Handling Twitchy Lungs
Asthma shouldn't sentence a child to a life of juggling drugs to ease breathing. Consider Aidan Meyers, age 4, of Schnecksville, Pennsylvania, who began coughing and wheezing with bronchiolitis at 8 months and continued off and mostly on for months. Finally, at 21 months, he was officially diagnosed with asthma, as well as food and household allergies. Initially, he had to take two medications four times a day as well as four others twice a day, but now Aidan is on just one preventive treatment a day.
All asthma patients have on hand a rescue drug (e.g., albuterol) to quickly open constricted airways, or an oral corticosteroid, such as prednisone (usually reserved for severe attacks and to be used only under a doctor's direction). Then, depending on the severity of the asthma, a child may also be put on a long-term medication -- such as an inhaled cortico-steroid, a leukotriene modifier (e.g., Singulair), or a long-acting bronchodilator -- to reduce inflammation, swelling, and mucus production.
These "controller" drugs make lungs less twitchy and less prone to overreact to triggers -- say, a virus, exercise, dust, pet dander, smoke, or stress. (Inhaled drugs also require equipment -- either a nebulizer, a machine that turns medicine into breathable mist, or a handheld inhaler that delivers a puff of the drug.) "Parents are often reluctant to put their kids on daily medication, but if the inflammation is controlled, everything is better," says Dr. Liu.
Properly controlled asthma, for which rescue drugs are rarely used, should have little effect on a child's life. In fact, experts say, a kid with asthma should be just as active as any other -- without fear that running around will lead to fighting for breath. "Parents need to follow the three-strikes rule," says Dr. Liu. "If a toddler has daytime symptoms three times a week, nighttime symptoms three times a month, or prolonged attacks three times a year, talk to your doctor about adjusting your child's plan."
Household and Lifestyle Changes
Beyond administering treatments, you may need to make some household changes if your child has asthma. For example, as many as 80 percent of asthmatic kids have allergies, says Dr. Tracy. So if your child is allergic to something in dust, you might have to get rid of carpeting or stuffed animals, says Dr. Liu. "We let Aidan keep two favorites that fit in the freezer," says his mom, Nicole Meyers. (The cold kills dust mites, but once outside the freezer, stuffed animals will get reinfested, so you may want to dehumidify your home, says Dr. Liu.) Most important: Tell smokers at home to quit. "Smoking outside isn't enough -- smoke clings to hair and clothes and is detrimental to the lung function of sensitive kids," says Dr. Flaherman.
While the diagnosis of asthma might seem devastating, moving ahead is empowering, says Lois McDonald of Denver, a mother of four whose oldest son and daughter have asthma. "When they were toddlers, I took them to the doctor for what I thought were colds," says McDonald. Pinpointing the problem was a relief, she says: "It's a serious disease, but a little education takes away the fear. Now I know exactly how to help them."