About Asthma

If your child has asthma, she is not alone. Asthma is the most common chronic disease of childhood affecting approximately five million children in the United States alone.

What is asthma?

• Asthma is a chronic (recurring) disorder caused by inflammation (swelling) of the airways.
• Inflammation in the lungs makes it difficult for air to flow through the lungs.
• Inflammation can also make air passages more sensitive to things that can trigger asthma.

What happens during an asthma attack?

• Air passages in the lungs become swollen, narrow and produce thick mucous.
• Muscles around the airways become tight.
• The tightening of the muscles, called bronchospasm, causes airways to become more narrow.

What are the symptoms of asthma?

• Coughing (for some children, coughing is the only symptom)
• Shortness of breath
• Tightness in the chest
• Wheezing

Some early clues that asthma may be developing:

• Breathing changes or coughing
• Feeling tired
• Trouble sleeping
• Less energy for exercise
• Dark circles under the eyes
• Chin or throat itchiness
• Lower peak flow meter numbers

Each child's symptoms are different. The early warning signs of asthma are important to know and watch for. This will help you be aware that an asthma episode may be developing and seek medical care if necessary.

What is an asthma trigger?

Two types of triggers can make your child's asthma worse: irritants and allergies.

Irritants are substances that bother the nose, throat, or airways. Common irritants include:

• Cigarette smoke: It is important that no one smokes in the home or car with a child who has asthma.
• Strong smells: Avoid aerosol sprays, perfumes and strong smelling cleaning solutions in your home. Try to clean when your child is not home
• Colds: Teach your child to wash her hands often. Many children with asthma should get the flu shot every year. Check with your child's doctor to see if this is right for your child.

Some common allergies include:

• Pets: Keep furry or feathered animals out of the home.
• Pests(mice, cockroaches): Keep the kitchen clean and all food in closed containers. A professional exterminator is the best way to control household pests.
• Dust mites: Wash bedding in hot water. Remove stuffed animals and toys from your child's bed. Try to dust and vacuum once a week while the child is not in the room. It may be helpful to put mite-proof covers on mattresses and pillows.
• Mold: Mold growth can be found on bathroom tiles, in basements and outdoors in soil, leaves, and compost piles. Diluted household bleach or Lysol can be used when cleaning to prevent mold build-up. Using a dehumidifier regularly will help prevent mold growth in your home. Avoid plants, aquariums and humidifiers in your child's room.
• Pollen: Keep windows and doors closed during high pollen seasons and use air conditioning with a filter that can be cleaned often. Shower and wash hair after being outside for a long time.

How do allergies affect asthma?

Many children with asthma have allergies, which can make their asthma worse. In children with allergies, the immune system becomes sensitive to things called allergens. Exposure to these allergens increases inflammation (swelling) in the airways, and can cause asthma symptoms. Ongoing inflammation of the airways makes them more sensitive to triggers.

If you suspect that your child has allergies, talk to her doctor or nurse about referral to an allergy specialist. An allergist can tell you exactly what your child is allergic to so you can know what your child should avoid.

When is asthma an emergency?

Severe asthma symptoms can be a life threatening emergency and require immediate medical attention. If you see them in your child, seek emergency treatment immediately. Severe symptoms include:

• Severe coughing, shortness of breath, tightness in the chest and/or wheezing
• Difficulty talking
• Breathing hard and fast
• Nasal flaring when breathing, as though your child is trying to get as much air as possible
• Hunched shoulders
• Chest and neck muscles pull in when your child breathes
• Lips or fingernails turn gray or blue

How can you help control your child's asthma?

Asthma is not the same in every person. For some, symptoms are mild, while for others they can be very serious. There is no cure for asthma, but symptoms almost always can be controlled and your child can lead a normal, active life.

Things you can do to best control your child's asthma:

• Regular check-ups with your child's doctor or nurse are very important, even if you think your child has been symptom-free. Your child's healthcare providers are your partners in controlling your child's asthma. Remember to tell them about any changes in your child's home, school, activities, or overall health.
• Be sure your child takes all medications prescribed for her asthma.There are two types of asthma medicines:
• 'Controller' or 'preventive' medicines keep airways from swelling and make them less sensitive to triggers. These can be either inhalers or pills. It is important that your child take this type of medicine every day to keep asthma in control, even if she appears to be well and symptom-free.
• 'Reliever' medications quickly open the airways when symptoms occur. These are typically inhalers. They act by stopping the muscles around the airways from tightening, helping the airway to open up.


Most inhaled medicines should be taken using a spacer device, which will help your child breathe inhaled medicine more easily. If your doctor prescribes an inhaled medicine ask if a spacer device is needed.
• Follow a written asthma management plan written by you and your child's doctor or nurse. It should include which medications to give your child to keep her asthma under control. It also should tell what to do when your child's asthma worsens, including what medications to give, and when to contact your child's doctor and/or go to the emergency room.
• Monitor your child's asthma with a peak flow meter. Children approximately 6 years and older can tell how well their lungs are working by using a peak flow meter. This easy-to-use plastic tool measures how well air flows from the lungs. By breathing once into the device, blowing out as hard and quickly as possible, you can measure the lungs' current capacity. Ask your doctor or nurse if a peak flow meter should be part of your child's asthma management plan.
• Identify the triggers that cause your child's asthma symptoms. Everyone's asthma triggers are different, so it can be difficult to determine exactly what your child's triggers are. Your child's doctor may refer her to an allergy specialist for testing. Once you know the triggers, you and your child will be better able to avoid them at home, in school and outdoors.

With careful management by parents, doctors and children themselves, asthma symptoms can be controlled so children can lead normal, active and healthy lives.