Asthma is a common, often- inherited type of “twitchy” lung. The airways go into spasm and become narrow when allergic or irritating substances enter them. The airways respond by producing excessive amounts of mucus and inflammation. Viral respiratory infections trigger most attacks. If asthma is caused by pollens, the asthma only flares up during a particular season. Asthma often occurs in children who have allergies such as hayfever. Sometimes emotional stress can trigger asthma attacks. When medicines are taken as directed, the symptoms of asthma are reversible, and no permanent lung damage occurs. Symptoms are:
- Wheezing – a whistling sound produced during breathing out
- Recurrent attacks of wheezing, coughing, chest tightness and difficulty breathing
- Often associated with sneezing and a runny nose
- This diagnosis must be confirmed by a physician
Asthma is a chronic disease that requires close follow-up by a physician who coordinates the treatment program. Every child should have an asthma action plan so that you as a parent are clear about what medicines to use when. Some children only require reliever medication when they are having difficulties, but children who wheeze frequently will often require preventative care on a daily basis. If you have any doubt about whether your child is wheezing, start the medicine. The later the medicine is started, the harder it is to stop the wheezing. Once the medicine is begun, your child should not stop it until he has not wheezed or coughed for 48 hours. Every child with asthma and everyone in his or her family should get an annual flu shot in October to November. Every child with asthma should be completely protected from any second hand smoke.
Reliever Medication: The most commonly prescribed reliever is albuterol/Xopenex. Your child will need careful instructions on how to use the inhaler.
Preventative Medication: There are several types of preventative medications. Each child with asthma has different needs based on the frequency of symptoms and the severity of their asthma. If your child has needs to use his or her “reliever medication” more than 3 times per week or is limiting their activity based on breathing difficulty, please speak with your physician.
Spacers: Inhalers usually can’t be coordinated by young children unless they also use a plastic airway spacer. The spacer will trap the asthma medicine and give the child time to breath inhale it properly.
Asthma Nebulizer Treatments: Young children often need nebulized medicine treatment, using a machine. Even older children when they are feeling really “tight” report that they feel they get more of the medicine delivered to their lungs using a nebulizer rather than an inhaler.
Oral Steroids or Other Asthma Medicines: Although asthma is usually very well controlled using the preventative and reliever medications as prescribed by your physician, sometimes children with asthma will require the use of an oral steroid to calm down their lungs. These medications carry some side effects including agitation, difficulty sleeping and some stomach upset. However, the benefit of their use in asthma is quite clear and generally outweighs these risks.
Begin Treatment Early. Many children wheeze soon after they get coughs and colds. It is recommended that you begin the use of the asthma medicines at the first sign of any runny nose, coughing, or chest tightness. Always keep the medicine handy and refilled.
Fluid Intake. Normal hydration keeps the normal lung mucus from becoming sticky. Encourage your child to drink a normal intake of clear fluids. Sipping warm fluids may improve the wheezing and reduce cough.
Exercise Induced Asthma. Most people with asthma get 20 to 30 minute attacks of coughing and wheezing with strenuous exercise. Running, especially in cold air or polluted air, is the main trigger. This problem should not interfere with participation in most sports as the symptoms can be prevented by using an inhaler before exercise.
Allergies. For hay allergy symptoms, it’s okay to give antihistamines. Poor control of hay fever can make asthma attacks worse. Although antihistamines can dry the airway, they do not worsen asthma.
Going to School. Asthma is not contagious. Your child should go to school during mild asthma attacks but avoid gym and sports on these days. Arrange to have the asthma medicines available at school. Most children with asthma should be permitted to keep their inhaler with them.
Common Mistakes. The most common mistake is delaying the start of asthma medicines or not replacing them when they run out. Nonprescription inhalers and medicines are not helpful, and can be dangerous. Another common error is keeping pets that children are allergic to. Don’t panic during an attack, either. Fear can make tight breathing worse, so try to remain calm and reassure your child. Finally, don’t let asthma restrict your child’s activities, sports, or social life.
Prevention by Avoiding Triggers: Try to discover and avoid the substances that trigger attacks in your child. Second-hand smoke is the biggest offender. If someone in your household smokes, your child will have attacks more often, take more medicine, and require more emergency room visits. Try to keep pets outside, or out of your child’s room. Learn how to dustproof the bedroom, and avoid feather pillows. Change the filters on your heating/air conditioning system often, and keep the humidity low.
Call our Office IMMEDIATELY if . . .
- The wheezing is severe or the breathing is difficult or tight.
- Your child starts acting very sick or listless.
Call our office during regular hours if . . .
- The wheezing is not completely cleared by 5 days.
- You have other questions or concerns.