Asthma has reached epidemic proportions in American children. Asthma is the leading cause of hospital admissions and school absences in children.
Asthma is a lung disease that causes bronchiole (airway) muscles to tighten and mucus production to increase to a point where breathing becomes difficult. New drugs and treatments are constantly being introduced that allow patients (kids included) to take a more active role in monitoring their asthma and controlling their symptoms.
Who gets asthma?
One-third of asthmatic children exhibit the first signs of the disease by the age of two years, and eighty percent develop symptoms by age five years. Boys are twice as likely as girls to have asthma.
Recent research suggests that some children are born with airways that overreact to stimuli. Also, parents with a history of asthma or allergies are more likely than those with no such history to have children with asthma.
Viral respiratory infections are a strong trigger of asthma. Another study suggests kids between three and four years of age who have frequent colds are eight and a half times more likely to develop asthma than those who don’t catch colds often.
How can I tell if my child has asthma?
Asthma can be difficult to diagnose, especially in babies and toddlers who can’t tell you they are having difficulty breathing. Coughing, wheezing, and shortness of breath are all signs of asthma. Asthma without wheezing is also possible.
Children with a persistent cough that does not respond to treatment and children who have trouble catching their breath or keeping up with others should be evaluated for asthma. Simple diagnostic tests like chest or sinus x-rays and blood tests may be used to confirm a diagnosis of asthma.
What’s new in prevention?
There is no definitive way to prevent the development of asthma; however, certain measures can help. Breastfeeding babies for at least six months helps to prevent the development of allergies, asthma, and respiratory infections. Children should not be exposed to second-hand smoke from cigarettes. This has been shown to increase the likelihood of children developing allergies and asthma.
Allergens, substances that trigger allergic reactions in particular individuals, should be removed from the child’s environment as much as possible. These substances can aggravate a child’s airway, leading to inflammation and hypersensitivity. Allergens associated with asthma include dust mites, cockroaches, molds, and furry animals.
To minimize your child’s contact with allergens, cover her box spring, mattress, and pillow with allergy-proof covers. The packaging for the covers will indicate that they protect the sleeper from allergens. Wash bedding weekly in very hot water to avoid dust mites.
If your child develops environmental allergies or exhibits symptoms of asthma, remove stuffed animals from her bedroom and reduce her contact with pets. Keep the pets out of your child’s bedroom and primary play area.
How do you treat asthma?
Avoiding tragedies from asthma requires that even mild cases be treated aggressively with medications. Asthma is both a chronic and episodic disease. One type of medication is used to treat the underlying inflammation that leads to asthma attacks, and another type of medication is used to treat the attacks when they occur.
Acute attacks are treated with bronchodilators that relax the muscles in the airways, allowing them to open and ease air exchange. These drugs, such as albuterol (Ventolin, Proventil) are often delivered via inhaled methods.
An inhaler can be used in older children who demonstrate adequate dexterity or in younger children with the addition of a spacer that holds the medication in a chamber until it is inhaled. Infants and toddlers will require the use of a nebulizer (portable machine) which blows medicated mist through a mask into the child’s face. Bronchodilators work wonders for an acute attack but do not help to prevent future occurrences.
Children who need bronchodilators more than twice a week should be placed on medication to help decrease inflammation and prevent attacks. Cromolyn sodium (Intal) is the most widely used. This medication has the least side effects and is administered by inhaler or nebulizer.
Inhaled corticosteroids are also effective in reducing swelling, inflammation, and decreasing mucus production in the lungs. These medications have more side effects, including oral thrush, associated with their use. The benefits of these medications outweigh the risks in children who do not respond to the non-steroidal treatments.
Asthma is a disease that can be managed using up-to-date knowledge and treatments. If you think your physician is uncomfortable using the latest treatments for asthma, either consult with a pediatric pulmonologist or choose a new physician. This potentially dangerous disease can be “tamed” with the implementation of new treatments.
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