Asthma is a lung condition that causes someone to have difficulty breathing. During an asthma attack, the lung's airways, called the bronchial tubes, narrow because the smooth muscle cells surrounding the airways contract. The lining of the airways becomes inflamed and swollen, and extra mucus is made. This combination of mucus production, inflammation, and tightening of the surrounding muscles causes the airways to become narrow. This makes it difficult for air to move in and out of the lungs. Asthma may be mild with occasional symptoms, or it may be severe with constant symptoms.
Many things can trigger an asthma attack, including the common cold and allergens, and substances that cause the immune system to overreact. Allergens cause allergies, and some children with allergies will develop asthma. Common allergens that trigger asthma attacks include dust mites, pollen, mold, and household pets (dogs, cats, rabbits, and guinea pigs). Physical exertion can trigger an asthma attack, as can exposure to cold air, cigarette smoke, air pollution, poor ventilation, and high humidity.
Asthma is the most common form of lung disease in children, affecting between 5 percent and 15 percent of all children. Asthma can start at any time during childhood, but about half of all children have their first asthma attack before the age of 3. Some children seem to grow out of their symptoms as they get older; others will have symptoms throughout their adult lives. Children whose parents or siblings have asthma have a higher chance of developing it themselves.
The typical symptoms of asthma are coughing and difficulties with breathing. The child may breathe faster than normal and use more effort, like engaging extra muscles, to get air in and out of the lungs. This is noticeable in the arch of the neck and below or between the ribs. Exhalation is particularly difficult with asthma and will take longer: A child with asthma has to force the air out through narrowed respiratory passages, making a whistling or wheezing noise. The child may have difficulty completing sentences, or produce a dry, hacking cough. For some children a long-lasting, nighttime cough may be the first sign of asthma.
Signs of a severe asthma attack include bluish skin color, grunting, flaring of nostrils, and pulling muscles inward in the neck or between the ribs
It is important that you understand your child's Asthma Action Plan, which will explain exactly which medication (how much and when) your child should take on a regular basis and what you should do if the condition gets worse. It will often be necessary to increase or decrease the dose of certain medicines depending on the severity of your child's asthma symptoms. During the more severe phases, it will be necessary to use higher doses or stronger medication.
If your child suffers from allergies, it is important that he be kept away from whatever causes them. There should be no smoking in homes or cars, and bedrooms should be vacuumed and dusted regularly. Avoid wall-to-wall carpets, curtains, stuffed animals, and household pets.
Children with asthma are encouraged to be physically active, but if exercise causes your child to have asthma, use medication about 30 minutes before strenuous activity to prevent an attack. When properly controlled, asthma should not disrupt the day-to-day life. Some children with asthma will seem grow out of their symptoms as they get older, but children with proven allergies have an increased chance of having their asthma continue into adulthood.
Untreated or poorly treated asthma will result in the child being less able to fill her lungs with air. She may become tired more quickly than other children and be limited in her physical activity. Poorly treated asthma can result in delayed growth and an increased risk of lung infections. If left untreated, it also can cause the heart muscles to work harder, eventually leading to heart problems.
Contact your doctor for an evaluation and an X-ray of the lungs. If allergies are causing asthma, your doctor will recommend an allergy test. For older children, a lung function test may also be given. A peak flow meter can be used (even at home) to test lung function by measuring the airflow out of the lungs; a spirometer will measure the amount of air flow both in and out of the lungs.
Your doctor will decide what kind of medicine is best for your child and work with you to prepare an Asthma Action Plan, which will be part of your child's medical record through the years. A copy should be sent to your child's school. Most children with asthma need two types of medication: rescue medicine to stop an asthma attack right away and controller medicine to prevent an asthma attack from happening. Rescue medicines should be taken at the first sign of an asthma attack; controller medicines should be taken regularly, every day.
There are various ways of taking asthma medications, depending on the medication and the age of the child. Some are inhaled; nebulizer machines are often used to administer inhaled medications to the youngest children. A small mask is held over the nose and mouth while the child breathes in the fine mist containing the medication. For children older than 5 or 6, medication can be given in the form of metered dose inhalers with spacers, dry powder inhalers, or tablets.
If your child has difficulty breathing as the result of an asthma attack, it is very important that you act calmly. Loosen tight clothing, and open the window to allow fresh air to enter the room. Talk softly and comfort your child by letting him sit upright in your lap, with good support, or by gently stroking his back. Encourage your child to drink plenty of fluids. An increase in fluid intake will prevent the mucus in the breathing passages from becoming sticky and difficult to cough up. If the usual asthma medications do not seem to be helping, contact the doctor.
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