Asthma

There is no simple test to diagnose asthma. However, there are some signs that may help your child's physician in deciding if your child has asthma:

• Wheezing (a high-pitched whistling sound) when your child breathes in and out.
• Frequent cough that may be worse while asleep, with exercise, or exposure to cold air.
• Difficulty keeping up with other children during play or self-limiting exercise activity.
• Respiratory illnesses (cough and colds) that last a long time ( more than two weeks).

If your child is diagnosed with asthma, you will be educated about how to identify signs and symptoms of an “attack.” If you have any question about the severity of your child's asthma symptoms, contact your physician. Your child's asthma treatment plan may need to be adjusted to both prevent symptoms and treat symptoms when they occur.

Mild Asthma Symptoms

• Breathing is a little difficult and only slightly faster than usual.
• Your child can easily speak in complete sentences.
• Your child has a slight wheeze, cough, shortness of breath and/or tightness in the chest.
• Skin color is good.
• Your child is alert and knows what's going on.
• The child is not drawing in the rib cage muscles to breathe.

Moderate Asthma Symptoms

• Breathing is more difficult and somewhat faster than usual.
• Your child speaks in short phrases because it's hard to breathe. Your child has a wheeze, cough, shortness of breath and/or tightness in the chest.
• Your child requires more than two courses of steroids taken by mouth (Prednisone, Orapred, etc.) on a yearly basis.
• Asthma symptoms awaken your child or prevent sleeping more than twice a month.
• Your child is using a reliever medication (albuterol, Xopenex, etc.) more than twice a week on a regular basis for asthma symptoms.
• Your child is missing school often or skipping activities due to asthma symptoms.

If your child has is experiencing any of the above warning signs, please contact your child's physician.

Once your child has been diagnosed with asthma, their physician will work with you to find out what triggers your child's asthma symptoms and how to avoid those irritants. The doctor will develop an asthma action plan to help you manage and control your child's asthma symptoms.

The following are potential asthma triggers:

• Allergens: pollens (such as trees, grass, weeds); molds; house dust mites; animals; cockroaches or mice.
• Infections: viral infections; pneumonia and sinus infections.
• Irritants: tobacco smoke; air pollution (chemicals, smog, auto exhaust, etc.); dry or cold air; sudden changes in the weather.
• Exercise or strenuous activity.
• Emotional stress, laughing or crying.

Minimizing Exposure to Allergens

Once you have determined what your child's asthma triggers are, there are steps you can take to minimize your child's exposure to particular triggers.

Outdoor Pollens & Molds

• Stay indoors during the midday and afternoon when the pollen count is high.
• Use air conditioning if possible.
• Keep windows closed during seasons when pollen and mold are highest.
• Avoid sources of mold (wet leaves, lawn mowing and sandboxes).

House Dust Mites

Take these actions to control dust mites:

• Encase pillow(s), mattresses and box springs in an airtight allergen-proof cover.
• Avoid using blinds as window coverings; instead use shades or curtains and wash monthly.
• Avoid sleeping or lying on upholstered furniture.
• Wash bed covers, clothes and stuffed toys once a week in hot (130ºF) water.
• Put books and toys in sealed containers and limit the number of stuffed animals in the bedroom.
• If you have central air/heat, place filters on registers in your child’s bedroom.
• These actions are not essential, but will also help control dust mites:
• Remove carpets laid on concrete.
• Remove carpets from bedrooms.
• Avoid using a vacuum or being in a room while it is being vacuumed. Use a vacuum cleaner with a powerful suction and a HEPA filter.

Cockroach Allergen

• • Use insect gels or traps to eliminate cockroaches from the home.
• • If spraying, air out the home for a few hours afterwards.
• • Avoid eating outside of the kitchen or dining room.
• • Place all packaged food that has been opened in a sealed plastic bag.

Animal Dander

Dander refers to flakes in the skin, hair or feathers of all warm-blooded animals including dogs, cats, birds, and rodents. There is no such thing as an allergen-free dog. The length of a pet's hair does not affect dander production. The allergen, which can potentially trigger asthma, is in the saliva, urine, and dander of all pets.

• Remove animals from the house or school classroom.
• If you must have a pet, keep the pet out of your child’s bedroom at all times.
• If there is forced air heating in the home with a pet, place filters over air ducts.
• Wash the pet weekly.
• Limit visits to friends or relatives with pets.
• Remove wall-to-wall carpeting in homes with pets.

Indoor Molds

• Keep bathrooms, kitchens, and basements well ventilated.
• Clean bathrooms, kitchens, and basements regularly.
• Do not use humidifiers.
• Reduce indoor humidity to less than 50%. Use a dehumidifier if needed, particularly in damp basement areas. Set the humidity level for less than 50% but above 25%. Empty and clean the unit regularly.

Smoke

• Do not smoke.
• Use an indoor air cleaning device (with a HEPA filter).
• Avoid using a wood-burning heat stove or fireplace in your home.
• Avoid using kerosene heaters.

Strong Odors & Sprays

• Do not stay in your home while it is being painted. Allow enough time for the paint to dry before returning.
• Avoid perfume and perfumed cosmetics such as talcum powder and hair spray.
• Do not use room deodorizers.
• Use non-perfumed household cleaning products whenever possible.
• Reduce strong cooking odors (especially frying) by using a fan and opening windows.

Weather

• Have your child wear a scarf over the mouth and nose in cold weather or on windy days.

Once your child has been diagnosed with asthma, your child's physician will prescribe medications to control his or her symptoms. This plan may change over time as your child grows and changes. But every child with asthma needs a plan of action, and your child's asthma action plan should be available to all of their caregivers (at home, school, daycare, grandparents, etc.).

Asthma Medications

There are medications that can be used to prevent symptoms (controllers) and medications to treat symptoms when they occur (relievers).

Controller Medications

Controller medications decrease the swelling and inflammation in the airways. These medications also reduce mucus build-up in the airways. Controller medications can be given by inhaling them from a nebulizer, a metered dose inhaler or a dry powder inhaler.

Inhaled corticosteroids are the most effective of controller medications. The most common side effects of inhaled corticosteroids are yeast infections in the mouth or a hoarse voice. To prevent these symptoms, have your child rinse their mouth out after taking the medication. If they require a mask for administration, wash their face.
Leukotriene inhibitors are a class of medications taken by mouth.

Anti-IgE therapy binds allergic antibodies, decreasing allergic causes of inflammation in the lungs. This therapy requires injections given every two to four weeks in a specialist's office. It is a treatment option for those with more severe asthma.

Reliever Medications

Bronchodilators are reliever medications that open up narrow airways by relaxing the muscles that constrict them. Bronchodilators relieve coughing, wheezing, breathlessness and the feeling of tightness in the chest. Albuterol is one of the most commonly prescribed bronchodilators. Other names for albuterol include Ventolin HFA, ProAir HFA and Proventil HFA. Xopenex and Maxair are other medications very similar to albuterol.

These medications work best when inhaled, either by nebulizer or metered dose inhaler. They may cause mild restlessness in some children. They work very quickly and should be effective for four to six hours. If your child needs a bronchodilator more often than every four hours or does not experience relief from the medication, it is important that you seek medical attention.

Asthma Medication Delivery

Watch the videos below to learn how to properly administer certain types of asthma medication.

Holding Chamber with Mouthpiece 

Holding Chamber with Mask

Helping Your Child Use An Auto-Injector (EpiPen)

Helping Your Child Use a Nebulizer Machine

Helping Your Child Use Nasal Spray