Asthma in children is a leading cause of emergency hospital visits, hospitalizations and missed school days in Anguilla and many other countries. Asthma is a chronic lung disease affecting more than 12% of children. Although there is no cure for asthma, at this time, in many cases the condition can be controlled. Asthma in children if not properly managed, can result in serious complications including death.
What is childhood asthma?
Asthma can occur in adults and children. It is a chronic inflammatory disorder of the airways characterized by an obstruction of airflow. This obstruction may be completely or partially reversed with or without specific therapy. Airway inflammation is associated with airway hyperreactivity or bronchial hyperresponsiveness.
What causes childhood asthma?
The underlying causes of childhood asthma are not fully understood at this time. Developing an overly sensitive immune system generally plays a role. 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 other air pollution
Increased immune system sensitivity causes the lungs and airways to swell 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 mold
• Physical activity
• Weather changes or cold air
Sometimes asthma symptoms occur with no apparent triggers.
What are the signs and symptoms of childhood asthma?
Asthma signs and symptoms vary from child to child, and may get worse or better over time. A child may have only one sign or symptom, such as a lingering cough or chest congestion.
Common childhood asthma signs and symptoms include:
• Frequent, intermittent coughing
• A whistling or wheezing sound when exhaling
• Shortness of breath
• Chest congestion or tightness
• Chest pain, particularly in younger children
Other signs and symptoms of childhood asthma include:
• 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 or the flu
• Delayed recovery or bronchitis after a respiratory infection
• Trouble breathing that may limit play or exercise
• Fatigue which can be caused by poor sleep
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.
Diagnosis
Despite what many parents think, asthma in children can be very difficult to diagnose. A number of childhood conditions can have symptoms similar to those caused by asthma. To make things more complicated, these conditions also commonly co-occur with asthma.
If you suspect your child has asthma, it is 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. A number of tests and investigations are available to diagnose asthma.
Treatment
The goal of asthma treatment is to keep symptoms under control all of the time. Well-controlled asthma means that your child has:
• Minimal or no symptoms
• Few or no asthma flare-ups
• No limitations on physical activities or exercise
• Minimal use of quick-relief (rescue) inhalers
• Few or no side effects from medications
Treating asthma involves both preventing symptoms and treating an asthma attack in progress. 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.
Asthma and school
Teachers play an important role in identifying the child with early warning signs of poor asthma control. Managing asthma appropriately will allow children with asthma to fully participate in school. Parents and teachers must know and recognize the early signs of asthma. This lack of recognition sometimes delays the preventive measures needed to avoid an acute and serious attack. Children with asthma must not be prevented from using their inhalers at school. Children with well controlled asthma can take part in all sporting activities.
Preventing childhood asthma
In some cases, it is impossible to prevent a childhood asthmatic attack, but there are some steps that can be taken to reduce your child’s exposure to asthma triggers. Steps to help avoid triggers vary depending on what triggers your child’s asthma. Here are some things that may help:
• Maintain low humidity at home. If you live in a damp climate, talk to your child’s doctor about using a device to keep the air drier (dehumidifier).
• Keep indoor air clean. Have a heating and air conditioning professional check your air conditioning system every year. Change the filters in your furnace and air conditioner according to the manufacturer’s instructions.
• Reduce pet dander. If your child is allergic to dander, it is best to avoid pets with fur or feathers. Regularly bathing or grooming your pets also may reduce the amount of dander in your surroundings.
• Use your air conditioner. Air conditioning helps reduce the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your child’s exposure to dust mites. If you do not have air conditioning, try to keep your windows closed during pollen season.
• Keep dust to a minimum. Reduce dust that may aggravate nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dust-proof covers. Consider removing carpeting and installing hard flooring, particularly in your child’s bedroom. Use washable curtains and blinds.
• Clean regularly. Clean your home at least once a week to remove dust and allergens.
Conclusion
Childhood asthma is a common cause for children visiting the emergency room and taking time off from school. This common chronic inflammatory lung disorder can be controlled, but some children still have complications. Talk to your doctor about how your child’s asthma can be properly controlled so that severe complications can be prevented.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
