What is asthma?
Asthma is a chronic disease of the tubes that carry air to the lungs. The inner lining of the airways become swollen (inflammation) and the muscles around the airways tighten (bronchospasm) narrowing the airways further. The severity of asthma varies over time, and patients may not always have symptoms. When asthma is controlled, your child should be able to do everything someone without asthma can do.
Symptoms of asthma include:
- Coughing, especially at night
- Shortness of breath
- Tightness in the chest
If you are concerned your child may have asthma, talk to your healthcare provider.
It can be challenging, especially in young children, to be certain that asthma is the diagnosis. After examining your child, your provider will need to ask you specific questions about your child’s health. The information you give will help determine if your child has asthma.
This information includes:
- Your child’s symptoms, such as wheezing, coughing, and shortness of breath
- What triggers the symptoms or causes the symptoms to get worse
- Medications that were tried and if they helped
- Any family history of allergies or asthma
Once your child is old enough to cooperate, we can test your child’s airway function using a device called a spirometer which measures the amount of air blown out of the lungs over time. Your provider may also want to do another spirometry after giving asthma medication. It is important to keep in mind that not all children with repeated episodes of wheezing have asthma.
One goal of treatment is to minimize symptoms and allow children to participate in normal physical activities with minimum side effects. A second goal is to prevent ER visits and hospitalizations due to asthma attacks.
Asthma is different in every patient and symptoms can change over time. Which asthma medication is best for your child is decided upon based on the severity and frequency of symptoms and your child’s age. Children with asthma symptoms that occur only once in a while are often given medications for short periods only. Children with asthma whose symptoms occur more often need to take controller medications every day. Sometimes it is necessary to take several medications at the same time to control and prevent symptoms. Your provider may give your child several medications at first, to get the asthma symptoms under control, and then decrease the medications as needed.
Asthma medications are divided into two groups: quick-relief medications and controller medications. Inhalers should always be used with a “spacer” or “chamber” to optimize medication delivery. Please discuss this with your provider.
Quick-relief medications (bronchodilators) are for short-term use to open up narrowed airways and help relieve the feeling of tightness in the chest, wheezing and breathlessness. They can also be used to prevent exercise-induced asthma. The most common quick-relief medication is albuterol.
Controller medications are used on a daily basis to control asthma and reduce the number of days that your child has symptoms. They are not used for relief of symptoms. Children with asthma symptoms more than twice per week or those who are woken up by their asthma more than twice per month should be on controller medications. These medications need to be taken every day, even if your child is feeling well.
Inhaled corticosteroids, such as Flovent® and Pulmicort®, are very effective and, when used in the recommended doses, are safe for most children.
Asthma action plan
It is helpful to have an asthma action plan written down so you can refer to it from time to time. Such a plan should contain information on daily medications your child takes as well as instructions on what to do for symptoms. Ask your provider to help you create an action plan for your child.
Exercise can trigger symptoms in children with asthma. It can almost always be prevented with use of albuterol taken 15 minutes or more before exercise. If it occurs frequently, however, it may mean your child’s asthma is not under control. Proper asthma control can make a great difference in the ability of a child to exercise normally.
Get a flu shot every fall
Patients with asthma are at a much greater risk for complications when they are sick with influenza. Therefore, all patients and their household contacts are recommended to get immunized annually against influenza.