Asthma in Children

There is growing evidence that the number of children in Anguilla affected by asthma is on the increase. Asthma in children is a leading cause of emergency room visits, hospitalizations and missed school days. Childhood asthma must be taken seriously by parents and health care professionals as untreated asthma can be life-threatening in some instances. An acute asthmatic attack can be a medical emergency requiring urgent attention.

What are some signs and symptoms of childhood asthma?
The first signs of asthma in young children may be recurrent wheezing triggered by a respiratory virus. This could be a whistling sound when exhaling (breathing out air).

Asthma signs and symptoms vary from child to child, and may get worse or better over time. While wheezing is most commonly associated with asthma, not all children with asthma wheeze. Your child may have only one sign or symptom such as a lingering cough or chest congestion.
It may be difficult to tell whether your child’s symptoms are caused by asthma or something else. Periodic or long-lasting wheezing and other asthma-like symptoms may be caused by infectious bronchitis or another respiratory problem.

Other symptoms and signs of childhood asthma include:

? Frequent, intermittent coughing

? Shortness of breath

? Chest congestion or tightness

? Chest pain, particularly in younger children

? Trouble sleeping caused by shortness of breath, coughing or wheezing

? Bouts of coughing or wheezing that get worse with a respiratory infection such as a cold

? Delayed recovery or bronchitis after a respiratory infection

? Trouble breathing that may limit play or exercise

? Fatigue, which can be caused by poor sleep

What causes childhood asthma?
The underlying causes of childhood asthma are not fully understood. Some factors thought to be involved include:

? Inherited traits
? Some types of airway infections at a very young age

? Exposure to environmental factors such as cigarette smoke or air pollution

Increased immune system sensitivity causes the lungs and airways to easily become swollen and produce mucus when exposed to certain triggers. These triggers vary from child to child and can include:

? Viral infections such as the common cold

? Exposure to air pollutants, such as tobacco smoke

? Allergies to dust mites, pet dander, pollen or mould

? Physical activity

? Weather changes or cold air

Sometimes asthma symptoms occur with no apparent triggers.

Diagnosis
If you suspect your child has asthma, it’s important to see a doctor as soon as possible. Early diagnosis and proper treatment can prevent disruptions from daily activities such as sleep, play, sports and school. It may also prevent dangerous or life-threatening asthma attacks.

The doctor will ask for a detailed description of your child’s symptoms and health. Your child may also need medical tests. In children 6 years of age and older, doctors diagnose asthma with the same tests used to identify the disease in adults. Lung function tests (spirometry) measure how quickly and how much air your child can exhale. Allergy skin testing also may be needed. In younger children, diagnosis can be difficult because lung function tests are not accurate before 6 years of age. Some children simply outgrow asthma-like symptoms over time. Your doctor will rely on detailed information you and your child provide about symptoms. Sometimes a diagnosis cannot be made until later, after months or even years of observing symptoms.

Treatment
The goal of asthma treatment is to keep symptoms under control all of the time.

Treating asthma involves both preventing symptoms and treating an asthma attack in progress. Preventive, long-term control medications reduce the inflammation in your child’s airways that leads to symptoms. The right medication for your child depends on a number of things including his or her age, symptoms, asthma triggers and what seems to work best to keep his or her asthma under control. Your doctor would be able to give you advice on other lifestyle changes that can help in the management of childhood asthma. Taking steps to reduce your child’s exposure to his or her asthma triggers will lessen the possibility of asthma attacks. Steps to help avoid triggers vary depending on what triggers your child’s asthma.

Coping with asthma
Asthma is a chronic condition and can be stressful for both parents and the affected child. Parents can play a great role in helping the child cope with asthma, but other persons can help as well. Parents should involve teachers, school nurses, coaches, relatives and friends in helping their child manage his/her asthma. Adults should encourage normal play and activity. Parents should not limit their child’s activities out of fear of an asthma attack.

Conclusion
More and more children living in Anguilla are affected by childhood asthma. The vast majority of cases can be successfully managed, but some children do require many visits to the hospital to achieve good control. If your child is an asthmatic and is poorly controlled you should seek medical attention as uncontrolled childhood asthma can have severe complications, some of which can be life-threatening.

Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty five years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.