Asthma In Children

What is asthma in children?

Asthma is long-term inflammation and narrowing of the airways in your child's lungs. This causes less air flow to his lungs and makes it hard for your child to breathe. An asthma attack is when your child's symptoms are worse than usual. During an asthma attack, the muscles around your child's airways tighten. This causes the airways to swell and make more mucus.

What are the types of asthma in children?

• Intermittent: Your child has symptoms 2 times a month or less. His asthma attacks last minutes and his symptoms are mild. In between attacks, your child has no symptoms.
  
  
• Mild persistent: Your child has symptoms more than 2 times a week but not 2 days in a row. He has symptoms at night 2 to 4 times a month or less. His asthma attacks last minutes to hours. His symptoms interfere with his daily activities.
  
  
• Moderate persistent: Your child has symptoms each day. He has symptoms at night more than once a week but not every night. His asthma attacks last for hours or days. His symptoms keep him from doing any activity.
  
  
• Severe persistent: You child has symptoms has symptoms that last most of the day and night. His asthma attacks last for many days and can get worse over time. Your child may need to be taken to the hospital for treatment.

What triggers an asthma attack?

The exact cause of asthma is not known. The following may trigger an asthma attack:

• Activities:
  
  
  • Sports or exercise
    
    
  • Stress or strong emotions, such as fear, anger, or hard crying or laughing
  
  
• Allergens:
  
  
  • Certain foods
    
    
  • Cockroach droppings, dust, or dust mites
    
    
  • Dander (tiny dead skin flakes) from cats, dogs, and other animals
    
    
  • Mold or plant pollen
  
  
• Irritants:
  
  
  • Air pollution, chemical fumes, or cigarette smoke
    
    
  • Strong-smelling body care products
    
    
  • Very cold or hot weather, with high or low humidity
  
  
• Medical problems and medicines:
  
  
  • A cold or the flu
    
    
  • Infections in his airways, lungs, or sinuses caused by bacteria or viruses
    
    
  • Medicines such as NSAIDs or heart medicine

What increases my child's risk of asthma?

• Family history: He has parents or other family members who have asthma.
  
  
• Medical conditions: Lung infections, sinusitis, and gastric reflux can damage your child's airways and cause them to react easily to triggers.
  
  
• Closed, crowded spaces: Poor air flow in closed spaces may lead to buildup of dirt, dust, chemicals, and smoke. If your child breathes in these irritants, it may trigger an asthma attack.

What are the signs and symptoms of an asthma attack?

• Coughing: This is usually worse at night or early in the morning.
  
  
• Wheezing: This is a whistling or squeaky sound when your child breathes.
  
  
• Struggling with activities: Your child may get tired easily with small amounts of physical activity. He may have trouble playing sports. He may need to slow down or stop to catch his breath often.
  
  
• Allergies: Your child's nose may be red, runny, and clogged, and he may have itchy and teary eyes. Your child may also have dry, red, itchy or flaking skin, or an itchy, sore throat.
  
  
• Trouble breathing: Your child's chest may feel tight. He may take hard, fast breaths. Your child may feel like he cannot get enough air in or out of his lungs. He may raise his shoulders to force air in and out of his lungs.
  
  
• Trouble sleeping: Coughing and breathing problems may make it hard for your child to fall asleep. His symptoms may wake him from sleep. This can make him feel tired and sleepy the next day.

How is asthma in children diagnosed?

Your child's caregiver will ask about your child's medical history and examine him. He will ask about your child's symptoms and what triggers them. Tell your child's caregiver what medicine or other treatments have been used for your child's symptoms. Your child may need any of the following tests:

• Peak flow testing: A peak flow meter is a small tube-shaped device that measures how much and how fast your child exhales. This test can usually be given to children older than 5.
  
  
• Pulmonary function test: This helps caregivers learn how well your child's lungs work. During the test, your child breathes into a mouthpiece connected to a machine. The machine measures how much air he breathes in and out over a certain amount of time.
  
  
• Bronchoprovocation testing: This test measures how much air your child can breathe out as fast as he can. This test is done first to see how well his lungs work normally. Then, your child's caregiver will give your child a chemical to trigger a mild asthma attack. After 10 minutes, your child's caregiver will repeat the test. If the amount of air he breathes out decreases, it is likely that he has asthma.
  
  
• Allergy testing: These tests help caregivers find out if your child has allergies and if those allergies trigger his asthma. Your child's caregiver will put a drop of different liquids on his arm or back. These may include liquids from foods and some chemicals. He will prick the skin under these drops with a needle. He will wipe off the drops and watch closely for any redness or swelling on your child's skin. He will monitor your child closely during this test.
  
  
• Blood tests: Your child may need blood tests to determine if his asthma attack is triggered by an infection.
  
  
• Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
  
  
• Chest x-ray: This is a picture of your child's lungs to look for signs of infection, such as pneumonia.

How is asthma in children treated?

• Make an asthma action plan: This is a set of instructions to follow when your child has an asthma attack. Work with your child's caregiver to develop an asthma action plan. List any medicines your child takes and how much or how often he takes them. Also list his triggers. Write down his signs and symptoms and what to do if he has an attack. List emergency phone numbers. Update the plan when he has an asthma attack and write down what may have triggered it. The plan should explain when to seek immediate care for your child or call 911.
  
  
• Medicines:
  
  
  • Inhaled short-acting bronchodilators: These are given to help open your child's airways quickly. They start to work right away and are used to relieve sudden, severe symptoms, such as trouble breathing. These medicines may be called relievers or rescue inhalers.
    
    
  • Steroids: These help decrease swelling and open your child's airways to help him breathe easier. They may be given as a pill or an inhaler. After an asthma attack, your child may need steroid pills for several days. Inhaled steroids are used for long-term control.
    
    
  • Combination inhalers: These include a long-acting bronchodilator and a steroid. They can help open the airways over time, and are used to decrease and prevent breathing problems. They are only used when your child's asthma is not controlled with other medicines. They are not helpful during an asthma attack.
    
    
  • Leukotriene inhibitors: These can decrease the swelling in your child's lungs. They may help reduce your child's wheezing or shortness of breath. They may also help shorten your child's asthma attacks. They are used for long-term control of asthma. They are not used to treat an asthma attack.
    
    
  • Mast cell stabilizers: These help decrease inflammation and prevent your child's airways from becoming too narrow. They can be used regularly to decrease the number of asthma attacks. They can also be used right before your child is exposed to a trigger. They are not used once an asthma attack has started.

What types of inhalers may be used to treat my child's asthma?

• Metered dose inhaler: This is a small, tube-shaped device. Your child holds the open end inside his mouth. The medicine comes out as a mist when he presses a switch. Your child should breathe in deeply to get the right amount of medicine. He may use a spacer with this inhaler. A spacer is a large tube that holds the mist before your child breathes it in.
  
  
• Nebulizer: A long tube goes from the machine to a small round container that holds asthma medicine. The liquid turns into a mist once the machine is turned on. Your child breathes in this mist through a mouthpiece.
  
  
• Dry powder inhaler: This is a small tube or disc-shaped device that contains powder asthma medicine. Your child holds the open end inside his mouth. The powder is released when he presses a switch. With this type of inhaler, your child must breathe in hard to suck in the powder.

How can I help prevent my child from having an asthma attack?

• Avoid triggers.
  
  
• Follow your child's asthma action plan.
  
  
• Try to avoid people who are sick and stay up-to-date on your child's vaccines.
  
  
• Use air conditioning to control the temperature and humidity in your house.
  
  
• Keep pets out of your home. If you have cockroaches or other pests in your home, get rid of them quickly.
  
  
• Remove old carpets, fabric-covered furniture, drapes, and furry toys in your house. Use hypoallergenic covers for your child's mattresses and pillows.

What are the risks of asthma in children?

Without treatment, you child's asthma can get worse. His asthma attacks can last longer and happen more often. He may have trouble doing his usual activities or miss school. He may even need to be admitted to the hospital for treatment. Your child's lung tissue can get damaged and scarred. His body may not get enough oxygen. This can cause damage to his organs and be life-threatening.

Where can I find support and more information?

• American Academy of Allergy, Asthma, and Immunology
  555 E. Wells St, Suite 1100
  Milwaukee , WI 53202-3823
  Phone: 1- 800 - 822-2762
  Web Address: http://www.aaaai.org
  

• National Asthma Education and Prevention Program
  National Heart, Lung and Blood Institute
  National Asthma Education and Prevention Program
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/about/naepp/
  

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child coughs or wheezes more than usual.
  
  
• Your child's medicines do not relieve his symptoms as well as they used to.
  
  
• Your child's symptoms keep him from doing activities he enjoys.
  
  
• You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• Your child has wheezing or shortness of breath that does not get better with treatment.
  
  
• Your child faints or does not respond.
  
  
• Your child has severe chest pain.
  
  
• Your child's lips or fingernails turn gray or blue.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Learn more about Asthma In Children