How to Manage Your Child's Asthma

Prevention and When to See a Specialist

Can You Prevent Asthma?

Although there's no proven way to steer clear of asthma, there are steps you can take to reduce your child's risk of developing it. They are particularly important if there is a history of the disease in your immediate family.

  • Avoid smoking -- during pregnancy and after -- and don't expose your child to smoke.
  • Breastfeed for at least four to six months, and longer if possible, to strengthen your baby's immune system.
  • Know that pets are not necessarily a problem. Children born into a home with a dog -- especially more than one -- or a cat, to a lesser extent, appear to be at a lower risk of developing asthma. (But if your child develops asthma later, you'll need to find another home for your animals.)
  • Wait until at least 4 months before you start solids, and begin with just a tablespoon of pureed food or cereal once a day.
  • Reduce your child's exposure to allergens in the air, particularly dust mites. Use dust-mite covers for pillows and mattresses; try to limit the use of rugs and curtains because they trap dust; and wash bedding well weekly in hot water.
  • Try not to spend time outdoors on days when the air quality is poor (check airnow.gov). Children who are exposed to high levels of air pollution are more likely to have asthma.
  • Keep your home free of mold and cockroaches.
  • Minimize the use of antibacterial products and antibiotics. Many experts theorize that our reliance on these has caused our immune system to develop in ways that make allergies and asthma more likely. It's for similar reasons that kids who grow up on farms are less likely to have asthma and allergies. We don't understand this fully, but certain germs seem to be good for us. I'm not sure that having a dirty kid or making regular trips to the petting zoo will help, but at least you don't have to go nuts about sanitizing everything.

When It's Time for a Specialist

Your child should meet with a pulmonologist or a specialist in allergy and immunology, preferably one with pediatric training, if:

  • He has a known lung problem -- such as one related to having been born prematurely.
  • Allergies are suspected and not easily controlled with antihistamines.
  • He often has sinusitis, ear infections, or pneumonia.
  • He needs to use his rescue inhaler more than twice a week, has either frequent symptoms (a few days a week or more) or severe attacks, even with treatment.
  • You want more help learning about and managing your child's asthma than your pediatrician is able to give you.

Originally published in the May 2013 issue of Parents magazine.

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