PAMF Health Blog

Be Well, Be Well Informed

Children and Asthma

Posted on Mar 25, 2014

Young child blowing bubbles

According to the Centers for Disease Control and Prevention, one in 14 people has asthma and it’s the most common serious chronic disease of childhood.

“Asthma attacks can cause serious medical problems, leading to missed school days and the unwanted distress and expense of emergency room visits or hospital stays,” says pediatrician Rebecca Fazilat, M.D., who is one of the physician leaders of the Palo Alto Medical Foundation’s Asthma Management Program. “Fortunately, many children with asthma do improve as they get older. If your child’s asthma does not get better, good asthma control can make this condition almost invisible and ensure lifelong good health.”

In this blog post, Dr. Fazilat answers some of the most common questions from parents about asthma.

What is asthma?

Asthma is a lung condition or a reactive airway disease that has multiple triggers including respiratory infections, tobacco smoke, dust mites, furry pets or outdoor air pollution. If your child has asthma it means that his or her airways are more sensitive or reactive to these triggers. During an asthma attack, the lung’s airways become narrower and inflamed, making breathing difficult. Asthma symptoms include wheezing, chronic coughing, a tight feeling in the chest and a shortness of breath. Some people equate an asthma attack to feeling like a fish out of water. This can be very scary for the child and parent.

This condition can be difficult to diagnose, particularly in children less than 3 years of age, as the symptoms can be similar to those of other conditions including respiratory infections or allergies. The key to a clear diagnosis is whether the child is experiencing symptoms repeatedly over a period of more than one year. As a general rule, if your child has had three or more episodes of wheezing in a two year period and those episodes responded to asthma medications, it is likely that your child has asthma. Talk to your child’s doctor if you are concerned your child might have asthma.

What’s the best treatment for asthma?

Early recognition of asthma symptoms and knowing what triggers your child’s asthma are very important to successful asthma treatment. Make sure your child learns to recognize his or her particular symptoms. Then don’t delay! Your child should immediately start taking his or her prescribed medications. This will minimize the likelihood of a full-blown asthma attack.

There are two types of safe and effective medications used for treating and preventing asthma, these are ‘rescue or reliever’ and ‘controller’ medications:

  • ‘Rescue’ or ‘reliever’ medications are bronchodilators (such as Albuterol or Xopenex). They are fast-acting, inhaled directly into the lungs and used to relieve asthma symptoms once they have started. These medications relax the muscles around the airways to ease breathing. Although they work immediately, they are short-acting and should only be used occasionally (no more than twice a week).
  • ‘Controller’ medications are corticosteroids that work over a period of time to decrease inflammation in the airways and help prevent asthma symptoms from reoccurring. These medications do not have an immediate effect and are generally taken daily even if your child is not experiencing any symptoms.

If the controller medication is not used regularly, the underlying inflammation may continue to cause more asthma symptoms or make it more difficult to get through the next exacerbation.

There is no one-size-fits-all treatment therapy for asthma. Each child with asthma will need a personalized treatment plan to manage his or her condition effectively. The plan will include information on the daily medications your child should take and instructions on what to do for symptoms. This plan should also be shared with your child’s school. Establishing this plan and sticking to it is one of the best ways to limit unwanted asthma attacks.

Is it OK to exercise if you have asthma?

Having asthma should not limit your child’s ability to exercise. Good control of your child’s asthma and using medications as directed by your child’s doctor will ensure your child can enjoy all the activities he or she loves. There is a type of asthma that is only triggered by exercise; this mainly affects children in their early teens. Using a bronchodilator medication 30 minutes before starting a workout routine will help eliminate any symptoms and your teen will be able to exercise at his or her previous level.

My child has asthma and starts school in the fall. How can I avoid any unnecessary asthma flare ups?

Know that your child will probably not be the only child in his class with asthma. In a class of 30 kids, on average three students may have asthma. It’s a good idea to talk to your child’s teacher and the school nurse (if the school has one) before school starts to help them know as much as possible about your child’s asthma. Make sure the school has an asthma school treatment plan on hand (completed by your child’s doctor), so everyone knows what actions need to be taken in case of an asthma attack. Also, find out if your school allows children to carry and take their own medications at school. Make any necessary arrangements so your child can immediately start taking his or her medication and avoid an asthma attack.

My son’s best friend has asthma. Is there anything I need to do if he comes to our house?

Talk to your son’s friend’s parents so you are aware of his asthma triggers and what actions you should take. Make sure he has any necessary asthma medications with him and check with his parents if he needs help taking them. Know that asthma symptoms generally start well-ahead of a full-blown asthma attack (at least 30 minutes to an hour), so there is usually time to make sure he takes his medications to control the symptoms. One of the main things you can do is stay calm and reassuring, as any anxiety can make breathing issues worse. If symptoms are severe, seek urgent medical attention.

Fazilat_Rebecca300 4webRebecca Fazilat, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation (PAMF). She is a physician leader of PAMF’s Asthma Management Program.