Ask the Doctor: Asthma

The AF expert explains what parents need to know about this chronic breathing condition.

Q: Our child’s referral says he has asthma. How will this affect him? What can we do to optimize his care?

A: Asthma is one of the most common chronic childhood diseases, affecting one out of 10 children in the U.S. It is a disease of the lower airways and lungs that results in difficulty in breathing.

Though asthma is a serious condition that must be treated on a daily basis, it is manageable. If treatment is aggressive and parents are vigilant, asthmatic children are able to fully participate in sports and other activities.

What Are The Symptoms?

There are varying degrees of asthma. Eighty-five percent of children with asthma develop its symptoms before age five. Some children have fits of coughing while exercising or asleep, when it is harder to take deep breaths. Others experience more extreme symptoms, including shortness of breath, wheezing, and tightness of the chest. A flare-up of asthma symptoms is often called an attack.

What Triggers Asthma?

Asthma triggers include exposure to cigarette smoke, environmental pollution, pollen, mold, plants, and dust mites. Allergies to any of those irritants can cause asthma attacks as well. Some children’s symptoms are brought on by sudden temperature changes or by upper respiratory infections, such as colds or earaches. Acid reflux and food allergies are also possible triggers.

How Do Doctors Diagnose and Treat Asthma?

Most doctors do not diagnose asthma before age two. Nonetheless, parents should seek medical attention if they observe bouts of shortness of breath, particularly during or after exercise. A doctor may detect wheezing or observe the chest sucking in with each breath. In milder cases of the disease, symptoms are not always apparent, so a doctor makes a diagnosis based on the parent’s report of the child’s breathing difficulties.

Asthma must be treated daily, not just when a child has symptoms. Doctors focus on treating the airway inflammation that causes asthma attacks, in order to prevent coughing, wheezing, and respiratory distress. Children who exhibit symptoms only infrequently soothe flare-ups by taking airway-dilating medications via a device called an inhaler. Children who have more frequent symptoms take daily medication, usually in the form of inhaled corticosteroids. These medications are taken via a nebulizer machine or an inhaler.

How Can Asthma Be Kept Under Control?

Many doctors provide parents with an asthma care plan, which will help determine whether a child’s asthma is worsening or requires medical treatment. The plan will also likely include instructions for using a device called a peak flow meter, which monitors lung capacity. The peak flow meter can often detect a child’s condition worsening, before symptoms even begin.

In addition to medical treatment, its important to eliminate anything around the house that may precipitate asthma attacks. This means not smoking at home, keeping humidity low to prevent mold from growing, and preventing dust and dust-mite buildups. Animal fur can also aggravate asthma, so use caution before introducing your child to pets.

If your child plays a sport, be aware that exercise can trigger attacks. Keep an inhaler on the sidelines at all times.

What Information Should I Look For In The Referral Records?

If you’re adopting a child who has been diagnosed with asthma, find out what medications he is taking, whether he’s been hospitalized, or if he has trouble exercising.

Studies show that there may be a link between smoking during pregnancy and a child developing asthma later in life, so find out whether your child was exposed to tobacco smoke before birth. Has he ever had any environmental allergies? How often does he have symptoms? What were previous caregivers told to do when he experiences those symptoms? Asthma is a genetic condition. If you have contact with the birth mother, ask whether there is a family history of asthma, breathing problems, or environmental allergies, such as to dust, pollen, or grass (many children who have allergies also develop asthma).

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