Asthma in children

What is asthma in children?

Asthma is a lung condition that causes someone with it to have a hard time breathing.

During an asthma attack, the lung's airways (called the bronchial tubes) narrow because the smooth muscle cells surrounding the airways contract. In addition, the lining the airways becomes inflamed and swollen, and extra mucus is made.

The combination of mucus production, inflammation, and tightening of the surrounding muscles causes the airways to become narrow. This makes it difficult for air to move in and out of the lungs. Asthma may be mild with occasional symptoms, or it may be severe with constant symptoms.

There are many things that can trigger an asthma attack. The common cold can do it, as can allergens, substances that cause the immune system to overreact. Allergens cause allergies, and some children with allergies will develop asthma. Common allergens that trigger asthma attacks in children are house dust mites, pollen, mold, and household pets, such as dogs, cats, rabbits, and guinea pigs.

Physical exertion can trigger an asthma attack in some children. Other children can suffer an asthma attack when exposed to cold air, cigarette smoke, air pollution, poor ventilation and high humidity.

Asthma is very common in children and adolescents. It is the most common form of lung disease in children, affecting between 5 and 15% of all children.

Asthma can start at any time during childhood, but about half of all children have their first asthma attack before the age of 3. Some children will seem to "grow out of their symptoms" as they get older; others will have symptoms throughout their adult lives. Children whose parents or siblings have asthma have a higher chance of developing it themselves.

Treatment / What you should do if your child has asthma

If you suspect that your child has asthma, you should contact your doctor so that an evaluation can be made.

The doctor will want to examine the child and may want to look at the lungs with an X-ray. In older children, lung (pulmonary) function tests may be helpful. A peak flow meter tests lung function by measuring the air flow out of the lungs, while spirometry measures the amount of air flow both in and out of the lungs. Peak flow meters can be used at home, to better monitor asthma symptoms. If allergies are suspected, the doctor may suggest that your child be tested for allergies.

Most children with asthma need two types of medication: "rescue" medicine to help stop an asthma attack right away and "controller" medicine to prevent an asthma attack from happening in the first place.

Rescue medicines should be taken at the first sign of an asthma attack, whereas controller medicine should be taken regularly, every day, to prevent attacks.

There are various ways of taking asthma medications, depending on medication and the age of the child. Some asthma medications are inhaled. Nebulizer machines are often used to administer inhaled medications to the youngest children. A small mask is held over the nose and mouth while the child breathes in the fine mist containing the medication. For children over 5-6 years old, medication can be given in the form of metered dose inhalers with spacers, dry powder inhalers, or tablets. Your doctor will decide what kind of medicine is best for your child.

Your doctor will work with you to prepare an "Asthma Action Plan" which will explain exactly which medication (how much and when) your child should take on a regular basis and what you should do if the condition gets worse.

This plan will be part of your child's medical record and follow the child as he or she gets older. A copy should be sent to your child's school.

Older children may be given a peak flow meter to be used at home to measure the amount of airflow out of the lungs. This allows children and their parents to monitor how well the child's asthma is being controlled and gives early warning of an asthma attack.

If your child has difficulty breathing due to an asthma attack, it is very important that you act calmly (even though you are very concerned).

Talk softly; comfort your child by letting him sit in your lap, or by gently stroking his back.

Let your child sit upright with good support. This will make your child's breathing easier.

Loosen tight clothing, and open the window to allow fresh air to enter the room.

Encourage your child to drink plenty of fluids. An increase in fluid intake will prevent the mucus in the breathing passages from becoming sticky and difficult to cough up.

If your child is having trouble breathing, seems to be tiring, or he just doesn't seem right to you, you should contact your doctor immediately, or call 911.

Signs of a severe asthma attack include bluish skin color, grunting, flaring of nostrils, and pulling in of muscles in the neck or between the ribs.

If your child has asthma symptoms and his or her usual asthma medications do not seem to be helping, contact the doctor immediately.