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Asthma, Pediatric

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Feb.20.2020
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 Asthma, Pediatric

Asthma, Pediatric

Asthma is a long-term (chronic) condition that causes repeated (recurrent) swelling and narrowing of the airways. The airways are the passages that lead from the nose and mouth down into the lungs. When asthma symptoms get worse, it is called an asthma flare, or asthma attack. When this happens, it can be difficult for your child to breathe. Asthma flares can range from minor to life-threatening.

Asthma cannot be cured, but medicines and lifestyle changes can help to control your child's asthma symptoms. It is important to keep your child's asthma well controlled in order to decrease how much this condition interferes with his or her daily life.

What are the causes?

The exact cause of asthma is not known. It is most likely caused by family (genetic) and environmental factors early in life.

What increases the risk?

Your child may have an increased risk of asthma if:
  • He or she has had certain types of repeated lung (respiratory) infections.
  • He or she has seasonal allergies or an allergic skin condition (eczema).
  • One or both parents have allergies or asthma.

What are the signs or symptoms?

Symptoms may vary depending on the child and his or her asthma flare triggers. Common symptoms include:
  • Wheezing.
  • Trouble breathing (shortness of breath).
  • Nighttime or early morning coughing.
  • Frequent or severe coughing with a common cold.
  • Chest tightness.
  • Difficulty talking in complete sentences during an asthma flare.
  • Poor exercise tolerance.

How is this diagnosed?

This condition may be diagnosed based on:
  • A physical exam and medical history.
  • Lung function studies (spirometry). These tests check for the flow of air in your lungs.
  • Allergy tests.
  • Imaging tests, such as X-rays.

How is this treated?

Treatment for this condition may depend on your child's triggers. Treatment may include:
  • Avoiding your child's asthma triggers.
  • Medicines. Two types of inhaled medicines are commonly used to treat asthma:
    • Controller medicines. These help prevent asthma symptoms from occurring. They are usually taken every day.
    • Fast-acting reliever or rescue medicines. These quickly relieve asthma symptoms. They are used as needed and provide short-term relief.
  • Using supplemental oxygen. This may be needed during a severe episode of asthma.
  • Using other medicines, such as:
    • Allergy medicines, such as antihistamines, if your asthma attacks are triggered by allergens.
    • Immune medicines (immunomodulators). These are medicines that help control the body's defense (immune) system.

Your child's health care provider will help you create a written plan for managing and treating your child's asthma flares (asthma action plan). This plan includes:
  • A list of your child's asthma triggers and how to avoid them.
  • Information on when medicines should be taken and when to change their dosage.

An action plan also involves using a device that measures how well your child's lungs are working (peak flow meter). Often, your child's peak flow number will start to go down before you or your child recognizes asthma flare symptoms.

Follow these instructions at home:

  • Give over-the-counter and prescription medicines only as told by your child's health care provider.
  • Make sure to stay up to date on your child's vaccinations as told by your child's health care provider. This may include vaccines for the flu and pneumonia.
  • Use a peak flow meter as told by your child's health care provider. Record and keep track of your child's peak flow readings.
  • Once you know what your child's asthma triggers are, take actions to avoid them.
  • Understand and use the asthma action plan to address an asthma flare. Make sure that all people providing care for your child:
    • Have a copy of the asthma action plan.
    • Understand what to do during an asthma flare.
    • Have access to any needed medicines, if this applies.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

Contact a health care provider if:

  • Your child has wheezing, shortness of breath, or a cough that is not responding to medicines.
  • The mucus your child coughs up (sputum) is yellow, green, gray, bloody, or thicker than usual.
  • Your child's medicines are causing side effects, such as a rash, itching, swelling, or trouble breathing.
  • Your child needs reliever medicines more often than 2–3 times per week.
  • Your child's peak flow measurement is at 50–79% of his or her personal best (yellow zone) after following his or her asthma action plan for 1 hour.
  • Your child has a fever.

Get help right away if:

  • Your child's peak flow is less than 50% of his or her personal best (red zone).
  • Your child is getting worse and does not respond to treatment during an asthma flare.
  • Your child is short of breath at rest or when doing very little physical activity.
  • Your child has difficulty eating, drinking, or talking.
  • Your child has chest pain.
  • Your child's lips or fingernails look bluish.
  • Your child is light-headed or dizzy, or he or she faints.
  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

Summary

  • Asthma is a long-term (chronic) condition that causes recurrent episodes in which the airways become tight and narrow. Asthma episodes, also called asthma attacks, can cause coughing, wheezing, shortness of breath, and chest pain.
  • Asthma cannot be cured, but medicines and lifestyle changes can help control it and treat asthma flares.
  • Make sure you understand how to help avoid triggers and how and when your child should use medicines.
  • Asthma flares can range from minor to life threatening. Get help right away if your child has an asthma flare and does not respond to treatment with the usual rescue medicines.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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