Longitudinal studies2–5 over the past 2 decades have furthered our concepts of the natural history of infantile wheezing. Although as many as 50% of children will have at least one episode of wheezing by 3 years of age, only a third of them seem to be at risk for recurrent wheezing later in life.6 A genetic predisposition for atopic diseases, seen by a positive family history among first-degree relatives and a personal history of infantile eczema and allergic rhinitis, is the most significant risk factor for asthma.4–5,7 In fact, the National Heart Lung Blood Institute, in updating the Guidelines for the Diagnosis and Management of Asthma, incorporated the asthma predictive index,7in its recommendations for which preschool children should be started on daily antiinflammatory therapy.8An infant or young child with recurrent wheezing and either one major criteria (parental history of asthma or a personal history of eczema), or two minor criteria (allergic rhinitis, wheezing apart from colds and peripheral eosinophilia > 4%), has approximately an 80% chance of persistent wheezing. Although such algorithms do not yet provide a dichotomous answer to the age-old question of whether a young child or infant has asthma, they identify those at risk, not only for recurrent wheezing, but also for potentially progressive failure to attain normal lung function. Whether daily inhaled corticosteroids started in preschool children can prevent the loss of lung function, which is still seen in 5- to 12-year-olds treated with nebulized budesonide,9–10 is not yet known. Alternatively, the abnormal lung function seen in some, regardless of therapy, may not be the result of inadequately treated asthma but rather its cause. Therefore, even earlier identification and proof of atopy in a child might offer a better chance for successful therapeutic intervention.