Childhood Asthma - What to do

by Adaobi Kanu, M.D.

Asthma is one of the most common diseases in childhood, affecting more than 6 million children in the United States and is the leading cause for missed school days from a chronic condition.

Children with asthma have symptoms such as:

wheezing (high pitched whistling sound) when the child breaths)

say can't catch breath

a persistent cough especially with colds, exercise and laughing

recurrent bouts of (wheezy bronchitis) or pneumonia

Other indications child might have asthma:

Children with asthma have heightened airway inflammation and tightening of the muscles surrounding the airway. This occurs in response to triggers such as colds or viral infections, allergen or allergies such as dust, pet dander, tree pollen and weeds, cigarette/tobacco smoke exposure, exercise and strong chemicals.

This response results in the airway becoming narrower and compromising oxygen delivery to the body.

What can cause asthma?

Early exposure to certain respiratory viral illnesses during infancy and early exposure to allergies can increase the risk of developing asthma in childhood. Also genetic factors influence development of asthma, so if a parent has asthma, the child is more likely to develop asthma.
Studies on tobacco smoke exposure indicate that exposure during infancy and toddlerhood exposure increases the risk of wheezing and can compromise future lung function. Therefore, it is recommended that smoking not occur in the home, car or around the child.

If your child has wheezing, cough (more than two weeks), chest tightness, difficulty breathing, recurrent (wheezy bronchitis) or recurrent pneumonia, he should see his doctor to determine if he has asthma. It is important to make sure no other lung problem exists. Your child may need to have breathing tests to test for asthma.

Does your child already have asthma?

If your child has already been diagnosed with asthma and placed on medication, it is important that he is well-controlled.

Lifestyle with asthma

Well-controlled means that the child should not have problems with his asthma or have to use his rescue inhaler more than two days a week.

He should be able to exercise without any problems.

Not regulated?

The child should be taken to the doctor to see why the asthma is not well controlled and what therapy may be needed to address chronic airway inflammation. Poorly controlled asthma places a child at higher risk of emergency department visits, hospital admissions and death.

While at the doctor...

During your child's visit with the doctor, the doctor should review how severe your child's asthma is, factors that may be triggering his asthma, what medications should be used and what to do if the asthma becomes worse. Your child may need to see a Pulmonologist or lung specialist if the asthma is poorly controlled despite appropriate therapy or if asthma symptoms persist. Your child may need to see an allergist or allergy specialist if asthma is due to severe allergies.

To help control your child's asthma:

Give medication as directed by the doctor for your child's asthma. If he is on a medication daily for his asthma, he should not stop even if he is feeling good.
Be aware of your child's asthma medications and understand how they are to be used
Be aware of your child's asthma triggers and what to do if his asthma is worse
Discourage tobacco/cigarette exposure.
If your child is allergic to dust: wash the child's beddings in hot water weekly, encase the pillows/mattress with allergen covers, minimize stuffed animals and vacuum the carpets regularly
If your child is allergic to animal/pet dander and removal of the pet is not an option: keep the pet out of the child's room and isolate the pet from the upholstered furniture and carpets where the child stays.

Good News

Fortunately, there are therapies that can control your child's asthma and allow him to live a normal quality of life. Therefore, it is important to that your child be on appropriate therapy for asthma control.

References:

National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program: Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, Full Report 2007

^{Adaobi Kanu, M.D., is a physician with Texas Tech Physicians-Pediatrics}

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