For as many as 8 million children in the United States, the simple, usually unconscious process of breathing is a daily concern and problem. These youngsters have asthma, a respiratory condition in which the air passages of the lungs (the bronchioles) tighten up, making breathing difficult. During an asthmatic episode the membranes lining the airways become inflamed; they swell, and thick mucus builds up within the air passages, and the bronchial muscles surrounding the airways go into spasm. With every breath the air must struggle through the narrowed breathing tubes to make its way into and out of the lungs. Each time the child exhales, she may make the high-pitched wheezing sound so often identified with asthma.
What causes asthma? In those children whose airways are susceptible, it is usually an overreaction to infections, allergens, cold air, exercise, or something in the air that the child breathes. For instance, viral respiratory infections (colds, influenza) are responsible for many asthma attacks, and some children experience asthma only when they have such an infection.
Inhaled pollens can also provoke an episode, as can other allergens like animal dander, dust mites, and irritating fumes. A sudden change in temperature—for instance, exposure to very cold air—can trigger an episode too. Emotional distress can sometimes bring on an asthma attack, as can some medications.
Children with asthma often miss more school than their friends and sometimes are restricted from playground activities that could worsen their condition. Asthma can be a frightening disorder for both parent and child. Although it is not a common event, hundreds of children do die from asthma attacks every year in the United States. However, keep in mind that most asthma is treatable, and newer medications are capable of preventing attacks and reducing symptoms, with minimal side effects.
When a child has an asthma attack, she needs immediate treatment to relieve bronchial muscle-tightening. If possible, the first treatment involves removing the child from the situation that has triggered the symptoms: stop exercising, come in from the cold, get away from the cat, and so on.
The front line of therapy for a child who is experiencing wheezing from asthma is a hand-held inhaler (metered dose inhaler) or nebulizer. Most children over four years of age can use these devices on their own very successfully, particularly when the instruments are equipped with a chamber or "spacer" that makes it easier for the child to coordinate her breathing with the release of the drug, and ensures that the desired dosage is inhaled. Be sure your child understands and follows the instructions of the doctor carefully when using an inhaler, to maximize its effect in controlling asthma symptoms. The most common problem when these inhalers fail to work is the lack of proper administration.
If your child does not respond to her medication, contact your doctor promptly. Sometimes your youngster's asthma episode may warrant an immediate call to the doctor's office. Call your physician if your child's wheezing is severe and her breathing becomes very difficult. Also, contact your doctor immediately if your child's lips turn blue, if she cannot speak, or if she vomits asthma medication that she took by mouth.
During exercise some children develop shortness of breath and other symptoms of asthma. The child who wheezes during exercise does not necessarily need to limit her participation in most sports. Instead, your doctor may recommend that your youngster use an inhaler about ten minutes before exercising as a way to prevent symptoms from occurring. In certain sports like swimming, children with asthma actually do quite well.
Schools vary in their rules about asthma medication. Some insist that all medication be kept in the principal's office and that it be administered only by the school nurse. This may be a problem for children who require medication but feel embarrassed about leaving class to take it. These youngsters may need encouragement and support to recognize that the medicine is preferable to having a serious, disruptive asthma attack.
Whenever possible, youngsters should stay away from those things that tend to trigger their asthma. In some children, that may mean avoiding certain foods. Others need to keep away from cigarette smoke, feather pillows, or flowers, or remain indoors on particularly smoggy days.
The Signs of Asthma
