Asthma in children is a leading cause of children visiting the emergency room at the Princess Alexandra Hospital in Anguilla. It is also a common cause of days off from school and it can interfere with many childhood activities. With treatment, many of the symptoms of childhood asthma can be controlled and serious complications avoided.
What is asthma?
Asthma is a chronic (long-term) illness in which the airways become blocked or narrowed. This is usually temporary, but it causes shortness of breath, trouble breathing, and other symptoms. If asthma becomes severe, the person may need emergency treatment to restore normal breathing.
The symptoms of asthma are triggered by things in the environment. These vary from person to person, but common triggers include cold air; exercise; allergens (things that cause allergies) such as dust mites, mold, pollen, animal dander or cockroach debris; and some types of viral infections.
Which children get asthma?
Asthma is one of the most common chronic disease of childhood. The numbers of young people getting appears to be increasing in the past 20 years.
Although asthma can occur in people of any age, even in infants, most children with the illness developed it by about age 5. Asthma seems to be more common in boys than in girls in early childhood.
What causes asthma in children?
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
What are some risk factors for getting childhood asthma?
Although any child can get asthma, studies have shown that there are some risk factors that increase the chances of a child getting asthma. These risk factors can alert parents to watch for signs of the disease so that your child can be treated promptly. The following are some risk factors for childhood asthma:
Heredity. To some extent, asthma seems to run in families. Children whose brothers, sisters, or parents have asthma are more likely to develop the illness themselves. If both parents have asthma, the risk is greater than if only one parent has it.
Atopy. Certain types of allergies can increase a child’s risk of developing asthma. A person is said to have atopy (or to be atopic) when he or she is prone to have allergies. This tendency is passed on from the person’s parents. It is not the same as inheriting a specific type of allergy. It is merely the tendency to develop allergies.
What are some asthma triggers?
Most children with asthma are aware that certain things can trigger an asthma attack or make it worse. These triggers vary from one individual to another but some common triggers for childhood asthma are:
Allergens. Some allergens (substances that cause allergies) are more likely to trigger an asthma attack. Some foods can be allergic and bring on an asthma attack. These include: eggs, cow’s milk, wheat, soybean products, tree nuts and peanuts.
Viral infections. Some types of viral infections can also trigger asthma. Two of the most likely culprits are respiratory syncytial virus (RSV) and parainfluenza virus.
Tobacco smoke. Smoking or second hand smoke is a common trigger for asthma. It may seem obvious that people with asthma should not smoke, but they should also avoid the smoke from other smokers. Other irritants in the environment can also bring on an asthma attack. These irritants may include paint fumes, smog, aerosol sprays and even perfume.
Exercise. Exercise—especially in cold air—is a frequent asthma trigger. A form of asthma called exercise-induced asthma is triggered by physical activity. Symptoms of this kind of asthma may not appear until several minutes of sustained exercise. (When symptoms appear sooner than this, it usually means that the person needs to adjust his or her treatment.) The kind of physical activities that can bring on asthma symptoms include not only exercise, but also laughing, crying, holding one’s breath and hyperventilating (rapid, shallow breathing).
The symptoms of exercise-induced asthma usually go away within a few hours. With proper treatment, a child with exercise-induced asthma does not need to limit his or her overall physical activity.
Other triggers. Cold air, wind, rain and sudden changes in the weather can sometimes bring on an asthma attack.
The ways in which children react to asthma triggers vary. In addition, asthma attacks do not always occur right after exposure to a trigger. Depending on the type of trigger, and how sensitive a child is to it, asthma attacks may be delayed.
What are some signs and symptoms of childhood asthma?
Asthma signs and symptoms vary from child to child, and may get worse or better overtime. 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. 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
• Bronchitis after a respiratory infection
• Trouble breathing that may limit play or exercise
• Fatigue, which can be caused by poor sleep
The first signs of asthma in young children may be recurrent wheezing triggered by a respiratory virus. As children grow older, asthma associated with respiratory allergies is more common.
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.
Treatment for childhood asthma
Asthma in children varies tremendously, therefore treatment should be tailored for each child. The goal of asthma treatment is to keep symptoms under control all of the time. For all children if a trigger, or triggers, is known this should be removed from the child’s environment. When these measures fail to control symptoms and signs, your child should be evaluated by his or her doctor and one or a combination of medications can be used to control symptoms. Treating asthma involves both preventing symptoms and treating an asthma attack in progress. Like any medication, asthma treatments often have side effects. Be sure to ask your doctor about the side effects of the medications your child is prescribed – and what warning signs should prompt you to contact your doctor.
Teachers and childhood asthma
All teachers should be aware of the signs and symptoms of asthma and should be informed if a particular child has asthma. Teachers should not prevent children from using their medications, including sprays, when they are having an acute asthmatic attack. Indeed, quick and expert help from teachers and school nurses can prevent many of the serious complications associated with acute childhood asthma. One of the most serious complications of childhood asthma is sudden death.
Conclusion
Childhood asthma is a common disorder in children, yet many parents in Anguilla lack knowledge of this disorder. If your child has asthma you should try to understand the disorder and work with his or her doctor, and other healthcare providers, so that the signs and symptoms can be controlled. Parents, relatives and teachers must work with health workers to ensure that all children with asthma in Anguilla have their symptoms well controlled so that they can lead a normal, healthy and enjoyable life.
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).
