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Asthma

Asthma and Your Child
Asthma is a chronic disease of the breathing tubes that carry air to the lungs. These airways become narrow and their linings become swollen, irritated, and inflamed. In patients with asthma, the airways are always irritated and inflamed, even though symptoms are not always present. The degree and severity of airway irritation varies over time. One of the most important goals of asthma treatment is to control the irritation in the airways.

Who gets asthma?
Asthma is the most common serious chronic disease of childhood. It is the leading cause of school absence for chronic disease. In the United States, nearly 5 million children have asthma. It can cause lots of sickness and result in hospital stays and even death.

What are symptoms of asthma?
Symptoms of asthma can be different for each person. They can appear quickly or develop slowly. Some children have symptoms of asthma often enough that they have to take medicine every day. Other children may need medicine just once in a while.

A cough may be the first and sometimes only asthma symptom. Other symptoms may include

• Difficulty breathing

• Wheezing

• Shortness of breath

• Tightness in the chest

• Decreased exercise tolerance

What are asthma triggers?
Certain things cause asthma attacks or make asthma worse. These are called triggers. Some common asthma triggers are:

1. Allergens: Things to which your child might be allergic. Nearly all children with asthma have allergies, and allergies can be a major cause of asthma symptoms.

• House dust mites

• Animal dander

• Cockroaches

• Mold

• Pollens

2. Infections of the lungs and sinuses

• Viral infections

• Other infections such as pneumonia or sinus infections

3. Irritants in the environment (air that you breathe)

• Cigarette and other smoke

• Air pollution

• Cold or dry air

• Odors, fragrances, chemicals in sprays, and cleaning products

• Unventilated space heaters (gas or kerosene) and fireplaces

• Odors and gases released from new carpets, furniture, or materials in new buildings

4. Exercise (About 80% of people with asthma develop wheezing, coughing, and a tight feeling in the chest when they exercise.)

These triggers can be found in your home, your child's school, child care, and relatives' homes.

Avoiding Triggers
While you can't make your home completely allergen- or irritant-free, there are things you can do to reduce your child's exposure to triggers. The following are tips that may help decrease symptoms as well as the need for asthma medicines:

• Don't smoke. Also, don't let anyone else smoke in your home or car.

• Reduce exposure to dust mites. If your child is allergic to dust mites, cover your child's mattress and pillows with special allergy-proof covers, wash his bedding in hot water every 1 to 2 weeks, remove stuffed toys from the bedroom, and vacuum and dust often. If possible, use a dehumidifier or remove carpeting in the bedroom. Bedrooms in basements should not be carpeted.

• Reduce exposure to pet allergens. If your child is allergic to furry pets, remove the pets from the home. If this isn't possible, keep the pets out of your child's bedroom and wash them often. Consider a high-efficiency particulate air (HEPA) filter in the bedroom and if possible, remove carpeting.

• Control cockroaches.

· Prevent mold. Mold in homes is often caused by excessive moisture indoors. Repair any sources of water leakage. Control indoor humidity by using exhaust fans in the bathrooms and kitchen and adding a dehumidifier in areas with high humidity. The Environmental Protection Agency (EPA) currently recommends cleaning existing mold with detergent and water. Some materials such as wallboards with mold have to be replaced.

• Reduce pollen exposure. If your child is allergic to pollen, use an air conditioner in your child's bedroom, with the fresh air vent closed, and leave doors and windows closed during high pollen times.

• Reduce indoor irritants. Use unscented cleaning products and avoid mothballs, room deodorizers, and scented candles.

• Check air quality reports. When the air quality is very poor, keep your child indoors. Check weather forecasts or the Internet for air quality reports.

How is asthma treated?
The goal of asthma treatment is to reduce symptoms so children can fully participate in normal physical activities. This can be done by avoiding asthma triggers and providing asthma medicine. It's also important to prevent emergency department visits and hospital stays because of asthma attacks. If your child experiences asthma symptoms more than once or twice per week, let your pediatrician know.

Exercise and Asthma
Physical activity is important for your child's physical and mental health. Children with asthma should be able and encouraged to participate completely in physical education, sports, and other activities in school.

Exercise can often trigger symptoms in children with asthma. It can almost always be prevented with the use of quick-relief medicines taken 10 to 15 minutes before exercise. If it occurs often, however, it may mean your child's asthma isn't under control. Proper asthma control can make a great difference in your child's ability to exercise normally.

Asthma and Schools
Children spend many hours at school. Good communication is important to asthma care and management in school. You might want to meet with your child's teachers, the school nurse, and coaches at the beginning of the school year. The school needs to know about your child's asthma, how severe it is, what medicines your child takes, and what to do in an emergency. This communication can be helped by having your pediatrician complete an asthma action plan for the school, as well as a medicine permission form that includes whether your child should be allowed to carry and use her own inhaler. Ask the school about its policies on how your child will get access to her medicines and how they deal with emergencies, field trips, and after-school activities. The school should also inform you about any changes or problems with your child's symptoms while she is at school.

Remember
Asthma is a complicated yet treatable condition. By using medicines, avoiding triggers and environments that can cause asthma attacks, and carefully managing symptoms, children with asthma can lead normal and healthy lives.

The following are some things to keep in mind:

• If you are concerned your child may have asthma, talk with your pediatrician. Your pediatrician may test your child's airway function. It is important to remember that asthma is a complicated disease to diagnose, and the results of airway function testing may be normal even if your child has asthma.

• Decreasing your child's exposure to triggers will help decrease symptoms and the need for asthma medicines.

• There is no one magic medicine that controls all asthma. Your pediatrician will help you choose the best medicines for your child and talk with you about when to use them.

• It's important that asthma symptoms are well managed while your child is at school.

If you have any questions about your child's health, symptoms of asthma, or how your child's asthma is being managed, talk with your pediatrician.