Disease: Asthma, childhood

With childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as airborne pollen. In other cases, childhood asthma flares up with a cold or other respiratory infection. Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, unmanaged asthma can cause dangerous asthma attacks.

Childhood asthma isn't a different disease from asthma in adults, but children do face unique challenges. Asthma in children is a leading cause of emergency department visits, hospitalizations and missed school days. Unfortunately, childhood asthma can't be cured, and symptoms may continue into adulthood. But with the right treatment, you and your child can keep symptoms under control and prevent damage to growing lungs.

Source: http://www.mayoclinic.com

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

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.

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.

When to see a doctor

Take your child to see the doctor as soon as possible if you suspect he or she may have asthma. Early treatment will not only help control day-to-day asthma symptoms, but also may prevent asthma attacks.

Make an appointment with your child's doctor if you notice:

  • Coughing that's constant, intermittent or seems to be linked to physical activity
  • Wheezing or whistling sounds when your child exhales
  • Shortness of breath or rapid breathing
  • Complaints of chest tightness
  • Repeated episodes of suspected bronchitis or pneumonia

If your child has asthma, he or she may say things such as, "My chest feels funny" or "I'm always coughing." Asthma can be worse at night, so listen for coughing during sleep or coughing that awakens your child. Crying, laughing, yelling, or strong emotional reactions and stress also may trigger coughing or wheezing.

If your child is diagnosed with asthma, creating an asthma action plan can help you and other caregivers monitor symptoms and know what to do if an asthma attack does occur.

When to seek emergency treatment

In severe cases, you may see your child's chest and sides pulling inward as he or she struggles to breathe. Your child may have an increased heartbeat, sweating and chest pain. Seek emergency care if your child:

  • Has to stop in midsentence to catch his or her breath
  • Is using abdominal muscles to breathe
  • Has widened nostrils when breathing in
  • Is trying so hard to breathe that the abdomen is sucked under the ribs when he or she breathes in

Even if your child hasn't been diagnosed with asthma, seek medical attention immediately if he or she has trouble breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing, which progresses to wheezing and labored breathing.

Source: http://www.mayoclinic.com

The underlying causes of childhood asthma aren't fully understood. 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. Reaction to a trigger may be delayed, making it more difficult to identify the trigger. 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.

Source: http://www.mayoclinic.com

Asthma can be hard to diagnose. Your child's doctor will consider the nature and frequency of symptoms and may use tests to rule out other conditions and to identify the most likely cause of his or her symptoms.

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. So your child's doctor will have to determine whether your child's symptoms are caused by asthma, a condition other than asthma, or both asthma and another condition. Some conditions that can cause asthma-like symptoms include:

  • Rhinitis
  • Sinusitus
  • Acid reflux or gastroesophageal reflux disease (GERD)
  • Airway abnormalities
  • Vocal cord dysfunction
  • Respiratory tract infections such as bronchiolitis and respiratory syncytial virus (RSV)

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. Your child may have lung function tests at rest, after exercising and after taking asthma medication. Allergy skin testing also may be needed.
  • In younger children, diagnosis can be difficult because lung function tests aren't 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 can't be made until later, after months or even years of observing symptoms.

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.

For children younger than age 3 who have symptoms of asthma, the doctor may use a wait-and-see approach. This is because the long-term effects of asthma medication on infants and young children aren't clear. If an infant or toddler has frequent or severe wheezing episodes, a medication may be prescribed to see if it improves symptoms.

Allergy skin tests for allergic asthma

If your child seems to have asthma that's triggered by allergies, the doctor may want to do allergy skin testing. During a skin test, the skin is pricked with extracts of common allergy-causing substances and observed for signs of an allergic reaction. This test may help identify whether your child is allergic to animal dander, mold, dust mites or other allergens. This information can be useful in taking steps to help your child avoid his or her particular asthma triggers.

Source: http://www.mayoclinic.com

Asthma may cause a number of complications, including:

  • Severe asthma attacks that require emergency treatment or hospital care
  • Permanent narrowing of the airways (bronchial tubes)
  • Missed school days or getting behind in school
  • Poor sleep and fatigue
  • Symptoms that interfere with play, sports or other activities

Source: http://www.mayoclinic.com

Careful planning and steering clear of asthma triggers are the best ways to prevent asthma attacks.

  • Limit exposure to asthma triggers. Be proactive in helping your child avoid the allergens and irritants that trigger asthma symptoms.
  • Don't allow smoking around your child. Exposure to tobacco smoke during infancy is a strong risk factor for childhood asthma, as well as a common trigger of asthma attacks.
  • Encourage your child to be active. As long as your child's asthma is well controlled, regular physical activity can condition the lungs to work more efficiently.
  • See the doctor when necessary. Check in on a regular basis. Don't ignore signs that your child's asthma may not be under control, such as needing to use a quick-relief inhaler too often. Asthma changes over time. Consulting your child's doctor can help you make any needed treatment adjustments to keep symptoms under control.

Source: http://www.mayoclinic.com

While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative treatments that may help with asthma include:

  • Breathing techniques. These include structured breathing programs, such as the Buteyko breathing technique, the Papworth method and yoga breathing exercises (pranayama).
  • Acupuncture. This technique has roots in traditional Chinese medicine. It involves placing very thin needles at strategic points on your child's body. Acupuncture requires holding still for up to a few minutes, which can be hard for young children. It's safe and generally painless.
  • Relaxation techniques. Techniques such as meditation, biofeedback, hypnosis and progressive muscle relaxation may help with asthma by reducing tension and stress.
  • Homeopathy. Homeopathy aims to stimulate the body's self-healing response by using very small doses of substances that cause symptoms. In the case of asthma, homeopathic remedies are made from substances that trigger an asthmatic reaction, such as pollen or weeds. There's still not enough evidence to determine whether homeopathy helps treat asthma caused by allergies or not.
  • Herbal remedies and supplements. A number of herbal remedies have been tried for asthma, such as butterbur, ginkgo and dried ivy. Studies are unclear about the benefit of these and other herbal treatments for asthma. Herbs and supplements can have side effects and some may interact with other medications your child is taking. Talk to your child's doctor before trying any herbs or supplements.

Source: http://www.mayoclinic.com

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. 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. Also consider installing a small-particle filter in your ventilation system.
  • Reduce pet dander. If your child is allergic to dander, it's 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 don't 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.
  • Reduce your child's exposure to cold air. If your child's asthma is worsened by cold, dry air, wearing a face mask outside can help.

Help your child stay healthy

Staying active and treating other conditions linked to asthma will help keep your child's asthma under control.

  • Make treatment a regular part of life. If your child has to take daily medication, don't make a big deal out of it — it should be as routine as eating breakfast or brushing teeth.
  • Make sure your child gets exercise. Don't let asthma sideline your child. Regular exercise reduces symptoms and is important for your child's overall health. With asthma under control, there should be no limit to your child's physical activity level.
  • Help your child maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts your child at risk of other health problems.
  • Keep heartburn under control. Acid reflux or severe heartburn (gastroesophageal reflux disease, or GERD) may worsen your child's asthma symptoms. He or she may need over-the-counter or prescription medications to control acid reflux.

Source: http://www.mayoclinic.com

It can be stressful to help your child manage his or her asthma. Keep these tips in mind to make life as normal as possible:

  • Use a written asthma action plan. Work with your child's doctor to develop your child's action plan, and give a copy of it to all of your child's caregivers, such as child care providers, teachers, coaches, and the parents of your child's friends. Following a written plan can help you and your child identify symptoms early, providing important information on how to treat your child's asthma from day to day and how to deal with an asthma attack.
  • Be encouraging. Focus attention on the things your child can do, not on the things he or she can't. Involve teachers, school nurses, coaches, relatives and friends in helping your child manage asthma. Encourage normal play and activity. Don't limit your child's activities out of fear of an asthma attack — work with your child's doctor to control exercise-induced symptoms.
  • Be calm and in control when facing asthma symptoms. Don't get rattled if you see asthma symptoms getting worse. Focus on your child's asthma action plan and involve your child in each step so that he or she understands what's happening.
  • Talk to other parents of children with asthma. Chat rooms and message boards on the Internet or a local support group can connect you with parents facing similar challenges and let you know that you and your child are not alone in dealing with asthma.
  • Help your child connect with others who have asthma. Send your child to "asthma camp" or find other organized activities for children with asthma. This can help your child feel less isolated and help him or her gain a better understanding of asthma and its treatment.

Source: http://www.mayoclinic.com

Factors that may increase your child's likelihood of developing asthma include:

  • Exposure to tobacco smoke
  • Previous allergic reactions, including skin reactions, food allergies or hay fever (allergic rhinitis)
  • A family history of asthma, allergic rhinitis, hives or eczema
  • Living in an urban area with increased exposure to air pollution
  • Low birth weight
  • Obesity
  • A chronic runny or stuffy nose (rhinitis)
  • Severe lower respiratory tract infection, such as pneumonia
  • Inflamed sinuses (sinusitis)
  • Heartburn (gastroesophageal reflux disease, or GERD)
  • Being male

Source: http://www.mayoclinic.com

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