COUGHING ? WHEEZING? ALL THAT YOU NEED TO KNOW ABOUT YOUR KID'S ASTHMA

ASTHMA IN CHILDREN

 WHAT IS ASTHMA?

Asthma is a chronic condition with symptoms of cough, wheezing, chest tightness or pain, and/or difficulty breathing. These symptoms occur periodically, usually related to specific triggering events.

Asthma is the most common chronic disease in children in developed countries, affecting approximately 12 percent of children who are less than 18 years of age. It is more common in males than females under the age of 15 years.

DO YOU KNOW THE RISK FACTORS?

Asthma occurs when the small airways in the lungs become inflamed and narrowed, which limits the flow of air out of the lungs .This narrowing is almost always completely reversible with treatment in children. Many different genetic, infectious, and environmental factors may increase the risk of developing asthma a few of which include:

●        If your child had viral infections - Children who have wheezing with respiratory syncytial virus or rhinovirus seem to be at increased risk for developing asthma

●       If your child is exposed to indoor or outdoor pollution--Increased exposure to indoor and outdoor pollution may increase the risk of developing asthma.

●       If your child has exposure to tobacco smoke - Exposure to tobacco smoke during pregnancy and throughout childhood increases the risk of developing asthma.

●       If any conditions such as asthma, allergies, or eczema run in your family-Children with a personal or family history of certain medical problems, such as asthma, allergies, or eczema, are at increased risk of developing asthma.

●       If your child is stressed-Severely negative life events in children increase the risk of asthma attacks over the subsequent few weeks.

However, not all children with asthma have known risk factors. In other words, even children who live in unpolluted areas and whose parents do not smoke or have asthma can develop asthma.

WHAT ARE THE TRIGGERS ?

Allergens

Indoor and outdoor allergens are an important trigger of childhood asthma, particularly for children older than three years of age

They include House dust mites, Cockroaches, Animal exposures; Cats and Dogs, Pollens ,Molds

●       Environmental tobacco smoke or second hand smoke

●       Air pollution

●       Chemicals and strong smells

●       Weather changes

●       Upper respiratory infections

●       Cold air

●       Strong emotions

●       Exercise

WHAT ARE THE SYMPTOMS?

●       Cough - day and night

Symptoms of asthma in children include coughing and wheezing. The cough is usually dry and hacking and is most noticeable while the child sleeps and during early morning hours. It may also be triggered by exercise or cold air exposure.       

●       Wheezing, or noisy breathing

 Wheezing is a high-pitched, musical noise that is usually heard when the child breathes out.  

●       A tight feeling in the chest

●       Trouble breathing                               

●       Nocturnal cough

CATEGORIES OF ASTHMA

CATEGORIES OF ASTHMA SYMPTOMS

Intermittent asthma — A child is defined as having intermittent asthma if he or she has asthma with minimal symptoms and infrequent asthma flares. Specifically, children with intermittent asthma have the following characteristics:

●Symptoms of asthma occur two or fewer times per week

●Asthma does not interfere with daily activities

●Awakenings during the night due to asthma symptoms occur two or fewer times per month

●Asthma flares require oral glucocorticoids (also called corticosteroids or steroids) no more than once per year

A child with asthma symptoms that are triggered only during exercise (exercise-induced bronchoconstriction) may have intermittent asthma. However, symptoms during exercise may also indicate that the child may have persistent asthma.

Persistent asthma — Children with persistent asthma have symptoms regularly. There may be days when activities are limited due to asthma symptoms, and the child may be awakened from sleep. Lung function is usually normal between episodes but becomes abnormal during an asthma attack. Persistent asthma can be mild, moderate, or severe.

The criteria that are used to determine a child's asthma severity include the number of days per week that a child has one or more of the following:

●Symptoms, such as cough, wheeze, or shortness of breath

●Awakenings during the night due to cough or wheeze

●Use of a bronchodilator (reliever medication)

●Symptoms that affect the child's ability to participate in normal activities

The number of asthma flares (also called exacerbations or episodes) per year that require treatment with oral glucocorticoids (also called corticosteroids or steroids) are also taken into consideration when determining asthma severity.

HOW DO YOU KNOW YOUR CHILD HAS ASTHMA?

The diagnosis of asthma in children requires a careful review of a child's current and past medical history, family history, and a physical examination.

Spirometry testing — Spirometry measures the flow and volume of air blown out after a child takes a very deep breath and then forcefully exhales. If airflow obstruction is present, the test may be repeated after the child uses an asthma inhaler or nebulizer (bronchodilator) to confirm that the obstruction is reversible (a feature of asthma).

Children younger than six years sometimes have a hard time following the instructions to perform spirometry.Your doctor will also do an exam and ask questions such as:

●What symptoms does your child have?

●How often does he or she have the symptoms?

●Do the symptoms wake him or her up at night?

●Do the symptoms keep your child from playing or going to school?

●Do certain things make symptoms worse, like having a cold or exercising?

●Do certain things make symptoms better, like medicine or resting?

ALLERGIC ASTHMA is the  most common cause of asthma in children, and treatment starts with first of all finding out  the root cause. By doing a simple test called Allergy skin prick testing, one can exactly pinpoint the root cause of your  kids allergies, and institute specific  treatment for their allergic asthma.

HOW IS ASTHMA TREATED?

Asthma is treated with different types of medicines. The medicines can be inhalers, liquids, or pills. Your doctor will prescribe medicine based on your child's age and his or her symptoms. Asthma medicines work in 1 of 2 ways:

●  Quick-relief medicines stop symptoms quickly. These medicines should only be used once in a while. If your child regularly needs these medicines more than twice a week, tell his or her doctor. You should also call your child's doctor if this medicine is used for an asthma attack and symptoms come back quickly, or do not get better.

●  Long-term controller medicines control asthma and prevent future symptoms. If your child has frequent symptoms or several severe episodes in a year, he or she might need to take these each day

Almost all children with asthma use an inhaler with a device called a "spacer." Some children also need a machine called a "nebulizer" to breathe in their medicine. A doctor or nurse will show you the right way to use these.

Allergen Immunotherapy.
Once you find out what your child is allergic to,  this treatment may be initiated which will help in modifying the immune response towards the specific allergen he or she is sensitized to, hence providing long term immunity towards the particular allergen. This will help in reducing the attacks and the  use of medications in the long run.

It is very important that you give your child all the medicines the doctor prescribes. You might worry about giving a child a lot of medicine. But leaving your child's asthma untreated has much bigger risks than any risks the medicines might have. Asthma that is not treated with the right medicines can:

●       Prevent children from doing normal activities, such as playing sports

●       Make children miss school and  have poor scholastic performance

●       Recurrent RTI

●       Recurrent Pneumonia

●       Growth retardation

WHAT IS AN ASTHMA ACTION PLAN?

An asthma action plan is a list of instructions that tell you:

    ●What medicines your child should use at home each day

    ●What warning symptoms to watch for (which suggest that asthma is getting worse)

   ●What other medicines to give your child if the symptoms get worse.

With appropriate therapy, children with asthma can participate in all activities including sports at any level.So if your child has asthma, talk to your doctor and get your child started on the healthy , happy life they deserve

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