Asthma in children is not uncommon. In the US, about 10% of the child population suffers from asthma. This percentage has been on the rise over the years for unknown reasons. Asthma can occur at any age, but in most cases, the onset of the disease occurs before the age of five. If your child has asthma, understanding the disease, its symptoms and treatment will help you manage it better.
Is my child having asthma?
Early detection and treatment of asthma can make things easier. Look for these symptoms in your child.
1. Coughs frequently at night or during activities that need faster breathing or a change in breathing pattern, for example, running, laughing or blowing a balloon.
2. Becomes out of breath after running a short distance and needs rest breaks to normalize breathing.
3. Complains of weakness, tiredness, low energy, poor stamina and seems disinterested in activities that require physical activity.
4. Complains about tightness in chest or chest pain.
5. Noticeable heavy or rapid breathing and the movement of the chest is clearly visible.
6. Crackling or whistling sound while breathing (wheezing).
7. Headaches.
8. Dark circles under the eyes.
9. Poor appetite.
Your child may not have all these symptoms. Sometimes, coughing is the only symptom. Similar symptoms may also occur due to other problems like bronchitis or upper respiratory tract infections. Whatever the cause, these symptoms need immediate attention and treatment. Only a doctor will be able to give you an accurate diagnosis.
Diagnosis of asthma in children
Diagnosis of asthma is difficult in infants. In older children, a more reliable diagnosis can be made. Doctors will base their diagnosis on the symptoms experienced, physical examination, tests, medical history of the child and the medical history of parents and close blood relatives. A family history of respiratory problems or immune system problems like asthma, eczema and allergies increase the probability of your child getting asthma.
There are tests that can help doctors make a more accurate diagnosis and decide the best line of treatment. A chest X-ray will show the amount of inflammation in the lungs. It will also help the doctor in ruling out other causes of the symptoms.
Lung function tests (also called pulmonary function tests or breathing tests) help doctors estimate the capacity of the lungs and the extent of the problem if it exists. It is calculated by measuring how much air the lungs can hold and how fast it can be exhaled. Lung function tests are not very reliable in children below the age of five due to the difficulty in making them follow the instructions during the test.
Skin allergy tests help in identifying the possible triggers that could be causing the symptoms. Doctors may also do a blood test and may check for problems like sinus infections, acidity or GERD. A child’s response to asthma treatment also helps in reconfirming the diagnosis.
What can you expect from asthma treatment for your child?
The aim of asthma treatment is to keep your child symptom free and allow him or her to engage in normal activities. Your child should not miss school due to the ailment or have difficulty in physical activities like playing with other kids or engaging in normal sporting activities. Your child should be able to sleep well at night without troublesome symptoms. Asthma should be kept in control with minimum use of medicines and without troublesome side-effects or harm. It should reduce the need for emergency medical assistance and emergency doctor visits.
Treatment of asthma in children
The following treatment strategy is used to control asthma.
1. Identify and avoid asthma triggers to prevent symptoms and flare-ups.
2. If necessary, use long-acting preventive medications to keep symptoms in check.
3. Provide quick relief and bring the situation back to normal when a flare-up occurs.
To minimize the use of medicines, your doctor will initially keep the dosage low and gradually increase it until it is just enough to keep your child symptom-free. If no symptoms appear for several months, the doctor may decide to reduce the dosage gradually. If symptoms start to reappear the dosage is readjusted. When the symptoms intensify or a sudden flare-up occurs, a quick-relief medicine is used to control the situation. If the doctor finds that the child is using the quick-relief medicine too often, either the preventive medicine or its dosage will need adjustment.
Your doctor will give a written asthma action plan that tells you what to do in any situation. With an action plan, you will be able to quickly take action to gain control of the situation and bring it back to normal in case your child’s condition deteriorates. You must ensure that everyone at home understands the plan. It should also be shared with and explained to the school authorities and to the staff at your child’s daycare center.
Medicines used for treatment of asthma in children
Long-term medicines are used to prevent symptoms and asthma attacks. These medicines have to be taken regularly even when your child is symptom free. The commonly prescribed long-term medicines contain inhaled corticosteroids. If asthma cannot be controlled with the inhaled version, oral corticosteroids may be used.
Short-acting medicines are used for treatment of asthma flare-ups or attacks. They open up the airways and give quick relief from asthma symptoms. Their effect lasts for four to six hours. For children who experience symptoms rarely, it may be possible to treat asthma with just the short-acting medicines. This removes the need to be on a preventive medication. Frequent reliance on short-acting medicines is a sign that the long-term therapy has to be reviewed.
Asthma medicines are usually administered as a controlled dose inhaler for children over five years. These inhalers need a deep inhalation to get the drug into the airways. Smaller children can also use them if they use a mask attachment. With the attachment, it is possible to take the drug in multiple inhalations. For infants and very small children who can’t use inhalers, the drug is administered by using a nebulizer.
Signs of an emergency and what to do if it occurs
Children tend to bear with or ignore symptoms until it starts bothering them. Observe and watch for signs of trouble such as wheezing, crackling cough, noisy breathing and hard breathing that requires the tummy to contract and to go below the ribs. A change of voice or difficulty speaking is also a warning sign of an asthma flare-up.
In an emergency, do exactly what the doctor has told you to do in the action plan. If the situation is beyond you or does not improve, don’t hesitate to call the emergency services.
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