Managing Asthma in Children
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Asthma is the No. 1 cause of hospitalizations among children, but with proper management, children can have full participation in school and sporting events.
Experts estimate nearly 20 million Americans have asthma, ranging from 7 percent to 12 percent of children. Among African-Americans the rate of asthma is even higher.
H. James Wedner, M.D., professor of medicine at Washington University School of Medicine in St. Louis and chief of the Division of Allergy and Immunology, says how asthma will affect a child throughout his/her lifetime varies, depending on the child.
“For some children, asthma improves during the teenage years, while others have symptoms that become more severe over time,” Wedner says. “About half of the children who have asthma at a young age appear to ‘outgrow’ it, although the asthma symptoms may reappear later in life.”
Asthma is a chronic, inflammatory disease in which the airways become sensitive to allergens (any substance that triggers an allergic reaction). When the airways are exposed to certain triggers, the lining of the airways become swollen and inflamed, the muscles that surround the airways tighten, and the production of mucus increases. All of these factors will cause the airways to narrow, making it difficult for air to go in and out of the lungs, causing the symptoms of asthma.
Although there are common symptoms of asthma, each child may experience symptoms differently. Symptoms may include:
• coughing (either constant or intermittently)
• wheezing (this is a whistling sound that may be heard while breathing)
• trouble breathing or shortness of breath while exercising
• chest tightness
• fatigue
• nighttime cough
• noisy breathing
The symptoms of asthma may resemble other problems or medical conditions. Always consult your child’s pediatrician for a diagnosis.
Exercise, such as running, may trigger an asthma attack in the majority of children with asthma. However, with proper management, a child with asthma can maintain full participation in most sports, Wedner says. Aerobic exercise actually improves airway function by strengthening breathing muscles. Some tips for exercising with asthma include the following:
• Have your child stretch before and after exercising, breathing through the nose and not the mouth to warm and humidify the air before it enters the airways.
• Give your child asthma medication before exercising, as recommended by your child’s physician.
• Have your child carry a “reliever” or “reserve” medication, just in case of an asthma attack.
• During cold weather, have your child wear a scarf over the mouth and nose, so that the air breathed in is warm and easier to inhale.
Some children with asthma may need to take their medications during school hours, says Anne Borgmeyer, an allergy/pulmonary nurse practitioner at St. Louis Children’s Hospital, an affiliate of Washington University School of Medicine.
“It is important that the child, family, physician and school staff all work together toward meeting the child’s asthma treatment goals,” Borgmeyer says. “To ensure optimal asthma care for your child at school, the American Academy of Allergy, Asthma, and Immunology recommends meeting with teachers, the school nurse and other relevant school staff to inform them about your child’s condition and special needs. Educate with school personnel on your child’s asthma medications and how to assist during an asthma attack, and ask school staff to treat your child ‘normally’ when the asthma is under control. “
In addition, Borgmeyer says before starting a physical education class, talk with that teacher or coach on exercise-induced asthma, and take steps to prevent asthma symptoms from starting that could hamper your child’s energy level. Ensure your child’s emotional well-being by reassuring him/her that asthma does not have to slow him/her down or make him/her different from the other children.
Washington University School of Medicine’s full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.
Source: Washington University in St. Louis
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