The impact of asthma is well brought out by the fact that it accounts for more hospitalizations in children than any other chronic illness. Also, as expected, asthma causes more school absences than any other chronic illness. It affects more than one out of every 10 children and, for unknown reasons, it is steadily increasing. It can begin at any age.
Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (infants to 5-year-old children) can be hard to diagnose. It is hard to tell whether a child has asthma or another childhood condition. The symptoms of asthma are similar to the symptoms of other conditions.
How to Diagnose Asthma in Children
Asthma is a disorder caused by inflammation of the airways. It causes airways to tighten which blocks air from flowing freely into the lungs, making it hard to breathe. Young children who wheeze when they get colds or respiratory infections don’t go on to have asthma. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:
- One or both parents have asthma.
- The child has allergic reactions to pollens or other airborne allergens.
- The child has signs of allergies, including the allergic skin condition eczema.
The child wheezes even when he or she doesn’t have a cold or other infection. The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it is hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children’s medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds.
Factors that Influence Development of Asthma in Children
There are many risk factors for developing childhood asthma. These include:
- Family history of asthma or allergies.
- Frequent respiratory infections. These are usually viral infections. In some patients other infections with fungi, bacteria, or parasites might be responsible.
- Weather changes. Asthma attacks can be related to changes in the weather or the quality of the air.
- Emotional factors. Some children can have asthma attacks that are caused or made worse by emotional upsets.
- Allergies. An allergen is anything in a child’s environment that causes an allergic reaction. Allergens can be foods, pet dander, molds, fungi, roach allergens, or dust mites. Allergens can also be seasonal outdoor allergens (for example, mold spores, pollens, grass, trees, etc.).
- Gastroesophageal reflux disease (GERD). GERD is characterized by the symptom of heartburn.
- Inflammation of the upper airways (including the nasal passages and the sinuses). This is caused by allergies, sinus infections, or lung (respiratory) infections, and must be treated before asthmatic symptoms can be completely controlled.
- Irritants. Tobacco smoke, cold air, chemicals, perfumes, paint odors, hair sprays, and air pollutants are irritants that can cause inflammation in the lungs and result in asthma symptoms.
- Low birth weight.
- Being male. Studies are favoring the fact that males are more prone to developing asthma than females.
Signs and Symptoms of Asthma in Children
- Frequent coughing spells, which may occur during play, at night, or while laughing.
- Less energy during play and feeling weak or tired.
- Rapid breathing.
- Complaint of chest or neck tightness or chest “hurting.”
- Whistling sound (wheezing) when breathing in or out.
- See-saw motions (retractions) in the chest from labored breathing.
- Shortness of breath, loss of breath.
- Dark circles under the eyes.
- Frequent headaches.
- Loss of appetite.
Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from one asthma episode to the next in the same child. Also note that not all wheezing or coughing is caused by asthma.
In kids under 5 years of age, the most common cause of asthma-like symptoms is upper respiratory viral infections such as the common cold.
How to Prevent Child from Asthma Attacks
Identify and Control Asthma Triggers
Keep a record of when symptoms occur and how long they last. Once patterns are discovered, some of the triggers can be avoided through indoor controls. This is a bit time consuming though.
- Use only polyester-filled pillows and comforters to control dust mites.
- Use mite-proof covers over pillows and mattresses.
- Keep covers clean by vacuuming or wiping them down once a week.
- Keep upholstered furniture, window mini-blinds, and carpeting out of a child’s bedroom and playroom because they can collect dust and dust mites (especially carpets). Use washable throw rugs and curtains and wash them in hot water weekly. Vinyl window shades that can be wiped down can also be used.
- Reduce the number of dust-collecting houseplants, books, knickknacks, and non-washable stuffed animals in your home.
- Vacuum the room.
- Avoid humidifiers when possible because moist air promotes dust-mite infestation.
- Ventilate bathrooms, basements, and other damp places where mold can grow. Consider keeping a light on in closets and using a dehumidifier in basements to remove air moisture.
- Use air conditioning because it removes excess air moisture, filters out pollens from the outside, and provides air circulation throughout your home. Filters should be changed once a month.
- Avoid wallpaper and carpets in bathrooms because mold can grow under them.
- Use bleach to kill mold in bathrooms.
- Keep windows and doors shut during pollen season.
- Do not smoke (or allow others to smoke) at home, even when a child is not present.
- Do not burn wood fires in fireplaces or wood stoves.
- Avoid strong odors from paint, perfume, hair spray, disinfectants, chemical cleaners, air fresheners, and glues.
- If your child is allergic to a pet, you may have to consider finding a new home for the animal or keeping the pet outside at all times. Never allow the pet into the allergic child’s bedroom.
- Cockroach may trigger asthma attack, so destroy them.
- Avoid mosquito coils in closed rooms.
- When mold or pollen counts are high, give your child medications recommended by your doctor before going outdoors or on a regular basis (as prescribed by your doctor).
- Drive with the car windows shut and air conditioning on during mold and pollen seasons.
- Don’t let a child mow the grass or rake leaves especially if he/she has allergies to grass.
- Take bath and change dress after going for outing in pollen seasons.
Asthma Management Plans
Every child with asthma should have an asthma management plan. This involves you and your child:
- Knowing what triggers asthma symptoms.
- Understanding how to take the asthma medication – how much, how often and how to use the inhaler correctly.
- Knowing what to do if your child’s symptoms get worse, and what to do in an emergency if your child doesn’t respond to the drugs that are usually taken (with the help of a doctor).
It’s a good idea for your child to see her doctor or nurse regularly to monitor her asthma symptoms and treatment.
Getting On with Life
Most children with asthma can lead perfectly normal lives. Keep encouraging your child to participate in sport and exercise. Your child might benefit from taking her asthma medication just before exercise to prevent a wheeze or a cough from happening.
If your child has frequent attacks or if symptoms prevent him from playing sport, sleeping at night, or feeling healthy, it is likely that he is being undertreated. Talk to your doctor about this so the treatment can be changed as needed. It is also important to let your child’s school know about his/her asthma. Asthma is a life-long condition, but it shouldn’t stop your child leading a full and active life if you learn how to manage it.