Exercise-induced Bronchospasm In Children

WHAT YOU SHOULD KNOW:

• Exercise-induced bronchospasm, or EIB, is a condition where your child's airway swells and becomes narrow. The airway is made up of many tubes that carry air in and out of the lungs. With EIB, your child's airway tightens and swells after he exercises too hard, especially in cold weather. Exercise includes sports or other physical activities. EIB is thought to be caused by heat and water loss from your child's airways.
  
  
• Coughing, chest pain or tightness, trouble breathing, and wheezing are the most common signs and symptoms of EIB. Your child may also feel out of shape, avoid activities, or have trouble keeping up with peers. To find out if your child has EIB, his caregiver will ask what his symptoms are and when they appeared. Your child's caregiver may ask him to do breathing and exercise tests. Treatment may include resting and taking medicines, such as anti-allergy medicines, bronchodilators, and steroids. Having your child's EIB treated will relieve his symptoms and let him lead an active life.

INSTRUCTIONS:

Medicines:

• Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  
  
• Allergy medicines: These medicines, also called anti-histamines, can treat allergies which may be causing your child's breathing problems. Taking these medicines can decrease your child's risk of having EIB.
  
  
• Bronchodilators: Bronchodilators may be given to help open the air passages in your child's lungs to help him breathe easier.
  
  
• Leukotriene inhibitors: These medicines can decrease the swelling in your child's lungs. They may stop your child from having more wheezing or shortness of breath. They may also prevent your child's attacks from lasting for long periods.
  
  
• Mast cell stabilizers: Mast cells are found in the smaller tubes in your child's lungs. They are in charge of releasing some chemicals that can cause your child's airway to narrow. This kind of medicine may help prevent your child's lungs from swelling.
  
  
• Steroids: Steroid medicine may help open your child's air passages so he can breathe easier. Give this medicine as ordered by your child's caregiver. Stopping this medicine without the caregiver's OK may cause a bad response.

Follow-up visit information:

Your child's caregiver will check how well your child's treatment is working. Your child may need to visit his caregiver more often if his symptoms do not go away. Your child's caregiver may add more medicines to relieve his symptoms, or remove them when he gets better. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Inhalers:

Your child's medicines may come inside small devices called inhalers. An inhaler gives your child's medicine in mist form which he can breathe into his lungs. A metered dose inhaler (MDI) is one type of inhaler. This is a small tube shaped device that holds the liquid asthma medicine inside. Your child may use a spacer with this inhaler. A spacer is a large tube which holds the mist inside it before your child breathes it in. This helps your child get the right amount of medicine. A MDI with spacer also decreases the risk of side effects, such as hoarseness, mouth yeast infection, and hacking cough. Ask your child's caregiver for information on how to use an inhaler correctly.

Peak expiratory flow:

• Peak expiratory flow (PEF) is the air your child blows out of his mouth. It is checked using a peak flow meter, which is a small tube-shaped device. PEF shows how fast air moves out of your child's lungs. The air your child breathes out is usually decreased during an EIB attack. Checking your child's PEF can help show if your child needs medicines before doing certain activities.
  
  
• PEF checks may also be done while your child exercises. Your child's EIB can be treated quickly if his PEF reading changes. Make sure your child always uses the same peak flow meter. Buy the same brand if your child needs another meter. Ask your child's caregiver for more information on peak flow meters, and how your child should use one.

Physical activities and EIB:

Your child's caregiver may give you a written action plan. This plan contains your child's treatment instructions. It may also have information on how you can recognize symptoms of EIB in your child. EIB may be prevented by any of the following:

• Breathing: Breathing through the nose, especially when exercising, may help prevent EIB. Nose breathing lets the outside air get warm before reaching your child's airway. Deep breathing will also help open your child's airway.
  
  
• Diet: Fish, or foods high in beta carotene and lycopene may help decrease your child's symptoms, or prevent EIB. A diet low in salt may also help. Supplements, such as vitamins C and E, and fish oils, may also help prevent EIB. Caffeine, found in coffee and other beverages, can help loosen your child's tight airway. Talk with your child's caregiver first before giving your child vitamins or supplements.
  
  
• Exercise area: EIB may be prevented by exercising indoors where the air can be controlled, and made warm and humid. Swimming pools, ice rinks, and other indoor arenas may have increased amounts of gases in the air. If chlorine or other gases trigger your child's EIB, an outdoor arena may need to be used. Outdoor physical activities should be avoided during the afternoon and evening when air pollution is highest.
  
  
• Medicine: Your child may take his medicines before doing exercise or physical activities to prevent EIB. If your child is given controller medicines, make sure he uses them as instructed by his caregiver. Your child should carry his inhaler with him at all times. He may also need vaccines to help protect his body from infection. Ask your child's caregiver if your child should get shots to help prevent the flu and pneumonia.
  
  
• Mouth and nose cover: Your child's mouth and nose should be covered when exercising outside. This helps warm the air he breathes in during cold weather. It may also help him from breathing in germ causing infections, allergens, and irritants. Your child may wear a scarf or mask, or use breathing masks or filters.
  
  
• Smoking: Do not smoke around your child or let your child smoke. Smoking can harm your child's heart, lungs and blood. It also increases his risk of certain types of infections. He is also more likely to get lung disease and cancer later in his life. If you or your child smoke, quit. If you are having trouble quitting, talk to your caregiver.
  
  
• Warm up or cool down exercises and rest: Light exercises, such as walking or stretching, should be done before doing heavy exercise or physical activities. Cool down for at least 10 minutes after heavy exercise. If your child has just eaten, have him wait for two hours before exercising. If your child has a respiratory infection, he should not exercise. Your child may need to rest for 2 to 3 weeks after being sick. Take your child to see his caregiver before he starts exercising again.

CONTACT A CAREGIVER IF:

• Your child has problems that may be caused by his medicines. These include shakiness, trouble thinking clearly, pounding or fast heartbeat, or upset stomach.
  
  
• Your child has increased wheezing, coughing, or trouble breathing even after taking his medicines.
  
  
• Your child's medicines do not relieve his symptoms.
  
  
• You or your child has questions or concerns about his condition, medicines, or care.

SEEK CARE IMMEDIATELY IF:

• Your child has very bad pain in his chest.
  
  
• Your child has trouble thinking or faints.
  
  
• Your child is so short of breath that he has trouble walking and talking.
  
  
• Your child's chest and neck are pulled or sucked in with each breath.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Exercise-induced Bronchospasm In Children (Aftercare Instructions)