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by Kellicker PG

Asthma—Child

Definition

Asthma is a long-lasting health problem. It is a change in how the lining of the airways of the lungs work. Asthma makes the airways narrow and makes it hard to breathe.
There are different degrees of asthma. Some children may have mild asthma with rare flare-ups. Others may have a severe, constant asthma.
Inflamed Bronchial Tube
Inflammed Lung and asthma
© Nucleus Medical Media, Inc.

Causes

The exact causes of asthma are unknown, but genetics play a role.
Things that are known to trigger an asthma attack are:
  • Respiratory infection like colds or flus—more common in younger children
  • Exercise, especially in cold air—more common in teenagers
  • Common allergies such as:
    • Pollen
    • Dust
    • Animal dander
    • Mold
    • Food, rarely
  • Sinus infections
  • Tobacco smoke or other chemical irritants
  • Sudden change in weather

Risk Factors

Things that may increase your child’s chance of asthma include:
  • Family history
  • History of allergies and/or eczema
  • Exposure to tobacco smoke
  • Respiratory infections before age 1, especially bronchiolitis, and common colds before age 6 months
  • Premature birth
  • Chlorinated pool use in children who are already at risk for asthma
  • Taking some medicines, such as aspirin or other nonsteroidal anti-inflammatory drugs

Symptoms

An asthma attack can cause:
  • Coughing
  • Chest tightness
  • Shortness of breath and fast breathing
  • Wheezing
  • Trouble breathing
  • Fatigue
  • Complaints of chest pain
  • Difficulty during feeding in infants
  • Trouble sleeping
  • Avoidance of exercise or sports

Diagnosis

A doctor will ask about your child’s symptoms and past health. A physical exam will be done. The doctor will listen to your child’s lungs. Your child may be referred to a specialist.
Your child may be tested for common allergens that may trigger symptoms. This can be done with skin testing or blood tests.
Your child's lungs may be tested with:
  • Spirometry test—blowing in a tube to measure amount of air that is moved
  • Challenge test—measures breath after exposure to medicine or allergen

Treatment

The doctor will create an asthma action plan. This is a plan to help control asthma, handle asthma attacks, and prevent limits to child's play. Treatment will vary based on age, symptoms, and how often asthma attacks happen. The treatment plan will help to decrease number of attacks or stop attacks from happening.
Treatment options include the following:

Medications

Medicine used to treat asthma may be long-term or short-term.
Long-term medicine will help to avoid asthma attacks. They cannot treat an attack itself. One or more may be used:
  • Inhaled corticosteroids—to prevent airway swelling and inflammation
  • Inhaled long-acting beta agonists—to relax the airways
  • Oral leukotriene modifiers—to prevent airway inflammation and swelling, decrease the amount of mucus in the lungs, and open the airways
  • Inhaled cromolyn or nedocromil—to prevent airways from swelling in response to an asthma trigger
  • Oral theophylline—to relax the airways
Short-term control medicine is used to treat an asthma attack. It may include:
  • Inhaled quick-acting beta agonists and anticholinergic agents—to open the airways
  • Oral corticosteroids—to reduce severe airway inflammation

Avoiding Triggers

Exercise may help the lungs work better. Treatment should allow normal exercise and activity levels, including sports.
Changes or things in the air can trigger an asthma attack. The exact triggers may be a bit different from person to person. Some helpful steps include:
  • Have allergy tests to better understand triggers. Common problems include pollen, dust, foods, and air pollution.
  • Avoid outside time if there are high levels of air pollution, pollen, or mold spores.
  • Keep windows closed during seasons with high pollen or mold spores. Air conditioning may help clear allergens from indoor air.
  • An air cleaner with a HEPA filter may help clear indoor air. It can be most helpful in sleeping area, heating/cooling system, and vacuum cleaner.
  • Avoid exposure to tobacco smoke.
  • Check for and control mold growth in the house.
  • Vaccines to protect against airway infections. Children older than 6 months should get a yearly flu shot.
  • Allergy shots may be considered to reduce reactions to allergy triggers.

Prevention

Asthma cannot be prevented.

RESOURCES

American Academy of Allergy, Asthma, & Immunology
http://www.aaaai.org
Asthma and Allergy Foundation of America
http://www.aafa.org

CANADIAN RESOURCES

Asthma Society of Canada
http://www.asthma.ca
The Lung Association
http://www.lung.ca

References

Chronic asthma in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-asthma-in-children. Accessed August 28, 2020.
Asthma: kids. Centers for Disease Control website. Available at: http://www.cdc.gov/ASTHMA/children.htm. Accessed August 28, 2020.
Childhood asthma,. American Academy of Allergy, Asthma, & Immunology website. Available at http://www.aaaai.org/conditions-and-treatments/library/at-a-glance/childhood-asthma.aspx. Accessed August 28, 2020.
What causes asthma? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma%5FCauses.html. Accessed August 28, 2020.
8/27/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T500326/Asthma-in-children : Kim JM, Lin SY, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.
11/2/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T500326/Asthma-in-children : Normansell R, Kew KM, et al. Sublingual immunotherapy for asthma. Cochrane Database Syst Rev. 2015 Aug 28;8:CD011293.

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