How Children Can Live Well with Asthma

If your child has asthma, take time to learn about the disease and how it's successfully treated.

A frequent or lingering cough, particularly at night or after running; frequent respiratory infections, wheezing, shortness of breath, tightness in the chest—if any of these seem to happen with some regularity to your child, talk to your health care provider. They could be symptoms of asthma, or perhaps some other serious condition that could benefit from treatment.

"Asthma is common, and it's deadly, but there are treatments that can keep it under control and manage the symptoms," says Derek K. Johnson, M.D., a pediatric allergy specialist in Philadelphia.

When asthma isn't controlled, children miss school and may give up sports and other daily activities. Each year 14 million days of school are missed because of asthma, according to the CDC.

When this chronic disease is well managed, however, children with the condition can do just about any kind of activity. The following information can help you help your child live a full, long life, despite a diagnosis of asthma.

Understanding asthma

Asthma is inflammation and swelling in the airways that carry air to and from the lungs. In a person with asthma, the airways overreact to the things that can irritate them or that can cause an allergic response.

The airways react to these "triggers" by becoming narrower; the muscles surrounding the airways tighten; and the airways begin to produce more mucus than usual. All these factors combined make breathing more difficult and bring on other symptoms, such as coughing or wheezing.

The symptoms may seem harmless. For example, your child may have a lingering chest cold or a cough that takes more than 10 days to subside.

Untreated asthma can lead to serious complications. In a severe attack, breathing may be so impaired that oxygen levels in the body fall drastically, sometimes enough to cause death.

Learning about triggers

Experts don't know for sure what causes the underlying inflammation of asthma. It's clear, however, that certain allergens and irritants commonly trigger asthma attacks.

Allergens are substances that cause allergic reactions in some people, but not others. About half of all people with asthma have allergic asthma. Allergens commonly include:

• Pollen from trees, grass, and weeds

• Animal dander

• Dust mites found in pillows, mattresses, and carpets

• Cockroach debris

• Indoor or outdoor mold

Irritants are substances that can cause the muscles around the airways to constrict in some people, leading to an asthma attack. Common irritants include:

• Cold air

• Rapid changes in temperature

• Chemicals, including those found in air pollution, cigarette smoke, perfumes, gasoline, paint thinner, and cleaning products

• Particulates, including those found in cigarette smoke, diesel exhaust, smog, and air pollution

Exercise also can bring on an acute asthma attack in many children, as can emotional stress and some types of viral infections.

Treating the condition

If your child is diagnosed with asthma, try to learn as much as you can about it and work with your child's physician to keep it under control.

Your child's doctor will tell you how to:

• Monitor your child' condition. Your child may be asked to use a hand-held peak flow meter to measure his or her lung function and see how well his or her asthma is being controlled.

• Identify and avoid your child's personal triggers. No child with asthma should be around secondhand tobacco smoke. It's a good idea to have your child remain indoors as much as possible when air pollution is high or when winds are high and carrying a lot of dust.

• In addition, if your child is allergic to the family pet, your options are to keep it out of your child's bedroom; to wash it more often; or to find a new home for the animal. Dust mites can be controlled by frequently washing bed linens, blankets, and stuffed toys in hot water and using dust-proof mattress and pillow covers.

• Have your child take appropriate medications. "If avoiding the allergens doesn't work, allergy medications or allergy shots can be helpful remedies," says Dr. Johnson. Controller medications are taken daily over a long period of time to treat the underlying inflammation.

Most people with asthma need a minimum of two medications: one to reduce inflammation (called an anti-inflammatory) and one to help maintain open airways (called a bronchodilator). Depending on the medication, it may be inhaled, taken by mouth, or given with a nebulizer. A nebulizer is a device that delivers medication as a mist that a young child can inhale through a mask.

Rescue medications act quickly to ease muscle spasms in the lungs. People with allergic asthma have additional options.