Asthma—Child
See also:
Definition
Air travels in and out of the lungs through bronchial tubes. Asthma is a chronic inflammation of these tubes. This inflammation causes airways to narrow. This makes it hard to breath. There are different degrees of asthma. Some people may have very mild asthma with rare flare-ups. Others may have a severe, constant asthma.
Inflamed Bronchial Tube
Asthma is the most common chronic disease found in children. If your child is having trouble breathing, call 911 immediately. This is a potentially serious condition that needs immediate medical attention.
If it is not an emergency, but you suspect your child may have asthma, contact your doctor. With proper treatment, asthma can be controlled.
Causes
The exact causes of asthma are unknown. It is thought that a mix of genes and environment causes asthma. Possible causes include:
- Family history
- Tendency to develop allergies
- Respiratory infections
- Contact with allergens when immune system is developing
Certain conditions are known to trigger an asthma attack. These include:
- Exercise—especially in cold air
- Tobacco smoke
-
Substances that cause allergies (allergens)
- Dust
- Food—peanuts, milk, wheat, eggs, and tree nuts are common
- Mold
- Animal hair
- Respiratory infection
- Abrupt change in weather
Risk Factors
These factors increase your child’s chance of asthma. Tell your doctor if your child has any of these risk factors:
- Family history
- Tendency to develop allergies
- History of respiratory infections
- Exposure to tobacco smoke
- Premature birth
- History of allergies and/or eczema
- Chlorinated pool use in children who are already at risk for asthma
Symptoms
If your child has any of these symptoms do not assume it is due to asthma. These may be caused by other conditions. Tell your doctor if your child has any of these:
- Shortness of breath
- Coughing
- Trouble breathing
- Wheezing
- Chest tightness
- Fatigue
- Child complains of chest pain or odd sensations
- Difficulty during feeding in infants
- Trouble sleeping
- Child avoids exercise or sports
Diagnosis
Your doctor will ask about you about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen to your child’s lungs. Your doctor may refer you to a specialist. A pulmonologist focuses on the lungs. An immunologist focuses on allergies.
Tests may include the following:
- Spirometry test—test that measures how well your child breaths; your child will be asked to take deep breaths and then exhale into a tube that is hooked to a machine
- Challenge test—test that uses spirometry to measure how well your child breaths after causing asthma symptoms
- Pulse oximetry—test that uses a sensor on a finger to measure oxygen concentration
- Medication—in young children unable to undergo spirometry testing, the doctor may prescribe a bronchodilator medication (drug that opens airways); if your child’s symptoms get better then the doctor may diagnose asthma
- X-ray —test that uses radiation to form an image; chest x-ray used to rule out infection and disease
- Skin testing —test that introduces very small amounts of common allergens into the skin; used to identify common allergens that may trigger asthma symptoms
Treatment
Talk with your child’s doctor about the best plan for your child. You and your child's doctor should also create an asthma action plan. This is a plan your child will follow to help control his asthma and handle asthma attacks. Treatment will vary based on how many asthma episodes your child has and any specific symptoms. Treatment options include the following:
Medications
Medications used to treat asthma fall into one of two categories:
Quick relief medications—usually given as inhalers
- These are also sometimes called rescue medications and are used to quickly treat breathing difficulties. Common inhalers include:
Long-term control:
- Inhaled corticosteroids
- Systemic corticosteroids
- Long-acting bronchodilators
- Leukotriene modifiers such as montelukast (Singulair) and zafirlukast (Accolate)
- Theophylline
- Cromolyn or nedocromil
- Zileuton (Zyflo), a 5-lipoxygenase inhibitor
- Combination medications that include a long-acting bronchodilator and an inhaled corticosteroid
Allergy Shots (Immunotherapy)
Your child’s asthma may be triggered by allergies. In this case, your doctor may recommend allergy shots. These shots are very small amounts of an allergen injected into the skin. Over time your child will react less to the specific allergen(s). With less triggers the asthma also decreases.
Prevention
There are no known ways to prevent your child from developing asthma. However you can help your child reduce his or her chance of triggering an asthma attack, by taking the following steps:
- Know what your child is allergic to and avoid known triggers.
- Use hot water to wash linens.
- Use hypoallergenic pillows and mattress covers.
- Avoid foods that your child is allergic to.
- Avoid exposure to tobacco smoke.
- If your child is older than six months old, have her get a yearly seasonal flu shot . Also get the pandemic H1N1 flu vaccine once it is available.
RESOURCES:
American Academy of Allergy, Asthma, & Immunology
http://www.aaaai.org/patients.stm
Asthma and Allergy Foundation of America
http://www.aafa.org/
National Heart Lung and Blood Institute
http://www.nhlbi.nih.gov/
CANADIAN RESOURCES:
Asthma Society for Asthma
http://www.asthma.ca/
Canadian Lung Association
http://www.lung.ca/
References:
Asthma. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed November 12, 2008.
Asthma, steps in diagnosis. Mayo Clinic website. Available at: http://www.mayoclinic.com/print/asthma/AS00003/METHOD=print . Accessed November 12, 2008.
The diagnosis is asthma, now what? American Academy of Allergy, Asthma, & Immunology website. Available at: http://www.aaaai.org/patients/allergic_conditions/pediatric_asthma/diagnosis_asthma.stm . Accessed November 12, 2008.
What causes asthma? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Causes.html . Accessed November 12, 2008.
What is asthma? How can you tell if your child has it? American Academy of Allergy, Asthma, & Immunology website. Available at: http://www.aaaai.org/patients/allergic_conditions/pediatric_asthma/what_is_asthma.stm . Accessed November 12, 2008.
SW Stoloff. The current and future state of asthma treatment. Clinical Cornerstone: The Current and Future State of Asthma Treatment. 2008; 8(4):26-43.
US Centers for Disease Control and Prevention. Asthma information for patients and parents. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/H1N1flu/asthma.htm . Updated September 15, 2009. Accessed September 18, 2009.
10/9/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mireku N, Wang Y, Ager J, Reddy R, Baptist A. Changes in weather and the effects on pediatric asthma exacerbations. Ann Allergy Asthma Immunol. 2009;(3):220.
10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Bernard A, Nickmilder M, Voisin C, Sardella A. Impact of chlorinated swimming pool attendance on the respiratory health of adolescents. Pediatrics. 2009;124(4):1110-1118.
Last reviewed September 2009 by Christine Colpitts, CRT, MA
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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