rates of childhood asthma in the country. Thousands of children are rushed to the CHAM Emergency Department for specialized asthma treatment each year. Our team of Pediatric Respiratory Medicine and Allergy experts comprised of physicians, nurse practitioners and health educators are committed to preventing these emergency room visits and hospitalizations. We take a unique approach to asthma treatment, based on the idea that it is a controllable condition and every child with asthma should be able to do everything their peers without asthma are doing.

The Asthma Center is staffed by Dr. Deepa Rastogi, the lung specialist, Dr. Tatyana Gavrilova, the allergist, Ms. Marisa Greechan, pulmonary nurse practitioner, and Ms. Arlene Tran, the health educator. The Center offers a comprehensive evaluation of your child’s asthma by lung specialists and allergy specialists to identify the main factors playing a role in poor control of disease. Over a span of 3-4 visits, we will help you understand your child’s lung function, and allergies and factors that are contributing to poor asthma control. We will review with you the best way to keep your child’s lung function in the normal range, allow normal physical activity and prevent sleepless nights and missed school days due to coughing or wheezing.

Controlling asthma: a common childhood condition

Asthma causes the lungs to become more reactive to exposures than normal. It can be triggered by:

  • Viruses
  • Cigarette smoke
  • Pets
  • Exercise
  • Environmental exposures such as dust, roaches, mice and mold.

As the breathing tubes become irritated, the inner lining of the tubes becomes inflamed and swollen, making the muscles in the tubes contract, narrowing the passageway for air.

Up to 80 percent of children with asthma develop symptoms before age five, including:

  • Coughing during day or night or after exercise
  • Coughing for several weeks after a cold
  • Feeling out of breath after exercise
  • A wheezing sound that is detectable with a stethoscope.

While there is no single test for asthma, we can diagnosis it by taking a patient's history, performing a physical examination and conducting pulmonary function tests and exercise tests. We invite parents to play an important role, as the observations made by caregivers can help doctors to make a proper diagnosis.

After we have diagnosed asthma, we implement a care management plan that often includes specialized environmental management, such as providing children with a smoke free environment, and daily medication to protect the lungs, as well as medication to have on hand in case of an attack. We aim to help children and their caregivers identify possible triggers, in order to avoid full fledged asthma attacks and the cumulative damage they cause, and to help children to have the highest quality of life possible.

Asthma and Obesity: We offer a specialized program for asthmatic children who are obese. We promote physical activity thereby facilitating weight loss and improved asthma.

Asthma and Allergy: We identify the allergy profile of children and help the families manage it better. In cases where changes in the home environment are helpful but do not completely take away the problem, we administer a specialized medication that decreases the body’s reaction to substances that the child is allergic to.

Asthma and the Community: We are actively involved in asthma programs in the community and advocate improved access to care for children with asthma.