Asthma and your child

By Audrey Rogers, M.D.

As someone who lives with asthma, I’m proof that the condition does not have to slow you down. It’s important for most children to know they can still partake in all of the fun activities of other kids, just as long as they properly take their medicine.

I join about 10 percent of the general population who are asthmatics. Children have an even greater incidence of suffering from asthma, and the prevalence of asthma is increasing in both adults and children.

First let’s define asthma. Asthma is a condition caused by narrowing of the small air tubes in the lungs with inflammation and constriction of the smooth muscle surrounding the small air tubes.

There are many symptoms of asthma, including wheezing, shortness of breath and exercise intolerance. Some people complain of “tightness in their chest.” The symptoms do vary with the severity of the asthma and whether the person is having an asthma attack.

Anyone who has the condition knows about the triggers that can cause an asthma flare. The most important factor is the common cold; viral upper respiratory infections are the most common reason for an asthma attack in both adults and children. Allergies are the second most important trigger but other factors like, exercise and weather changes can cause trouble as well.

To measure whether your child’s asthma is under control, I use the “Rule of Twos.” Your asthma is not under control if:

• You have to use albuterol more than twice a week on average during the daytime, or twice a month on average at night.
• You have to use oral steroids more than twice a year.
• You go through two albuterol puffers a year.
• When your asthma is not under good control, I would either add an inhaled steroid or increase the dose of the inhaled steroid.

Discuss this with your pediatrician and make sure you have an asthma plan. Teach the plan to your children as they grow up to help prevent asthma attacks.

The most effective preventive medication is an inhaled steroid, which comes in both a puffer form and in the nebulizer. This medication needs to be taken on a daily basis to prevent inflammation, which narrows the small air tubes.

All of the research over the past 20-30 years has shown that if asthmatics take their preventive medication regularly their asthma improves. Another helpful measure is avoidance of allergy triggers such as, dust mites and cat dander, which are the two most common allergens in our society.

The mainstay of treatment for an asthma flare is a drug called albuterol. It comes in several forms, but it is mainly used in a “puffer” or metered dose inhaler, or in a solution that is used in a nebulizer.

This medication is a bronchodilator which opens up tight airways. The other commonly used medication is an oral steroid such as, prednisone which decreases inflammation in the small air tubes.

I wouldn’t describe living life with asthma as easy and it does come with challenges. But if you take care of yourself, follow your medication treatment prescribed by your Cook Children’s pediatrician and avoid triggers as best you can, children should be able to live normal and productive lives.

They may even become a pediatrician themselves someday and take care of other kids with asthma.