Asthma in Children

By Chris Woolston

What is asthma?

Most people associate asthma with sudden fits of coughing and wheezing, but the condition is a round-the-clock disease. If your child has asthma, the tubes that carry air to her lungs are inflamed and may be swollen and clogged with mucus. This state may not impair her breathing, but it does set the stage for asthma attacks. The inflamed airway is extra sensitive, and something as seemingly harmless as dust, cold air, or exercise can cause the muscles lining the airway to suddenly squeeze tight, leaving little room for air to pass.

Is asthma common among children?

About 9 million Americans under the age of 18 have been diagnosed with asthma. It can strike at almost any age, but the first symptoms usually appear early in life, most often when kids are in grade school. The good news is that 50 to 70 percent of youngsters with the disease are free of symptoms by adulthood.

How can I tell if my child has asthma?

Childhood asthma can be hard to spot. Coughing and wheezing (especially at night) are the most common symptoms in children, but not every kid with asthma has them. Some simply suffer from congestion and tightness in their chests or rapid, raspy breathing.

One clue is allergies: Most children with asthma also have allergies. So if your child suffers from hay fever, eczema, or other allergic reactions, take any sign of asthma seriously. Also, since colds and other upper respiratory infections often lead to attacks, you should suspect asthma if your child is still coughing more than seven to 10 days after getting what appears to be a cold.

How is asthma treated?

Doctors primarily use two kinds of medications -- long-term control medications and quick-relief medications.

Corticosteroids control asthma over the long-term. Corticosteroids and similar drugs are inhaled, injected, or taken as pills; these drugs can ease the inflammation in your child's airways and make her less likely to have attacks. Your child's doctor will periodically assess how much control your child has by evaluating the frequency of her symptoms, her level of activity, how well her lungs function, how often medicine is necessary for the quick relief of asthma, and how often her asthma leads to nighttime awakenings. Your child's doctor will then adjust her medication up or down, depending on her symptoms.

The more familiar, quick-relief asthma medications are called short-acting bronchodilators. Taken through an inhaler, these drugs make breathing easier by relaxing the muscles that squeeze the airway during an asthma attack. If your child is still struggling to breathe after using the inhaler, call 911 or get her to an emergency room immediately.

If your child has allergic asthma that doesnt respond to these medicines or isnt controlled by avoiding asthma triggers, you may want to ask your doctor about allergy shots. Your doctor can determine which allergens bring on your childs asthma by administering skin tests. Then, your child will get regular injections containing tiny doses of the allergens over the next three to five years. The allergic asthma symptoms should gradually diminish.

For children over 5, doctors usually prescribe a peak-flow meter, which you can use to measure the strength of your child's breathing. Taking a reading every morning over a period of months will give you an idea of how much air is getting to your child's lungs and how well the treatments are working. Daily airflow measurement can also alert you and your child to problems that are about to arise, because the peak-flow reading will fall before the child shows symptoms of an asthma attack.

What can I do to prevent attacks?

Don't limit your child's physical activity just because she has asthma. Children with asthma can play sports and be athletic as long as they monitor their condition. Instead of restricting your child's play or exercise, try to protect her from the irritants that commonly trigger attacks. Keep her away from cigarette smoke, vacuum your home regularly, and clear her room of major dust collectors such as potted plants, stuffed animals, and shag carpeting. If she's allergic to your pets, consult your allergist for advice. Meanwhile, keep them outside or at least out of her room. If she has asthma attacks only in spring or fall, pollen may be the problem. Try keeping the windows closed and installing filters in your air conditioner.

Will asthma change my child's life?

It doesn't have to. Asthma can be deadly if left untreated, but almost all asthmatic children who take their medications and control the asthma triggers in their environment lead normal lives. You can help your child cope by getting involved. Make sure her teachers understand the disease and accept inhalers in the classroom, in gym class, and during other physical activities, and don't keep your child home from school unless it's necessary. Reassure her that her friends can't "catch" her asthma, and let her know that she's in control of the condition and not the other way around. Most of all, try to relax: A recent survey found that childhood asthma gives rise to far more anxiety in parents than in kids. Manage the disease calmly, and your child will follow suit.

Further Resources

The American Lung Association, which you can contact at (800) LUNG USA or http://www.lungusa.org, has more tips to help both of you cope.

References

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Clark NM, Brown RW, Parker E, Robins TG, Remick DG Jr, et al. Childhood asthma. Environ Health Perspect. 1999 Jun; 107 Suppl 3:421-9.

Wolfe R et al. Association between allergy and asthma from childhood to middle adulthood in an Australian cohort study. American Journal of Respiratory Critical Care Medicine. December 2000. 162(6): 2177-2181.

Martinez FD. Links between pediatric and adult asthma. Journal of Allergy and Clinical Immunology. May 2001. 107(5): S449-S455.

Sears MR. Evolution of asthma through childhood. Clinical and Experimental Allergy. November 1998. Suppl. 5: 82-89.

Nine Million U.S. Children Diagnosed with Asthma, New Report Finds. U.S. Centers for Disease Control and Prevention Press Release. March 31, 2004.

National Heart, Lung, and Blood Institute and National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. August 2007. http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf

National Center for Health Statistics. Asthma. Updated October 2010. http://www.cdc.gov/nchs/FASTATS/asthma.htm

Mayo Clinic. Treating asthma in children ages 5 to 11. March 2010. http://www.mayoclinic.com/health/asthma-in-children/AS00035

American Academy of Allergy Asthma & Immunology. Asthma Statistics. http://www.aaaai.org/media/statistics/asthma-statistics.asp

Last Updated: March 11, 2013

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