Childhood Asthma

Answers and advice to keep you and your child breathing easy

Learning your child has asthma can be life changing. But, Dr. Jaclyn Lozier says it can actually be life changing in a good way. A pediatrician at Southwestern Vermont Medical Center, Lozier says, “Getting a diagnosis is the first step to finding ways to treat the condition and minimize its impact on your child’s life.”

The ins and outs of childhood asthma
Asthma is a chronic condition in which the lungs overreact to triggers in the environment. These often include viruses, allergens (such as dust mites, pet dander, or pollen), exercise, cold air, and even smoke from cigarettes or wood and pellet stoves. Lozier explains, “When a child encounters a trigger, it causes an attack in which the airways in the lungs become swollen. The muscles around the lungs constrict, squeezing the already swollen airways tighter, and the cells lining the airways produce excess mucus. As a result, breathing becomes difficult.”

Lozier notes that getting a formal diagnosis of asthma isn’t usually possible before the age of two, but symptoms may appear earlier than that. Often triggered by a respiratory infection, the first signs of asthma may include runny nose and a cough—especially at night—that lasts a few days. But then, rather suddenly, the child’s breathing becomes rapid and labored. They may struggle to breathe while doing normal activities.

“If a child experiences a virus that evolves to this level three or four times before the age of two,” says Lozier, “there’s a strong likelihood they have asthma.” However, she notes, as some children grow and the size of their airways increase, it is possible for symptoms to be reduced to the point of being unnoticeable.

Different treatments for different types
Diagnosing asthma is not complicated. Often, a doctor can recognize it based on your child’s health history. Some pulmonary (lung) function tests can help confirm the diagnosis.

A diagnosis is then classified into one of four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent.

Lozier explains, “The type and frequency of symptoms experienced is what determines what type of asthma someone has and, to a large extent, what treatment they’ll receive.”

While there is no cure for asthma, it can be managed. The keys to managing asthma are avoiding triggers and taking medication.

Nipping cold-weather asthma attacks in the bud
Cold dry air can trigger asthma symptoms and flare-ups. You can prevent flare-ups by minimizing sudden temperature changes in the air your child breathes. Wrap their mouth and nose with a scarf before sending them outside to wait for the bus or to play. A gradual temperature change is less likely to trigger an attack.

“Once you’ve identified your child’s triggers,” says Lozier, “you can take actions to avoid them. That might mean staying inside when pollen counts are high or keeping a family pet out of your child’s room. If your child has exercise-induced asthma, work with your doctor to find ways to keep your child active.”

There are two types of asthma medications:

Quick relief medicines, also referred to as “rescue” medicines, work quickly to open up airways and can be used as needed. While these medicines act fast, their effect doesn’t last long.

Long-term control medicines manage asthma risk by preventing symptoms from happening. Taken every day, they reduce inflammation in the airways, which lead to swelling and mucus production.

Some kids only need quick-relief medicine, while others need both kinds to manage their asthma.

An asthma action plan to keep kids healthy
In addition to prescribing medication, your child’s doctor will provide an asthma action plan.

“Because no two children experience asthma the same way, it’s important that every child have their own asthma action plan (AAP),” explains Lozier.

Designed to help families manage a child’s asthma, an AAP can prevent asthma emergencies by preventing and controlling flareups. Your child’s personalized AAP will include a list of the medications taken, a list of known triggers, early warning signs for asthma symptoms, and instructions on when to use the medicines and/or call your healthcare provider.

“While an AAP is a helpful tool for families adjusting to an asthma diagnosis,” says Lozier, “it’s also important to share it with anyone who might be involved in decisions regarding your child’s care plan. This includes school nurses, athletic coaches, camp directors, grandparents, babysitters, etc.”

AAPs are divided into a traffic-light format. The green zone outlines the everyday plan when your child is feeling well. The yellow zone includes what to do when your child isn’t feeling quite right. The red zone details what to do when your child is experiencing an asthma attack.

“Easy to follow, AAPs are one of the best ways to help your child avoid a full-blown attack and ensure they get the proper treatment for their asthma,” says Lozier.

Breathe easy
The good news: asthma is a treatable condition. The better news: By using medication and avoiding triggers, your child can lead a normal and healthy life. If you are concerned your child may have asthma, talk with your child’s doctor. The sooner you get a diagnosis, the sooner you can begin managing your child’s symptoms.

Asthma Tools and Resources
Asthma: Get the Facts
A podcast for kids about asthma
tools.cdc.gov/medialibrary/index.aspx#/media/id/304721

Just for Kids
Online site featuring games, puzzles, and more to educate kids on asthma and allergens
aaaai.org/Conditions-Treatments/just-for-kids

Know how to use your inhaler: An instructional video for kids
cdc.gov/asthma/inhaler_video/default.htm

HealthyChildren.org
Articles and information related to asthma in children