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Asthma 101: What Parents Should Know

May is Asthma Awareness Month

May is Asthma Awareness Month, and Driscoll Children's Hospital wants you to know as much as you can about the disease so you can recognize it and, if necessary, help your child better deal with it. With proper treatment and a team approach to managing asthma, most children with asthma can live a normal life. Asthma, however, can be a life-threatening disease. It is important for families to work together with healthcare professionals to develop an asthma action plan to properly care for the child.

Pediatrician Daniel Vijjeswarapu, M.D., has treated children with asthma for 19 years. He provided the following information for parents whose children have asthma.

What causes asthma?

In children who have asthma, their airways are inflamed and "twitchy" because they overreact to irritants in the environment. These irritants are called triggers, and they include anything that sets off an asthma flare-up. Different children have different triggers. Some common asthma triggers are allergies, chest colds, pollution and exercise. To control your child's asthma, you have to find out what his or her triggers are and learn how to deal with them.

How does asthma work?

When your child has asthma, his or her airways are inflamed much of the time. This inflammation can make breathing difficult for three reasons:
  • The inside lining of the airways swells inward. This narrows the space inside their airways.
  • The muscles around the airways tighten. This tightening is called bronchospasm (or bronchoconstriction). Bronchospasm also narrows the airways.
  • The child's airways produce more mucous. Excess mucous clogs the airways, narrowing the space for air to pass through.

With their inflamed airways narrowed by swelling, bronchospasm and excess mucous, air doesn't move as easily into and out of their lungs. It can be like trying to breathe through a narrow straw - they have to work extra hard to get air in and out. Other asthma symptoms like coughing, wheezing and chest tightness can also happen. This is an asthma flare-up (also called an asthma "attack").

Asthma symptoms: From bad to worse

Below are some common asthma symptoms that can happen as an asthma flare-up worsens:
  • Cough. The first thing you may notice is a persistent (ongoing) cough, especially at night.
  • Wheezing. You may hear a high-pitched whistling sound as the child breathes. This sound, called wheezing, means that the air is having trouble moving through his or her airways. Wheezing usually happens when they breathe out. But as the asthma worsens, you might also hear wheezing when they breathe in.
  • Difficulty breathing, chest tightness. As the child's breathing becomes more difficult, he or she can feel pain or tightness in their chest. Children are likely to say that their chest hurts.
  • Shallow breathing. The child may find it difficult to take a deep breath. Their breaths become smaller and shallower as their condition worsens.
  • Fast breathing. As breathing becomes shallower, it also becomes faster as the child's body tries to get more oxygen into their lungs. A child breathing faster than 50 breaths a minute while at rest is breathing fast.
  • Retractions. As the asthma flare-up worsens, you may notice that the child's skin and muscles between their ribs and at the base of their throat are "pulling in" or "retracting" with each breath in. These retractions show that they're really struggling to get air into their lungs.
  • Life-threatening symptoms. If an asthma flare-up becomes very severe, the child won't be able to work hard enough to breathe in. At this point, the retractions and wheezing may actually begin to go away. Their breathing will become very shallow. And, because their body isn't getting enough oxygen, their face and lips may turn slightly blue. Symptoms like these are very dangerous and require immediate emergency care.

To get the most out of your child's asthma treatment, you should:

  • Understand the different types of medication and when your child should take them.
  • Make sure the child uses the medication delivery device - an inhaler or nebulizer - correctly.
  • Establish good habits for staying on schedule with your child's medication.

There are two basic types of asthma medications: Quick-relief and controller medications. Quick-relief medications, also called rescue medications, can stop an asthma flare-up from getting worse. They work immediately, usually within 5 to 10 minutes, to help open airways during an asthma flare-up. Quick-relief medications do not prevent future symptoms.

Controller medications, also called maintenance medications, should be taken every day on a regular basis even if the child is symptom-free and feeling well. Controller medications help prevent asthma flare-ups.

Some precautions asthmatic children should take in their daily lives

If your child isn't taking his or her medication properly, you need to talk and find out why. Keep the tone positive and encouraging. Start by pointing out what is working, then go on to explore the following possible problems together:
  • "I don't want to take my medication!" If your child actively resists taking medication, find out why. Is he or she embarrassed? Does the medication taste bad? Are medication side effects bothering him or her? Work with your child and your child's healthcare provider and teachers to find ways to minimize these problems.
  • "It's too hard." Make sure your child understands when and how to take various medications. (An asthma action plan can help here.) Have your doctor or asthma educator reinforce your child's technique for taking inhaled medications.
  • "I don't need medication." There are lots of reasons why children might think they don't need medication. They might have become used to poor lung function and think that it's normal. They could be practicing "wishful thinking" - deciding that their asthma has gone away. (Just because they don't have symptoms now doesn't mean their asthma is gone!) Or perhaps they're not getting much benefit from their medication, in which case they need to have their treatment adjusted. Make an appointment with your child's doctor to review and agree upon an asthma action plan.

Other precautions to take

You and your family can help control a child's asthma by helping get rid of the indoor triggers that make symptoms worse. If possible, keep pets outdoors, or at least away from the child's bedroom.

No one should smoke in a house or around a child with asthma. Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry smoke residue in and on their clothes and hair, and this can trigger asthma symptoms.

Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms - this helps reduce the possibility of cockroaches, which can trigger asthma attacks.

Bedding can be covered with "allergy-proof," polyurethane-coated casings to reduce exposure to dust mites. Detergents and cleaning agents in the home should be unscented. All of these efforts can make a significant difference to the child with asthma, even though it may not be obvious right away.

Myth and truth

Myth: "Children usually outgrow asthma."

Truth: How asthma affects children throughout their lifetimes varies. In some children, symptoms get worse over time. In other children, symptoms seem to go away as the lungs develop. Still, people who seem to have "outgrown" childhood asthma often have their symptoms reappear in adulthood.

The bottom line? Even if symptoms go away, the tendency toward asthma is still there. That's why children diagnosed with asthma should work with a doctor to match their treatment plan to their current condition.

Facts about Asthma

According to the latest available information from the National Institute of Allergy and Infectious Diseases and the Asthma & Allergy Foundation of America, consider the following statistics:
  • About 22.2 million people in the US have been diagnosed with asthma, with at least 6.5 million of them children under the age of 18.
  • Asthma is the most common chronic condition among children in the US.
  • Asthma accounts for 14 million absences from school each year.
  • Asthma is 26 percent more common in African-American children than in Caucasian children.
  • African-American children with asthma, most often from inner-city populations, generally experience more severe disability from asthma and have more frequent hospitalizations than do Caucasian children.
  • Asthma is the third most common cause of childhood hospitalizations under the age of 15.
  • More than 200,000 children with asthma experience symptoms that are more severe due to exposure to secondhand smoke.
  • About 10 million doctor's office visits annually result in a diagnosis of asthma.
  • Asthma cases and asthma deaths have been on the rise, and hospitalizations for asthma have increased.
  • Asthma treatment costs an estimated $18 billion each year, including direct and indirect expenditures.

Contact Information

Driscoll Children's Hospital
Children's Physicians Services of South Texas
Pulmonology Clinic

3533 S. Alameda Street
Corpus Christi, Texas 78411

Phone: 361-694-4447
Fax: 361-851-6867

Hours: Monday - Friday 8 a.m. - 5 p.m.

For TTY Deaf Messaging Connect to TTY Interpretation by dialing
(800) 735-2989
Child life specialists and respiratory therapists at Driscoll Children's Hospital use 'Radical Randy' to teach children about asthma and respiratory problems.
Child life specialists and respiratory therapists at Driscoll Children's Hospital use 'Radical Randy' to teach children about asthma and respiratory problems.

Registration is underway for Camp Easy Breathers!

Applications are being accepted for the 10th annual Camp Easy Breathers, a summer day-camp for children ages 7-14 with persistent asthma. Sponsored by Driscoll Children's Hospital, the Coastal Bend Community Foundation and the Coastal Bend Asthma Initiative, it will be from June 12-15, 2011 at Camp Aranzazu in Rockport. There will be a carnival this year with games, obstacle courses and other activities, as well as swimming, arts and crafts, outdoor games, sports and an awards show. The cost for the camp is $250 per child and scholarships are available. Deadline for registration is June 3, 2011. For information, call Shelly Bigelow at (361) 694-4580 or CLICK HERE.

Schedule an asthma class today

Driscoll offers resources for asthmatic children such as one-on-one classes with Candace, 'The Asthma Lady.' The classes are for families and can be scheduled at their convenience. If you're interested in attending an asthma class, contact Candace Martaus to schedule a time at (361) 694-4167 or The classes are free of charge.

Do you have questions about asthma?

Asthma Awareness Fair
Saturday, May 7
12:00 - 4:00 p.m.
La Palmera Mall

Join us!

Driscoll Children's Hospital and Driscoll Children's Health Plan will be at the Asthma Awareness Fair. Hospital and Health Plan representatives will be on-hand providing Pulmonary Function Tests and offering information on topics such as:
  • Asthma classes offered at Driscoll Children's Hospital
  • Getting your asthmatic child ready for school
  • Camp Easy Breathers, a summer day-camp for children with asthma
  • Anti-smoking information