What is asthma?
Asthma is a chronic (long-lasting) lung disease in which the lining of
the airways of the lungs is always swollen or inflamed. The airways
are also unusually sensitive to certain irritants or "triggers." An
asthma trigger can be something your child is allergic to such as
pollen, animal dander, or house dust. A trigger can also be an
irritant such as tobacco smoke, cold air, or a cold virus. When the
airways react to a trigger, the muscles around the airways tighten and
the lining of the airways swells and produces thick mucus. This
causes the airway to narrow and makes it harder to breathe. This
breathing difficulty is called an asthma attack. An asthma attack can
be mild, moderate, or severe. When your child is having an attack, he
will usually need to take medicine to control the symptoms.
Asthma does not go away when your child is not having symptoms. The
airways are still inflamed. Your child needs to have a treatment plan
and close follow-up by a health care provider.
What are the symptoms?
Symptoms of asthma may come and go. Asthma symptoms may include any
combination of:
- repeated coughing, especially at night or the early morning, with
exercise, or with viral infections such as colds
- wheezing (a high pitched whistling sound heard during breathing)
- trouble breathing
- speaking in short sentences or phrases only
- new or increased reluctance to participate in vigorous play or
activities requiring physical exertion
Other severe symptoms in children are:
- blue or gray lips or fingernails (Call 911.)
- flared nostrils when trying to breathe in
- sinking of skin or muscles between the ribs or the notch above the
Adam's apple when breathing in
- unusual paleness or sweating
- trouble walking or playing
- hunched over or struggling to breathe
- vomiting
- starts coughing and can't stop.
How long does it last?
Some children may have asthma symptoms for a few years and then grow
out of it. Asthma symptoms often improve during the teenage years.
For most children, however, asthma remains active all their lives.
Asthma attacks may be frightening, but they are treatable. When
medicines are taken as directed, the symptoms can be controlled or
completely clear up.
What type of medicine does my child need?
Quick-relief medicine
Quick-relief medicines quickly open your child's airways and are used
when your child is having an asthma attack. These medicines are
called bronchodilators.
If your child is having asthma symptoms (wheezing, coughing, trouble
breathing), he should take his quick-relief medicine. If you have any
doubt about whether or not your child is wheezing, have your child
take his asthma medicine. The longer he waits to take his medicine,
the longer it takes to stop the wheezing. Once treatment with the
medicine is begun, keep giving your child the quick-relief medicine
according to the dose prescribed by your health care provider. (Your
child may need to take the quick-relief medicine for several days.)
Preventive medicine
Preventive medicines help prevent asthma attacks. These medicines
keep the airways in your child's lungs from getting inflamed and
irritated. Many children with asthma do not need preventive medicine
in addition to quick-relief medicines during asthma attacks.
Children with the following symptoms usually need to take preventive
medicines every day to allow them to participate in normal activities:
- 2 or more attacks of wheezing per week
- 2 or more nighttime attacks a month
- asthma flareups lasting several days
- 3 or more visits per year for urgent medical care despite
proper use of inhaler
- more than 1 visit to urgent care or the emergency
department per year
- asthma triggered by pollens (may need to use a preventive
medicine daily during the pollen season).
How can I take care of my child?
- Hay fever. For hay fever symptoms, it's OK to give
antihistamines. Poor control of hay fever can make
asthma attacks worse. Research has shown that
antihistamines don't make asthma worse and may improve
asthma control.
- Colds. Most children with asthma wheeze when they get
coughs and colds. If this is true for your child, give
your child his quick-relief asthma medicine at the first
sign of any coughing or wheezing. The best "cough
medicine" for a person with asthma is an asthma medicine,
not a cough syrup. Watch your child carefully
when he has a cough or cold and call your health care
provider for advice if he is not improving after taking
asthma medicine or if the symptoms are getting worse.
- Exercise. Most people with asthma get short attacks of coughing
and wheezing when they exercise strenuously. Prolonged vigorous
exercise such as long distance running, especially in cold air, is
a major trigger. Crying and temper tantrums may also trigger an
asthma attack in very young children. If your child has exercise
induced asthma, let coaches, teachers, or others who supervise your
child's activities know what to do to help your child. Exercise
and other physical activities do not need to be avoided. If your
child is recovering from a viral illness and needs a few days to
fully recover, he may need to avoid gym class or sports for a short
time. Your child can usually avoid symptoms by using a
quick-relief medicine 15 to 30 minutes before exercise. If your child
still has a lot of symptoms with exercise even after using a quick
relief medicine, talk with his health care provider.
- Going to school. Asthma is not contagious. Your child
should go to school if he is having mild asthma symptoms,
but should avoid gym or vigorous activity on these days.
Arrange to have the asthma medicines, a peak flow meter,
and an Asthma Action Plan at school. The Asthma Action
Plan should be developed with your health care provider
and outline what to do if your child has asthma
symptoms while at school. If your child can't go to
school because of asthma, take him to your health care
provider that same day for advice about additional
treatment.
- Common mistakes. The most common mistake is delaying the start of
prescribed asthma medicines or not replacing them when they run
out. Nonprescription inhalers and medicines are not helpful.
Another serious error is continuing to expose your child to an
avoidable cause of asthma. For example, do not keep a cat if your
child is allergic to it. Also, do not allow smoking in your home.
Tobacco smoke can linger in the air for more than a week.
When your child is having an asthma attack, don't panic. Fear can
make tight breathing worse, so try to remain calm and reassure your
child. Finally, try not to let asthma restrict your child's
activities, sports, or social life. If your child's asthma symptoms
are worsening and affecting his lifestyle make an appointment to
discuss your concerns with your health care provider. A change or
increase in asthma medicines may be necessary to gain better control
of your child's asthma.
How can asthma attacks be prevented?
- Try to discover and avoid the substances that trigger
your child's asthma attacks. Second-hand tobacco smoke
is a common trigger. If someone in your household
smokes, your child will have more asthma attacks, take
more medicine, and need more emergency room visits.
- Try to keep pets outdoors or at least out of your child's
room.
- Learn how to dust-proof your child's bedroom. Change the
filters on your hot-air heating system or air conditioner
at least monthly.
- For allergies to molds or carpet dust mites, try to keep
the house humidity less than 50%. Use a dehumidifier if necessary.
- If your child wheezes after contact with grass,
weeds, or animals, there may be pollen or animal dander
remaining in your child's hair or on his clothes. Your
child should shower, wash his hair, and put on clean
clothes.
When should I call my child's health care provider?
Call IMMEDIATELY if your child:
- has severe wheezing
- is having trouble breathing
- has wheezing that has not improved after the second dose
of asthma medicine
- has a peak flow rate is less than 50% of the personal best.
Call within 24 hours if:
- The wheezing is not completely gone in 5 days.
- Your child needs to use the quick-relief inhaler every 4 hours for more
than 1 day.
- You have other questions or concerns.
Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.