Asthma in Children

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.

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