If your child has been diagnosed with asthma, one of the first questions you may ask is whether they will always have it. You may wonder if asthma is something your child can grow out of, or whether they will need inhalers and regular reviews long term.
The honest answer is that some children do improve as they get older, particularly those who mainly wheeze during viral infections in the preschool years. However, not every child grows out of asthma, and symptoms can sometimes return later even after a long symptom-free period.
This can feel confusing, but it becomes easier to understand when you see how asthma can change with age. Some children have fewer symptoms over time, while others continue to need ongoing management into later childhood or adulthood.
The most important thing is to keep your child’s asthma well controlled, attend regular reviews, and never stop treatment without medical advice, even if symptoms seem to have improved.
What Does “Growing Out of Asthma” Actually Mean?
When people say a child has “grown out of asthma”, they usually mean the child no longer has regular symptoms. They may stop coughing at night, stop wheezing with colds, and no longer need inhalers as often as before.
However, asthma can be more complicated than that. Some children go through long periods without symptoms but may still have sensitive airways that can react again later.
This is why doctors may talk about asthma being “in remission” rather than completely cured. Your child may seem well for years, but symptoms can sometimes return during teenage years, adulthood, viral infections, allergy seasons or heavy exposure to triggers.
Is Childhood Asthma Always Lifelong?
No, childhood asthma is not always lifelong in the same way for every child. Some children experience symptoms for a few years and then improve significantly over time.
This is particularly common in children who only wheeze during viral infections. Many preschool children develop wheezing during colds, but not all of them go on to have ongoing asthma as they grow older.
For other children, asthma can continue into school age, adolescence, or even adulthood. This is more likely when symptoms are frequent, triggered by allergies, occur between infections, or require regular preventer treatment to keep them under control.
Why Young Children Often Improve With Age
Young children have smaller airways, so even mild swelling or mucus during a cold can make breathing sound noisy. This can lead to wheezing, coughing or breathlessness during viral infections. As children grow, their airways become larger.
This can make viral wheeze less obvious and less troublesome over time. This is one reason some children appear to “grow out” of early wheezing. Their symptoms may improve because their lungs and airways mature, not because they had the same asthma pattern as an older child or adult.
Preschool Wheeze vs Asthma
Preschool wheeze and asthma can look very similar, but they are not always the same condition. Preschool wheeze usually refers to young children who wheeze mainly during viral infections, particularly common colds.
Some children with preschool wheeze have no breathing symptoms between infections. When they are well, they may run, play, and sleep normally without any noticeable difficulty breathing.
Asthma becomes more likely when symptoms happen repeatedly, occur between infections, disturb sleep, are triggered by exercise or allergens, or are associated with eczema, hay fever, or a family history of asthma. In these cases, a healthcare professional may consider closer review and longer-term management.
Why Diagnosis Can Be Difficult in Under-5s
Asthma can be more difficult to diagnose confidently in children under the age of five. This is because young children are usually not able to perform breathing tests reliably, which makes it harder to measure lung function in the same way as older children.
In this age group, doctors may use the term “suspected asthma” while they continue to observe symptoms over time. They may also suggest a trial of treatment and then review whether there is improvement in coughing, wheezing, or breathing difficulties.
This does not mean your child’s symptoms are not real. It simply reflects that breathing problems in young children can have several possible causes, and doctors often need to see how symptoms develop over time before confirming whether it is asthma or something like viral wheeze.
UK Guideline Note:
In the UK, asthma diagnosis and long-term management should follow recognised guidance such as the BTS/NICE/SIGN asthma guideline. In children under 5, diagnosis can take time because breathing tests may not be reliable. Your doctor may treat suspected asthma, review symptoms regularly, and consider objective tests when your child is old enough to perform them properly.
Which Children Are More Likely to Improve?
Children are more likely to improve if they only wheeze during colds and have no symptoms in between infections. You may also notice a better outlook if your child does not have eczema, hay fever, or strong allergy-related triggers.
Milder symptoms are generally more likely to settle over time compared with frequent or more severe symptoms. If your child rarely needs a reliever inhaler and has long periods without any breathing problems, this can be a reassuring sign that their asthma is well controlled.
However, no one can predict exactly how asthma will change as your child grows. It may improve, remain stable, or fluctuate over time, which is why regular review and ongoing monitoring remain important.
Which Children May Continue to Have Asthma?
Some children are more likely to continue having asthma symptoms as they get older. This may include children with frequent wheezing, night-time cough, exercise symptoms or symptoms between colds.
Asthma may also be more likely to continue if your child has eczema, hay fever, food allergies or a strong family history of asthma. These allergic conditions can show that the airways are more sensitive.
Children who have severe asthma attacks or need regular preventer treatment may also need ongoing care. This does not mean they cannot do well, but it does mean their asthma should be monitored carefully.
Signs Asthma May Be Improving
If your child has asthma, it can be reassuring to notice when symptoms start to reduce over time. Improvement usually happens gradually and shows up in everyday activities rather than overnight changes.
- Fewer night-time symptoms: Your child may stop waking up with coughing or breathing discomfort during the night. This often indicates better overall asthma control.
- Reduced need for reliever inhaler: You may notice your child needs their blue inhaler less often, suggesting fewer sudden flare-ups or breathing difficulties.
- Improved exercise tolerance: Your child can run, play, and take part in physical activities without becoming breathless or coughing as quickly as before.
- Fewer symptoms during colds: Viral infections may still occur, but they cause milder coughing or no wheezing compared to previous episodes.
- Better school attendance and daily routine: Your child may miss fewer school days and be able to sleep, learn, and play normally without asthma getting in the way.
When these improvements are consistent over time, they may suggest that asthma is becoming better controlled. However, regular review is still important even when symptoms improve.
Signs Asthma May Not Be Improving
Asthma may not be improving if your child still coughs at night, wheezes frequently, becomes breathless with exercise, or needs their reliever inhaler often. These symptoms suggest their asthma may not be well controlled.
You should also seek review if your child has repeated asthma attacks, needs oral steroids, misses school because of breathing symptoms, or avoids activities because they feel breathless.
Do not assume your child will simply grow out of these symptoms. Ongoing asthma symptoms deserve proper review and treatment.
Asthma Can Change During School Years
As children move from preschool into school age, their asthma pattern may become clearer. They may be able to describe symptoms better and perform breathing tests more reliably.
At school age, doctors may look at symptoms during exercise, night-time coughing, triggers, inhaler response and objective tests where appropriate. This can help confirm whether asthma is still present.
Some children improve at this stage, while others continue to need treatment. The important thing is to adjust the plan to your child’s current symptoms, not what was happening years ago.
Asthma During the Teenage Years
The teenage years can be a time when asthma changes again. Some children notice an improvement in their symptoms during adolescence, while others continue to experience asthma into their later teens.
Teenagers may also become less consistent with their inhalers because they feel well, forget doses, or do not want to feel different from their friends. This can lead to poorer asthma control, even when the condition is otherwise very manageable.
Your teenager should be actively involved in their own asthma care. They need to understand their symptoms, recognise their triggers, know how and when to use their inhalers, and feel confident about when to seek help if their symptoms change.
Can Asthma Come Back After Years Without Symptoms?
Yes, asthma symptoms can sometimes return after a long period without any noticeable problems. This may happen during the teenage years or adulthood, or after a respiratory infection, during allergy seasons, or following exposure to triggers such as smoke, pollution, or occupational irritants later in life.
This is why it is helpful for your child to understand their asthma history, even if they seem to have outgrown their symptoms. If wheezing, a persistent cough, or breathlessness returns, it should be reviewed by a healthcare professional rather than ignored.
A symptom-free period is still very positive news, but it does not always mean asthma has completely gone away. Instead, it may simply be in remission, and awareness of previous symptoms can help ensure early review if they return.
Evidence Note:
Long-term studies show that childhood asthma can follow different patterns. Some children experience remission during adolescence or early adulthood, while others continue to have symptoms or relapse after a symptom-free period. Factors such as allergic sensitisation, more severe childhood asthma, reduced lung function, frequent symptoms and airway hyperresponsiveness may increase the chance that asthma continues. For parents, this means improvement is possible, but asthma should still be reviewed regularly rather than assuming it has completely gone away.
Why You Should Not Stop Inhalers Without Medical Advice
If your child seems well, it is natural to wonder whether they still need their inhalers. This is a very common question for parents, especially when symptoms have not been present for some time.
However, you should not stop preventer treatment or make changes to your child’s asthma plan without first speaking to a doctor or asthma nurse. Stopping medication too early may allow symptoms to return or increase the risk of an asthma flare-up.
If your child has been symptom-free for a period of time, their clinician may consider reducing treatment gradually. This should always be done in a planned and safe way, with clear guidance on what to do if symptoms return.
What Does “Stepping Down” Treatment Mean?
Stepping down treatment means gradually reducing asthma medication when your child’s symptoms have been well controlled for a suitable period. This is done carefully and in a planned way to find the lowest level of treatment that still keeps your child well.
It may involve reducing the dose of a preventer inhaler, reviewing how often medication is used, or trialling a small change in the overall treatment plan. Any adjustment should always be guided by a healthcare professional, with clear follow-up to make sure symptoms remain controlled.
The aim is not to keep your child on more medication than they need. Instead, the goal is to maintain good asthma control while using the lowest effective treatment, avoiding unnecessary medication where it is safe to do so.
What If Your Child Only Needs an Inhaler During Colds?
Some children mainly need asthma or wheeze treatment during viral infections. They may be completely well between colds. In these cases, your doctor may give you a specific plan for what to do when a cold starts.
This can help you act early if coughing, wheezing or breathlessness begins. Even if your child only has symptoms during colds, you should still know when to seek urgent help. Viral-triggered wheeze can sometimes become severe.
What If Your Child Has Exercise Symptoms?
Some children appear well most of the time but develop coughing or breathlessness during exercise. You may notice this during running, PE lessons, football, swimming, or other active play.
This does not necessarily mean your child should avoid sport or physical activity. In most cases, the goal is to achieve good asthma control so your child can take part in exercise safely and confidently.
If exercise regularly triggers symptoms, it is important to have your child’s asthma plan reviewed. They may benefit from improved preventer treatment, a check of inhaler technique, or specific advice on how to manage symptoms during physical activity.
What If Your Child Has Allergy-Related Asthma?
Children with allergy-related asthma may be less likely to completely outgrow their symptoms, especially if the triggers that affect them are still present. Common triggers include pollen, dust mites, pets, mould, and seasonal conditions such as hay fever.
If you notice that your child’s asthma becomes worse at certain times of the year or in response to specific triggers, it is important to mention this during their review. In some cases, treating related conditions such as allergic rhinitis or hay fever can also help improve overall asthma control.
You do not need to eliminate every possible trigger from your child’s environment. Instead, the focus should be on identifying the most significant triggers and managing them in a realistic and practical way that supports your child’s daily life.
The Link Between Eczema, Hay Fever and Asthma
Asthma, eczema and hay fever often occur together. This is sometimes linked to an allergic tendency in the body. If your child has eczema or hay fever as well as asthma symptoms, their airways may be more likely to remain sensitive.
This does not mean they will definitely have lifelong asthma, but it may increase the chance of ongoing symptoms. Tell your child’s doctor about skin symptoms, nasal symptoms, food reactions and seasonal allergies. These details can help guide asthma management.
Can Good Treatment Help Asthma Improve?
Good asthma treatment can help your child stay well, sleep better, take part in exercise safely, and reduce the risk of severe flare-ups. While it may not cure asthma, it can make a significant difference to your child’s day-to-day comfort and quality of life.
Using preventer medication correctly, checking inhaler technique, avoiding known and avoidable triggers, and following a written asthma action plan can all contribute to better long-term control of symptoms.
Good control also helps doctors understand how your child’s asthma is behaving over time. If your child remains well because treatment is working effectively, a healthcare professional can then advise whether any changes or a gradual reduction in medication may be appropriate.
Why Inhaler Technique Matters
Sometimes asthma appears to be poorly controlled because the medication is not reaching your child’s lungs properly. This is quite common in children and can affect how well their treatment works, even when the correct medicine has been prescribed.
A spacer can help many children use their inhaler more effectively by making it easier for the medication to reach the airways. Younger children may need a spacer with a mask, while older children may be able to use a mouthpiece instead, depending on their age and ability.
Your child’s inhaler technique should be checked regularly, even if they have been using inhalers for several years. Small changes or mistakes in technique can reduce how much medicine reaches the lungs, which may make asthma symptoms harder to control.
The Role of an Asthma Action Plan
A written asthma action plan helps you understand what to do when your child is well, when symptoms start to worsen, and when urgent medical help is needed. It should clearly explain inhaler use, key warning signs, and the steps to take in an emergency.
This plan should be shared with your child’s school, nursery, relatives, or anyone else involved in their care. It ensures that everyone is aware of your child’s needs and knows how to respond if symptoms flare up.
An asthma action plan is helpful even when your child seems to be improving. It acts as a safety net, giving you clear guidance and reassurance if symptoms return or change.
How Doctors Decide Whether Asthma Has Improved
Doctors usually consider several factors before deciding whether your child’s asthma has improved. They may ask about daytime symptoms, night-time coughing, exercise tolerance, reliever inhaler use, recent flare-ups, and any school absences due to breathing problems.
They may also review inhaler technique, check your child’s growth, discuss possible triggers, and consider any side effects from medication. In older children, breathing tests can provide additional information about how well the lungs are working.
The decision is not usually based on a short period of improvement. Instead, doctors look for a consistent and stable pattern over time before making any changes or reducing treatment.
When Your Child May Need Ongoing Treatment
Your child may need ongoing treatment if they continue to experience regular symptoms, night-time coughing, reduced ability to exercise, frequent use of a reliever inhaler, or asthma attacks. These signs can indicate that asthma is still active and not fully under control.
Ongoing treatment may also be necessary if symptoms return when preventer medication is reduced. In some cases, this simply means your child needs more time on their current treatment before any step-down can be considered safely.
This can feel disappointing, but it is important to understand that it is not a setback. It simply means your child’s asthma still needs ongoing support to stay well managed and to reduce the risk of future flare-ups.
Can Children With Asthma Live Normally?
Yes, most children with asthma can live active, healthy lives when their symptoms are well controlled. Asthma should not automatically stop your child from going to school, joining in with sport, playing with friends or enjoying normal daily activities.
The key is good control. This means using inhalers correctly, following the asthma action plan, attending regular reviews and recognising when symptoms are starting to worsen. If your child avoids exercise, wakes at night coughing or needs their reliever inhaler often, their asthma plan may need review.
With the right support, asthma becomes something your child can understand and manage rather than something that limits them. The aim is always to help your child feel confident, safe and able to take part in everyday life as fully as possible.
Common Myths About Growing Out of Asthma
| Myth | Fact |
| “All children grow out of asthma.” | Some improve, but not all children grow out of asthma symptoms. |
| “If symptoms stop, asthma is cured forever.” | Symptoms can return later, especially with triggers or infections. |
| “My child can stop inhalers as soon as they feel better.” | Treatment should only be changed with medical advice. |
| “Exercise should be avoided if a child has asthma.” | Most children can stay active when asthma is well controlled. |
| “Preschool wheeze always becomes asthma.” | Many young children with viral wheeze improve as they grow. |
Factors That May Affect Whether Asthma Improves
| Factor | More Likely to Improve | More Likely to Continue |
| Symptom pattern | Wheeze only with colds | Symptoms between colds |
| Allergies | No eczema or hay fever | Eczema, hay fever or allergy triggers |
| Severity | Mild, occasional symptoms | Severe or frequent flare-ups |
| Night symptoms | Rare or absent | Frequent night cough or waking |
| Exercise symptoms | No limitation | Breathlessness or cough with activity |
| Family history | No strong asthma history | Parent or sibling with asthma |
When to Ask for an Asthma Review
You should ask for an asthma review if your child has symptoms more often than expected, wakes at night with coughing or breathlessness, avoids exercise, or needs their reliever inhaler frequently. These can all be signs that asthma is not fully controlled and may need reassessment.
You should also seek a review if your child seems well and you are wondering whether their treatment can be reduced. Any changes to asthma medication should always be discussed with a healthcare professional rather than made at home.
Regular asthma reviews are helpful even when your child is doing well. They ensure that treatment is still appropriate for their age, symptoms, and level of risk, and help maintain good long-term control.
What to Discuss at the Review
At the review, tell the doctor how often your child has symptoms, whether they wake at night, and whether they can exercise normally. Mention any flare-ups, emergency visits, steroid courses or missed school days. Bring your child’s inhalers and spacer if possible.
The doctor or asthma nurse can check technique and make sure the device still suits your child. You can also ask directly, “Is my child likely to grow out of this?” The answer may not be certain, but the doctor can explain what your child’s pattern suggests.
When to Seek Urgent Help
Do not wait for a routine asthma review if your child is struggling to breathe. Breathing difficulties in children should always be taken seriously and assessed urgently.
You should seek immediate help if your child is too breathless to speak, eat, or drink, has blue, grey or unusually pale lips or skin, is unusually drowsy, has severe chest pulling in, or is not improving after following their asthma action plan.
For life-threatening symptoms, call 999 or go to A&E without delay. If you are unsure what to do and the situation is not immediately life-threatening, NHS 111 can guide you to the most appropriate next step.
UK Safety-Net Note:
Asthma symptoms can sometimes worsen quickly. If your child is struggling to breathe, has blue, grey or unusually pale lips or skin, is too breathless to speak, eat or drink, becomes unusually drowsy, has severe chest pulling in, or does not improve after following their asthma action plan, seek urgent help immediately. In a life-threatening situation, call 999 or go straight to A&E.
Helping Your Child Understand Asthma
As your child gets older, it is helpful for them to gradually understand their asthma in a simple, age-appropriate way. They do not need detailed medical knowledge, but it is important that they recognise their symptoms and know when to ask for help.
You can explain asthma in straightforward language, such as saying that their “breathing tubes can become sensitive and the inhaler helps them open up so breathing feels easier.” Keeping explanations simple helps your child make sense of what is happening without feeling overwhelmed.
Try to keep conversations calm and practical so your child feels supported rather than worried. When asthma is explained in a reassuring way, your child is more likely to feel confident in managing their symptoms as they grow.
Supporting Your Child at School
If your child has asthma or suspected asthma, it is important that the school is aware. Staff should understand your child’s symptoms, when they may need their inhaler, and what steps to take if a flare-up occurs during the school day.
Your child should have access to their reliever inhaler in line with their care plan. In many cases, the school will also keep a copy of the asthma action plan so they know how to respond appropriately if symptoms worsen.
Even if your child seems to be doing well, it is still helpful to keep the school updated. Asthma symptoms can return unexpectedly, particularly during colds, exercise, or allergy seasons, so clear communication helps ensure your child stays safe and supported.
Private Asthma Review in London
If your child’s asthma symptoms are changing, becoming harder to control, or improving over time, a specialist review can help you understand what is happening. It may also be useful if you are unsure whether your child still needs the same treatment or whether their medication can be adjusted safely.
A paediatric asthma review usually includes a detailed history, examination, inhaler technique check, discussion of triggers, and review of current treatment. In some cases, further tests may be suggested to support the assessment.
Key Takeaways
- Some children do improve as they get older, especially those who mainly wheeze during viral infections.
- Not every child grows out of asthma, and symptoms can sometimes return after a symptom-free period.
- Asthma is more likely to continue if symptoms happen between colds, disturb sleep, affect exercise or are linked with allergies.
- Never stop or reduce inhalers without medical advice.
- Regular asthma reviews help decide whether treatment can safely be continued, adjusted or stepped down.
- Children with well-controlled asthma can usually take part in normal school, sport and daily activities.
- Seek urgent help if your child is struggling to breathe, has blue, grey or unusually pale lips or skin, becomes unusually drowsy or does not improve after following their asthma action plan.
FAQs:
1. Can childhood asthma come back after it seems to have gone away?
Yes. Some children have no asthma symptoms for several years but experience a return of coughing, wheezing or breathlessness later in life. Symptoms may reappear during adolescence, adulthood, viral infections or allergy seasons. Even after a long symptom-free period, it is important to recognise recurring symptoms and seek medical advice if they return.
2. At what age do children usually grow out of asthma?
There is no specific age at which children outgrow asthma. Some children improve during the primary school years, while others notice fewer symptoms during adolescence. Every child’s asthma is different, and regular reviews help determine whether treatment should be adjusted as they grow.
3. Does growing out of asthma mean my child is completely cured?
Not necessarily. Many children who appear to have grown out of asthma simply experience long periods without symptoms. Their airways may still remain sensitive, which means asthma symptoms could return later if triggered by infections, allergies, exercise or environmental factors.
4. Should my child stop using their inhaler if they no longer have asthma symptoms?
No. You should never stop your child’s preventer inhaler or change their treatment without medical advice. If asthma has remained well controlled for a prolonged period, your healthcare professional may recommend gradually reducing treatment while continuing to monitor symptoms.
5. Can children with asthma still lead normal, active lives?
Yes. Most children with well-controlled asthma can enjoy school, sports, holidays and everyday activities without significant limitations. Following the prescribed treatment plan, using inhalers correctly and attending regular asthma reviews can help your child stay active and healthy.
6. Does having eczema or hay fever mean my child is less likely to grow out of asthma?
Children with asthma alongside eczema, hay fever or other allergic conditions may be more likely to continue experiencing asthma symptoms as they get older. However, this does not mean improvement is impossible. Many children still achieve excellent asthma control with appropriate treatment and monitoring.
7. How often should my child have an asthma review?
Most children with asthma should have regular reviews, even when their symptoms are well controlled. These appointments allow healthcare professionals to assess symptom control, review inhaler technique, monitor medication and decide whether any changes to treatment are appropriate.
8. Can exercise make asthma worse permanently?
No. Exercise does not damage the lungs or make asthma permanently worse. If your child regularly develops coughing or breathlessness during physical activity, it usually means their asthma needs better control rather than avoiding exercise altogether.
9. What are the signs that my child’s asthma is getting better?
Signs of improvement include needing a reliever inhaler less often, sleeping through the night without coughing, having fewer flare-ups during colds, exercising comfortably and participating in normal daily activities without breathing difficulties. These improvements should still be discussed during routine asthma reviews before making any treatment changes.
10. When should a specialist asthma assessment be arranged for a child?
A specialist paediatric asthma assessment may be helpful if your child has frequent asthma symptoms, repeated wheezing, uncertainty about the diagnosis, poor symptom control despite treatment, recurrent asthma attacks or if you would like advice about whether treatment can safely be reduced. A specialist can provide a personalised management plan based on your child’s individual symptoms and needs.
Final Thoughts: Supporting Your Child’s Asthma Journey
While some children experience fewer asthma symptoms as they grow older, there is no way to predict with certainty whether asthma will disappear completely. The most important step is to keep your child’s asthma well managed through regular reviews, appropriate treatment and careful monitoring of any changes in symptoms. Even if your child has been symptom-free for some time, any decision to reduce or stop treatment should always be made with the guidance of a healthcare professional.
If you are looking for a trusted children’s asthma clinic in London, you can contact London Paediatric Clinic to arrange a consultation and discuss your child’s needs. A specialist assessment can provide personalised advice, help you understand how your child’s asthma is changing over time, and ensure they receive the most appropriate care for every stage of childhood.
References:
- National Institute for Health and Care Excellence (NICE) (2024) Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). NICE guideline NG245. Available at: https://www.nice.org.uk/guidance/ng245
- Sears, M.R., Greene, J.M., Willan, A.R., Wiecek, E.M., Taylor, D.R., Flannery, E.M., Cowan, J.O., Herbison, G.P., Silva, P.A. and Poulton, R. (2003) A longitudinal, population-based, cohort study of childhood asthma followed to adulthood, The New England Journal of Medicine, 349(15), pp.1414–1422. Available at: https://pubmed.ncbi.nlm.nih.gov/14534334/
- Wang, A.L., Datta, S., Weiss, S.T. and Tantisira, K.G. (2019) Remission of persistent childhood asthma: Early predictors of adult outcomes, Journal of Allergy and Clinical Immunology, 143(5), pp.1752–1759.e6. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7061344/
- Almqvist, L., Andersson, M., Backman, H., Rönmark, E. and Hedman, L. (2024) No remission in 60% of those with childhood-onset asthma: A population-based cohort followed from 8 to 28 years of age, Respiratory Medicine, 224, article 107581. Available at: https://www.sciencedirect.com/science/article/pii/S0954611124000556
- Guerra, S., Wright, A.L., Morgan, W.J., Sherrill, D.L., Holberg, C.J. and Martinez, F.D. (2004) Persistence of asthma symptoms during adolescence: Role of obesity and age at the onset of puberty, American Journal of Respiratory and Critical Care Medicine, 170(1), pp.78–85. Available at: https://academic.oup.com/ajrccm/article-abstract/170/1/78/8538450