Exercise-induced Bronchospasm In Children

WHAT YOU SHOULD KNOW:

Exercise-induced bronchospasm (EIB) is a condition that causes your child's airway to swell and become narrow. The airway tightens and swells after he exercises too hard, especially in cold weather.

INSTRUCTIONS:

Medicines:

• Allergy medicines: These treat allergies that may be causing your child's breathing problems. These medicines can decrease your child's risk of 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 decrease the swelling in your child's lungs. They may prevent wheezing or shortness of breath. They may also prevent your child's attacks from lasting for long periods.
  
  
• Mast cell stabilizers: These help prevent your child's lungs from swelling.
  
  
• Steroids: These may help open your child's air passages so he can breathe easier.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not helping or if he has side effects. Tell your child's primary healthcare provider if your child takes any vitamins, herbs, or other medicines. Keep a list of the medicines he takes. Include the amounts, and when and why he takes them. Bring the list or the pill bottles to follow-up visits.

Follow up with your child's primary healthcare provider as directed:

Write down your questions so you remember to ask them during your child's visits.

Inhalers:

An inhaler gives your child's medicine in a mist form that 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. Your child may use a spacer with this inhaler. A spacer is a large tube that 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 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 when he has EIB symptoms. Your child's PEF can help show if your child needs medicines before he does 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 for more information on peak flow meters, and how your child should use one.

Prevent EIB:

Your child's primary healthcare provider will 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. EIB may be prevented by any of the following:

• Breathe through the nose: Your child should breathe through his nose during exercise to help prevent EIB. Nose breathing lets the outside air get warm before reaching the airway. Deep breathing will also help open your child's airway.
  
  
• Exercise in areas that do not trigger EIB: EIB may be prevented by exercising indoors where the air can be controlled. 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.
  
  
• Take medicine as directed: 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 primary healthcare provider. Your child should carry his inhaler with him at all times. He may also need certain vaccines. Ask if your child should get vaccines to help prevent the flu and pneumonia.
  
  
• Cover the mouth and nose during outside exercise: Your child's mouth and nose should be covered while he exercises outside. This helps warm the air he breathes in during cold weather. It may also help prevent him from breathing in allergens, irritants, and germs that cause infections. Your child may wear a scarf or mask, or use breathing masks or filters.
  
  
• Avoid secondhand smoke and smoking: Do not let your child smoke. If you smoke, it is never too late to quit. Do not smoke around your child or let anyone else smoke around him. Secondhand smoke may trigger EIB and increases your child's risk of certain types of infections. He is also more likely to get lung disease and cancer later in his life. Ask for information if you or your child need help quitting.
  
  
• Do warm-up or cool-down exercises and rest: Your child should do warm-up exercises, such as walking or stretching, before intense exercise or physical activities. Cool down for at least 10 minutes after intense exercise. If your child has just eaten, he should wait for 2 hours before he exercises. 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. Ask when your child can exercise again.

For 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
  

• Asthma and Allergy Foundation of America
  8201 Corporate Drive, Suite 1000
  Landover , MD 20785
  Phone: 1- 800 - 727-8462
  Web Address: http://aafa.org
  

Contact your child's primary healthcare provider if:

• Your child has increased wheezing, coughing, or trouble breathing even after he takes his medicines.
  
  
• Your child's medicines do not relieve his symptoms.
  
  
• You or your child has questions or concerns about his condition or care.

Return to the emergency department if:

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

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