Asthma is a chronic inflammatory disease of the airways. With asthma, airways spasm, the lining of the airways becomes inflamed, causing them to narrow, and mucus production increases. Genetics and environmental factors play a significant role in making airways very sensitive to allergens. Some other known factors are exposure to cigarette smoke, outdoor and indoor air pollution (such as dust mites, pet dander, pollen and mold), food allergies, certain viral infections at a very young age, weather changes or extreme temperature change. Sometimes asthma occurs with no apparent triggers.
Factors that may increase your child's likelihood of developing asthma are exposure to tobacco smoke; previous allergic reactions, including skin reactions, food allergies or hay fever (allergic rhinitis); a family history of asthma, allergic rhinitis, or eczema; sinusitis; and low birth weight.
Asthma is a clinical diagnosis, which means it is diagnosed based on obtaining a thorough medical history, a lung examination, and a breathing test (depending on the child’s age). Children six years of age and older undergo a breathing test that measures lung function – the measurement of how quickly and how much air your child can breathe out in a single breath. A breathing test helps diagnosis, but a diagnosis does not solely depend on test results. Asthma is a reversible disease and it is possible to have a normal breathing test in between the episodes of asthma exacerbation. Early diagnosis and proper treatment can prevent interferences with daily activities such as sleep, play, sports, and school. And if allergies are triggering asthma, allergy testing can be done.
Persistent wheezing during early childhood or having eczema or hay fever, are clues that your child may develop or have asthma that's likely to persist into adolescence and adulthood.
Asthma can't be cured, but you can keep symptoms at a minimum by using a written asthma action plan you develop with your child's doctor to track symptoms so that treatment can be adjusted. Avoiding asthma triggers (such as tobacco smoke during infancy, an avoidable strong risk factor) are the best ways to prevent asthma attacks. Treatment includes preventing symptoms through long-term daily control medications, which help reduce the inflammation and mucus production in airways. Treating asthma attacks with quick-relief medications can open swollen airways, so that your child can breathe more easily and allergy medications can control allergies that trigger asthma attacks.
The goal of asthma treatment is to keep symptoms under control all of the time. If your child has well-controlled asthma, he/she will have minimal or no symptoms, few or no asthma flare-ups, no limitations on physical activities or exercise, and minimal need for a quick-relief (rescue) inhaler or nebulizer, such as albuterol.
Some asthma improves over a period of time during adolescence and young adulthood, but it is very individualized. Some children only have their symptoms go away for a short period of time. Other children may never outgrow their asthma. Also, children with more severe asthma are less likely to outgrow it.
Severe asthma attacks can lead to low oxygen in blood, respiratory failure and air leak and permanent narrowing of the airways (bronchial tubes) leading to abnormal lung function. Poorly controlled asthma results in absences and getting behind in school, poor sleep and chronic fatigue, irritable behavior and interference with sports or other routine activities.
Asthma can be life threatening. If a child is unable to speak in full sentences, and is confused and/or weak, or his or her skin is turning blue or grey, seek IMMEDIATE medical attention. A parent should not waste time calling a doctor at this point. Call 911 immediately.
It is important to develop a written asthma action plan with the help of your doctor, so you can track the occurrences and severity of the onset of symptoms or attacks. The Division of Pulmonology at The Children’s Hospital at Saint Peter’s University Hospital diagnoses and manages acute and chronic respiratory disorders and diseases such as asthma in children of all ages. Saint Peter’s offers comprehensive pulmonary evaluation, treatment and management for children with asthma, wheezing, croup, chronic cough, trouble breathing with exercise, pneumonia, unusual respiratory infections or chronic lung disease.
For more information or questions contact the Division of Pediatric Pulmonology at 732-565-5467.