David Kelly Crow

Health Matters 12/14: Helping Children With Asthma Breathe Easier

Did you know that asthma is the most common chronic illness in childhood?

That’s according to the Centers for Disease Control and Prevention, which reports that more than 6.1 million children across the United States are affected by the disease.

However, they don’t have to suffer. In most cases, asthma can be effectively managed with medication and by avoiding triggers.

A Chain Reaction

Asthma is a serious disease characterized by swelling and narrowing of the airways, which then become extremely sensitive to inhaled substances. When the airways react, the muscles constrict causing even further, narrowing and making it difficult to breathe. Additionally, this reaction may trigger increased mucus production, which in turn narrows the airways even more.

Asthma affects people of all ages, but typically starts in childhood. Symptoms of asthma include:

  • Wheezing is a squeaky or whistling sound when your child breathes.
  • Coughing from asthma is typically worse in the morning and at night.
  • Chest tightness. Some children may say they feel as if an elephant is sitting on their chest.
  • Shortness of breath. Children with asthma may have a hard time catching their breath.

Other red flags that may signal your child has asthma include chronic or recurrent bronchitis, recurrent pneumonia, chronic cough, or recurrent lower respiratory infections.

If your child experiences any of these symptoms, talk to your pediatrician about the possibility of asthma.

Allergies a Common Trigger

Allergies and asthma seem to go hand-in-hand. As the American Academy of Pediatrics notes, most children with asthma have allergies and most allergies trigger asthma symptoms. Common allergens include:

  • House dust mites
  • Animal dander
  • Pollen
  • Mold
  • Cockroaches

Other asthma triggers include:

  • Irritants such as cigarette smoke, air pollution, fragrances.
  • Changes in the weather, cold air, dry air.
  • Infections of the airways, including viral infections of the nose and throat.
  • Exercise. (About 80 percent of people with asthma develop symptoms when they exercise, according to the American Academy of Pediatrics.)
  • Stress.

Diagnosing and Managing Asthma

There are no specific tests for asthma, but doctors can typically make a diagnosis based on a physical exam, history and symptoms.

Once diagnosed, asthma can often be controlled and symptoms – or attacks – prevented through the use of medication. Quick-relief medicines such as albuterol are typically prescribed to stop asthma symptoms and long-term control medicines like inhaled steroids are normally prescribed to prevent attacks from occurring at all.

There are a variety of medications available, and they can come in different forms such an inhaler or a nebulizer. Your pediatrician will work with you to determine what works best for your child.

In addition, to help prevent asthma attacks, the American Academy of Pediatrics offers the following tips:

  • Do not smoke or let anyone else smoke in your home or car.
  • Reduce exposure to dust mites by covering your child’s mattress and pillows with special allergy-proof casing, washing bedding in hot water every 1 to 2 weeks, and vacuuming and dusting regularly.
  • Avoid pets or at least keep pets out of the child’s bedroom.
  • Reduce exposure to pollen by using an air conditioner in the child’s room with the vent closed, and leaving doors and windows closed during high pollen times.
  • Control indoor humidity to prevent mold growth.
  • Use unscented cleaning products and avoid room deodorizers or scented candles.

Moreover, all children should receive an annual flu vaccine and practice good hand washing to keep from getting sick. Children with asthma are especially susceptible to complications from the flu. Parents, grandparents, siblings and other caregivers or close relatives should also receive the flu vaccine.

If asthma is well managed, a child should not experience symptoms more than once or twice per week, symptoms should not wake a child at night more than twice per month, and a child should be able to play sports and participate in physical education activities.

When Asthma Becomes an Emergency

While asthma attacks can normally be prevented, an estimated one in six children with asthma visits the emergency department every year and about one in 20 are hospitalized for asthma, according to the CDC.

Signs that an asthmatic child may need emergency attention include:

  • A flare-up requiring medication more than every four hours, or that is not relieved after a few treatments.
  • Not being able to speak in full sentences.
  • Noticeable contracting of the chest, ribs or belly when breathing.
  • Unusual anxiety or restlessness.
  • Change in skin color.
  • Increased pulse.
  • Sweating.
  • Decreased level of alertness.

At Penn Medicine Princeton Medical Center, pediatricians from Children’s Hospital of Philadelphia are on-site 24/7 to consult on emergency cases involving infants, children and adolescents. And now a pediatrician from CHOP is in the emergency department every day from 2 p.m. to 10 p.m. – the hours when children visit most frequently. If a child needs to be admitted, he or she is cared for in PMC’s inpatient pediatric unit, where a CHOP pediatrician is on-site around-the-clock.

Alicia Brennan, M.D., is board certified in pediatrics and medical director of Children’s Hospital of Philadelphia Pediatric Care at Penn Medicine Princeton Medical Center.