Asthma in children
Definition
Alternative names
Causes
symptom
Tests and exams
Treatment
Expectations (prognosis)
When to contact a medical professional
References
Definition
Asthma is a disease that causes inflammation and narrowing of the respiratory tract. This causes wheezing, respiratory distress, tightness in the chest and cough.
Alternative names
Pediatric asthma; Asthma - pediatric; Wheezing - asthma - children
Causes
Asthma is caused by swelling (inflammation) of the airways. During an asthma attack, the muscles that surround the airways become stiff. The lining of the air ducts swells. As a result, less air can pass.
Asthma is commonly observed in children. It is an important cause of school absenteeism and hospital visits for children. An allergic reaction is a key part of asthma in children. Asthma and allergies often present together.
In children who have sensitive airways, the symptoms of asthma can be triggered by inhaling substances called allergens or triggers.
Normal bronchiole asthmatic bronchiole
Some common asthma triggers include:
Animals (hair or dandruff)
Dust, mold and pollen
Acetylsalicylic acid (aspirin) and other medications
Changes in weather conditions (in most cases, cold weather)
Chemicals in the air or in food
Smoke of the tabacco
Exercise
Strong emotions
Viral infections, such as the common cold
symptom
Respiratory problems are common. They can include:
Respiratory difficulty
Feeling short of breath
Panting
Difficulty exhaling (exhaling)
Breathing faster than normal
When the child is having trouble breathing, the skin of the chest and neck may sink.
Other symptoms of asthma in children include:
Cough that sometimes awakens the child at night (may be the only symptom).
Dark bags under the eyes.
Fatigue.
Irritability.
Rigidity in the chest.
Whistle produced when breathing (wheezing). It may be more noticeable when the child exhales.
Your child's asthma symptoms may vary. They can occur frequently or only when certain triggers are present. Some children are more likely to have asthma symptoms at night.
Tests and exams
The health care provider will use a stethoscope to listen to the child's lungs. The provider may be able to hear the sounds of asthma. However, lung sounds are usually normal when the child is not having an episode of asthma.
Peak expiratory flow meter
The provider will have the child breathe in a device called a spirometer. These devices can indicate how well the child can exhale the air from the lungs. If the airways are narrowed by asthma, the maximum flow values fall.
You and your child will learn to measure the maximum flow at home.
Exams may include:
Tests for skin allergies, or a blood test to see if your child is allergic to certain substances
Chest x-ray
Pulmonary function tests
Treatment
It is recommended that you and your child's provider collaborate to develop and carry out an asthma action plan.
This plan will tell you how:
Avoid triggers of asthma
Monitor the symptoms
Measure the maximum flow
Take the medications
The plan must also tell you when to call the provider. It is important to know what questions to ask your child's provider.
Children with asthma need a lot of support at school.
Present your asthma action plan to school staff so that they know how to treat their child's asthma.
Find out how to allow your child to take the medication during school hours. (You may have to sign an authorization).
Having your child with asthma does not mean he can not exercise. Coaches, physical education teachers and your child should know what to do if the child has symptoms caused by exercise.
MEDICATIONS FOR ASTHMAThere are two basic types of medications used for the treatment of asthma.
Long-term control medications are taken every day to prevent asthma symptoms. Your child should take them even when they have no symptoms. Some children may need more than one of these extended-control medications.
Types of extended-control medications include:
Inhaled steroids (they are usually the first treatment option)
Long-acting bronchodilators (almost always used with inhaled steroids)
Leukotriene inhibitors
Disodium chromoglycate
Quick-relief or rescue medications work quickly to control asthma symptoms. Children take them when they are having cough, wheezing, difficulty breathing or an asthma attack.
Some of your child's asthma medications can be taken through an inhaler.
Children who use an inhaler should also use a "spacer" device. This helps them carry the medication properly to the lung.
If your child uses the inhaler incorrectly, less medication enters the lungs. Ask the provider to show your child how to use an inhaler correctly.
Younger children can use a nebulizer to take their medication instead of an inhaler. A nebulizer converts asthma medication into a vapor that is inhaled.
ELIMINATE THE TRIGGERS
It is important to know the triggers of your child's asthma. Avoiding them is the first step in helping your child feel better.
Keep pets out of the house or at least away from the child's room.
Common triggers of asthma
No one should smoke in a house or near a child with asthma.
Removing tobacco smoke from the home is the most important thing a family can do to help a child with asthma.
Smoking outside the house is not enough. Family members and visitors who smoke carry smoke on their clothes and hair. This can trigger asthma symptoms.
DO NOT use fireplaces in interior spaces.
Keep the house clean. Keep food in containers and out of the bedrooms. This helps reduce the likelihood of cockroaches, which can trigger asthma attacks. Likewise, the cleaning products must be without aroma.
MONITOR YOUR CHILD'S ASTHMA
Measuring peak flow is one of the best ways to control asthma. This can help prevent your child's asthma from getting worse. Asthma attacks usually do NOT appear without warning.
Children younger than 5 may not be able to use a spirometer well enough to be useful. However, a child should start using spirometers at an early age to get used to them. An adult should always monitor a child's asthma symptoms.
Expectations (prognosis)
With proper treatment, most children with asthma can lead a normal life. When asthma is not well controlled, it can lead to school absenteeism, problems with sports, work absenteeism by parents and multiple visits to the doctor's office and emergency room.
The symptoms of asthma often diminish or disappear completely as the child grows. Asthma that is not well controlled can lead to lasting lung problems.
Rarely, asthma can be a deadly disease. Families should work closely with their providers to develop a plan to provide care for the child with asthma.
When to contact a medical professionalCall your child's care provider if you think you have new asthma symptoms. If your child was diagnosed with this disease, call the provider:
After a visit to the emergency room
When the maximum flow numbers have been going down
When symptoms are more frequent and more intense, even if your child is following the asthma action plan
Get medical help right away if your child is having trouble breathing or is having an asthma attack.
Emergency symptoms include:
Respiratory difficulty
Purple coloring of lips and face
Severe anxiety due to difficulty breathing
Fast pulse
Sweating
Decreased level of consciousness, such as drowsiness or serious confusion
A child who is having a severe asthma attack may need hospitalization and may be given oxygen and medication tothrough a vein (intravenously or IV).
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