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Tips to Remember: Childhood asthma
Children with asthma typically cough, wheeze, and experience chest tightness and shortness of breath. Many parents do not know that a child does not have to wheeze to have asthma - the only symptom may be a frequent, annoying cough particularly at night or during exercise. Children with reactive airway disease, recurrent bronchitis or wheezy bronchitis probably have asthma. Unfortunately, asthma is often not diagnosed properly and is under treated. Diagnosis To make a diagnosis of asthma your child's physician will want to know about the following:
If your child is old enough (usually older than 5-6), he or she may do a Pulmonary Function Test. The results will tell the physician about how the child's lungs actually work. This test helps not only in the diagnosis but will help the doctor follow the response to medication. For children, asthma symptoms can interfere with many school and extracurricular activities. Parents may notice their child has less stamina during play than other children, or they may notice the child trying to limit or avoid physical activities to prevent coughing or wheezing. More subtle signs of asthma, such as chest tightness, are often not identified as such by children. Sometimes they will complain that their "chest hurts" or that they can not "catch their breath." Often, recurrent or constant coughing spells may be the only observable symptom. The two most common triggers of asthma in children are colds and allergens (substances that trigger allergies). It is important for parents to know that most kids with asthma are allergic and should have an allergy evaluation as part of their care. Common allergens include dust mite, animal dander, cockroach, pollen and molds. We cannot do a lot about viral illnesses but there are ways to limit allergen exposure in the home environment if you know what things you need to avoid. Management SLEEP, LEARN and PLAY If asthma is waking the family at night: if the child cannot play soccer or dance ballet; if he or she is chronically missing school (and parents missing work) then the asthma is not controlled! Every child with asthma should have a written asthma management plan. This tells the child and parents what medications to take when well; how to go up on medication when the child has increasing symptoms and when to call the physician. This plan gives control to the patient and their parents and allows for early treatment of symptoms, before the asthma flare gets out of control. As part of an effective asthma management plan, the child's physician may prescribe specific medications and devices. These can include a peak flow meter to measure ease of breathing, metered dose inhalers (sometimes called pumps), spacers that attach to inhalers, a nebulizer that delivers medication in a mist, dry powder inhalers, or oral (tablet) medications. The physician should not only prescribe these medications and devices, but should teach children and parents how to use them correctly. Your physician may use one of the new technologies to monitor the intensity of the inflammation in your airway and guide the use of your anti-inflammatory medications. This can be done by counting inflammatory cells from sputum or by measuring chemicals or gases (nitric oxide) in the air you breathe from your lungs. Asthma medications include rescue medication or quick relievers to treat symptoms (i.e. albuterol) and long-term controller medicines to control the inflammation that causes asthma. If a child has symptoms more than twice a week or wakes more than twice a month at night, they should be on long-term controller therapy. For more information on asthma medications, please see the Tip brochure in this series. Answers to commonly asked questions Will my child outgrow his/her asthma? Can asthma be cured? Should my child exercise? Asthma at school To ensure optimal care at school, parents can also take the following proactive steps:
For children with asthma to function normally, school personnel, families and health care providers must effectively communicate and work together to encourage them to fully participate in activities with their peers. This team effort will help create a positive, healthy and safe environment for the child-both in and out of school-and ensure the best asthma care possible. The AAAAI's How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence provide information to assist patients and health care professionals in determining when a patient may need consultation or ongoing specialty care by the allergist/immunologist. Patients should see an allergist/immunologist if they:
Your allergist/immunologist can provide you with more information on childhood asthma.
The content of this brochure is for informational purposes only. It is not intended to replace evaluation by a physician. If you have questions or medical concerns, please contact your allergist/immunologist. American Academy of Allergy, AAAAI Web site ©2007, American Academy of Allergy, Asthma and Immunology. All rights reserved. May not be duplicated or appropriated without permission. For copyright permission, please email Marianne Canter, Director of Communications and Membership, at mcanter@aaaai.org.
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Asthma is the most common serious chronic disease of childhood, affecting nearly five million children in the United States. Asthma in children is the cause of almost three million physician visits and 200,000 hospitalizations each year.