To Your Health
Recognizing and Treating Asthma in Children


by Paulette Avery, R.N., M.S.N.


My youngest child recently developed occasional symptoms of asthma, although we have no family history of the disease. She is one of the many new cases of asthma being diagnosed in the U.S. Experts believe the dramatic increase may be due in part to societal lifestyle changes such as inactivity and increased exposure to indoor allergens, as well as greater air pollution. According to statistics from the National Center for Health Statistics, the number of people with asthma grew from 10.4 million to 14.6 million between 1990 and 1994. Nearly five million of them are children.

With proper treatment, children with asthma can lead normal, active lives. But parents need knowledge about what causes asthma and how to treat it in order to help their children keep this chronic disease under control. Here s information to help you recognize asthma symptoms and provide appropriate care.

What is asthma? Asthma occurs when the bronchioles or small breathing tubes in the lung swell and narrow in response to allergens or irritants in the environment.

The bronchioles become inflamed and produce extra mucus. Muscles around the bronchioles tighten, making breathing out difficult and causing a high-pitched sound called wheezing. Besides wheezing, other symptoms of asthma include coughing, shortness of breath, difficulty breathing, and chest tightness. Some children experience a scratchy throat, itchy eyes, and a runny nose during an asthma episode. Exhaling becomes more difficult than inhaling. Each child may respond with different symptoms.

Which children get asthma? Although any child can develop asthma, it occurs more frequently in children whose parents have asthma, allergies, or eczema. Asthma is also more common in children born prematurely or when parents smoke.

What triggers asthma? Episodes of asthma can result from many different triggers, both in the home and outside. Common triggers include animal dander, dust and dust mites, smoke, molds, Christmas trees, aspirin, perfumes, strong chemical fumes, aerosol sprays, pollen, grasses, cold dry air, smog, or a change in the weather. Asthma may also occur with infections or as a result of eating certain foods.

Prevention and treatment. Controlling triggers is essential to minimizing the effects of asthma on your child. Eliminating common triggers from the home and helping your child avoid triggers outside the home will help prevent asthma attacks. You can learn more specific information on dealing with triggers from your health care provider or from one of the asthma resources included here.

In addition to avoiding triggers, there are many medications available to help prevent and treat asthma. Asthma medications fall into one of three types. The first group, inhaled anti-inflammatory drugs, are used to prevent asthma. These medications, usually taken daily, work by decreasing the sensitivity of the breathing tubes and blocking inflammation. Symptom-relieving medications, called bronchodilators, make up the second group and are used to relax the muscles around the bronchioles. These are used when asthma symptoms begin or may be used before exercise for prevention. The final group of medications is used to control moderate to severe asthma symptoms. These oral corticosteroids, such as prednisone, are used for two to five days to reverse an asthma flareup.

New Drug Approved. Earlier this year, the FDA cleared a new drug called Singulair, a once-daily medication found to be safe for the prevention and treatment of asthma in both adultsand children as young as six. Used in combination with other asthma drugs, this pill may help reduce asthma symptoms, particularly in children with mild or exercise-induced asthma.

Allergy Testing. For children whose asthma is triggered primarily by allergens, allergy testing and appropriate immunotherapy to decrease the child s allergic response may greatly decrease the need for medications. An allergy specialist can help you decide if such treatment is appropriate for your child.

Be sure to seek medical advice if you suspect your child has asthma. The following are a few of the many asthma resources available which may provide helpful information.

Organizations:

Allergy and Asthma Network/Mothers of Asthmatics, Inc. (1-800-878-4403) provides newsletters, books, pamphlets, and videos on asthma.

American Lung Association (1-800-LUNG USA), a resource for written materials, support groups, research, and asthma camps.

Web Sites:

American Academy of Allergy, Asthma, and Immunology (http://www.aaaai.org) provides educational information for patients and the public.

Allergy, Asthma, & Immunology Online (http://allergy.mcg.edu), a source for information as well as an asthma life-quality test.

This article was adapted by the author from one slated to appear in San Francisco Peninsula Parent.