Childhood Asthma | Emma's Diary India

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Childhood asthma


Diagnosing asthma, its prevention and treatment in young children

Asthma is a chronic inflammatory disease of the lungs and airways and if your child has asthma, it will affect her ability to breath in some situations.

It's important that you work with your child's doctor to recognise the triggers for her asthma and work out how to prevent and treat any attacks.

With the right medication, education, an asthma action plan, and regular medical check-ups, most asthmatic children manage to do just fine.

Who gets it?

Asthma is very common - about 1 in 5 families in the UK will have a family member with asthma.

It is more likely to occur if one or more parents have asthma, or there is a family history of hay fever, eczema or food allergies.

Premature birth, low birth weight and smoking in pregnancy have all been linked to childhood asthma.

What is it?

In asthmatics, the airways are over sensitive or may be hyper-reactive so they react to various triggers by producing excess phlegm, coughing and muscle spasms which cause narrowing on the walls of the airways.

In more prolonged attacks part of the narrowing or obstruction may be caused by inflammatory swelling of the walls of the tubes.

When this happens it becomes more difficult because the bronchi (branching tubes) leading from the windpipe through the lungs become narrower.

It is hard to both take in and expel air through these narrowed tubes and the effort of forcing air through causes the familiar laboured breathing and wheezing sound of an asthma attack.

How to tell if your child is asthmatic

Hearing a child wheezing and gasping for breath may be alarming, but the chances are that it's not an asthma attack.

Many babies and young children wheeze when they have an upper respiratory tract infection or a cold.

In a baby, the airways are so small that they can make a wheezing sound which is not true asthma. Because of this it is unusual for a definite diagnosis of asthma to be made before the age of two years.

A firm diagnosis of asthma will only be made when your doctor sees a pattern of symptoms emerging over a period of time.

Symptoms to look out for include:

  • Wheezing
  • Coughing, especially at night and in the early morning and shortness of breath
  • Wheezing and coughing after exercise
  • In reaction to triggers such as dust, animal fur and pollen

Causes of asthma attacks

Many of the following factors can work together or by themselves to bring on asthmatic wheezing or an attack.

Parents usually soon learn which conditions are likely to make their child especially susceptible and give preventative treatment.

Allergy. Many children with asthma are allergic to something which causes them to cough and sneeze. In most cases, it could be an allergy to pollen, house dust, mould or fungus spores or furry animals.

It is the dust mites in household dust that cause the trouble for some. These are microscopic creatures which feed off bedding and furniture and shredded human or animal scales of skin. Food allergies may also act as a trigger for asthma.

Infections. These can act as a trigger to asthmatic wheezing or a full attack. Respiratory infections such as colds or coughs are particularly common triggers for asthma in the toddler age group and may cause prolonged flare-ups lasting for several days. Often these respiratory infections are viral, however, and do not require antibiotic treatment.

Exercise. Exercise can make asthmatic children start to wheeze but is not a reason to avoid sports and games and the wheeze usually settles rapidly on resting.

Emotions. Great excitement or upsets can bring on an attack of wheezing in an asthmatic child and general tension or anxiety often results in more frequent episodes of wheezing.

Smoke. Smoke can trigger wheezing so it is very important not to smoke if your child is asthmatic. Some fumes, paint smells and perfumes can also be irritating.

Weather. Sudden changes in climate can provoke asthma, sudden sharp cold or wind is particularly likely to irritate.

Treatment and prevention

The two main types of asthma medication are 'relievers', which are used as soon as asthma symptoms occur, and 'preventers' which are used regularly to help prevent the airways from being sensitive to asthma triggers.

Most asthma medication is breathed in through an inhaler, which means that it goes straight into the lungs.

Babies and young children use an aerosol inhaler with a device called a spacer. this is a large plastic container that has a mouthpiece at one end and a hole for the aerosol inhaler at the end.

A face mask will be attached to the mouthpiece for babies.

Other treatments

There are other types of asthma medicines available which can be used in addition to the inhaled reliever and preventer medication.

If the asthma attack is severe a short dose of steroid medication, which can be given as soluble tablets dissolved in water, may be needed to bring an asthma attack under control.

It is also important that your child is given all the usual baby and childhood vaccines which prevent infections. If your child has missed any vaccines make sure to speak to your doctor - which is now given as a nasal spray- so no needles!

Make sure you attend for regular review of your child's condition and bring along any medication they have been prescribed.

This will include how to treat the condition when there are few or no symptoms, as well as what to do if the condition becomes severe.

In the UK, the asthma society also has a downloadable personal action plan and general information for your child.

How can you help

Where possible avoid likely triggers to asthma, for example smoky atmospheres or specific animals that cause an allergic reaction.

Wash bedding regularly and vacuum mattresses and don’t do the dusting when an asthmatic child is around.

Can breastfeed help?

Breast feeding provides many benefits to babies and mothers are advised to breastfeed exclusively for six months. Studies suggest that exclusive breast feeding for 6 months can reduce the risk of your child developing asthma symptoms in early childhood.

But, as breastfeeding provides many other benefits to your baby the advice is that mothers should breastfeed exclusively for six months if possible.

What to do if your has an asthma attack

At the first sign of an asthma attack (laboured breathing and wheezing) sit your child down speaking calmly and reassuringly because if a child gets frightened or panics this can make matters worse.

Follow your child's asthma plan and administer any drugs that may have been prescribed and stay with her telling her to breathe deeply. It helps to sit your child on your lap and do the breathing alongside them.

If an asthma attack does not respond to treatment after five minutes call your doctor at once or rush to the nearest hospital emergency.

Living with asthmatic children

Providing you know how to handle the condition properly, there is no need, as a parent, to treat asthmatic children any differently from other children.

You should always tell your child's daycareor school about her asthma. Give them a copy of her asthma action plan and discuss how treatment should be administered in the event of your child having an attack.

Makes sure your child's inhalers and spacer go with her wherever she is and order a spare inhaler so that you never run out.

Learn as much as you can about asthma so you are best placed to help. The UK-based Asthma Society helps with excellent, up-to-date information and in India you could read more about the condition on Asthma Society of India.

Will my child grow out of asthma?

It is difficult to predict if a child will grow out of asthma.

Boys have been shown to be more likely than girls to grow out of asthma when they reach adolescence.

Children whose symptoms were triggered by an infection and who have no family history of asthma or allergies seem more likely to outgrow the condition, with symptoms easing off around the age of six years. However, for many children asthma is a lifelong condition.

Modern treatments for asthma are so effective however, that the majority of asthma suffers can lead just as full and active a life as anyone else.

For more information, visit The Asthma Society

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