Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Asthma—Child

by Patricia Griffin Kellicker, BSN

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Definition

Air travels in and out of the lungs through bronchial tubes. Asthma is a chronic inflammation of these tubes. This inflammation causes airways to narrow. This makes it hard to breath. There are different degrees of asthma. Some people may have very mild asthma with rare flare-ups. Others may have a severe, constant asthma.

Asthma is the most common chronic disease found in children. If your child is having trouble breathing, call 911 immediately. This is a potentially serious condition that needs immediate medical attention.

If it is not an emergency, but you suspect your child may have asthma, contact your doctor. With proper treatment, asthma can be controlled.

Causes

The exact causes of asthma are unknown. It is thought that a mix of genes and environment causes asthma. Possible causes include:

  • Contact with allergens when immune system is developing
  • Family history
  • Respiratory infections
  • Tendency to develop allergies

Certain conditions are known to trigger an asthma attack. These include:

  • Substances that cause allergies (allergens)
    • Animal hair
    • Dust
    • Food—peanuts, milk, wheat, eggs, and tree nuts are common
    • Mold
  • Abrupt change in weather
  • Exercise—especially in cold air
  • Respiratory infection
  • Tobacco smoke
Risk Factors

These factors increase your child’s chance of asthma. Tell your doctor if your child has any of these risk factors:

  • Exposure to tobacco smoke
  • History of allergies and/or eczema
  • Taking medicines such as acetaminophen
  • Tendency to develop allergies
  • Chlorinated pool use in children who are already at risk for asthma
  • Family history
  • History of respiratory infections
  • Premature birth
Symptoms

If your child has any of these symptoms do not assume it is due to asthma. These may be caused by other conditions. Tell your doctor if your child has any of these:

  • Chest tightness
  • Child avoids exercise or sports
  • Child complains of chest pain or odd sensations
  • Coughing
  • Difficulty during feeding in infants
  • Fatigue
  • Shortness of breath
  • Trouble breathing
  • Trouble sleeping
  • Wheezing
Diagnosis

Your doctor will ask about you about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen to your child’s lungs. Your doctor may refer you to a specialist. A pulmonologist focuses on the lungs. An immunologist focuses on allergies.

Tests may include the following:

  • Challenge test—test that uses spirometry to measure how well your child breaths after causing asthma symptoms
  • Medication—in young children unable to undergo spirometry testing, the doctor may prescribe a bronchodilator medication (drug that opens airways); if your child’s symptoms get better then the doctor may diagnose asthma
  • Pulse oximetry—test that uses a sensor on a finger to measure oxygen concentration
  • Skin testing —test that introduces very small amounts of common allergens into the skin; used to identify common allergens that may trigger asthma symptoms
  • Spirometry test—test that measures how well your child breaths; your child will be asked to take deep breaths and then exhale into a tube that is hooked to a machine
  • X-ray —test that uses radiation to form an image; chest x-ray used to rule out infection and disease
Treatment

Talk with your child’s doctor about the best plan for your child. You and your child's doctor should also create an asthma action plan. This is a plan your child will follow to help control his asthma and handle asthma attacks. Treatment will vary based on how many asthma episodes your child has and any specific symptoms. Treatment options include the following:

Medications

Medications used to treat asthma fall into one of two categories:

Quick relief medications—usually given as inhalers

  • These are also sometimes called rescue medications and are used to quickly treat breathing difficulties. Common inhalers include:
    • Albuterol
    • Ipratropium
    • Levalbuterol
    • Pirbuterol

Long-term control:

  • Leukotriene modifiers such as montelukast (Singulair) and zafirlukast (Accolate)
  • Combination medications that include a long-acting bronchodilator and an inhaled corticosteroid
  • Cromolyn or nedocromil
  • Inhaled corticosteroids
  • Long-acting beta agonist—in most cases, prescribed with an inhaled corticosteroid
  • Systemic corticosteroids
  • Theophylline
  • Zileuton (Zyflo), a 5-lipoxygenase inhibitor
Allergy Shots (Immunotherapy)

Your child’s asthma may be triggered by allergies. In this case, your doctor may recommend allergy shots . These shots are very small amounts of an allergen injected into the skin. Over time your child will react less to the specific allergen(s). With less triggers the asthma also decreases.

Prevention

There are no known ways to prevent your child from developing asthma. However you can help your child reduce his or her chance of triggering an asthma attack, by taking the following steps:

  • If your child is older than six months old, have her get a yearly seasonal flu shot.
  • Avoid exposure to tobacco smoke.
  • Avoid foods that your child is allergic to.
  • Go to follow-up appointments to monitor your child's progress.
  • If your child is prescribed controller medicines, make sure she uses them as prescribed.
  • Know what your child is allergic to and avoid known triggers.
  • Use hot water to wash linens.
  • Use hypoallergenic pillows and mattress covers.

Last reviewed: September 2011 by Tajender S. Vasu, MD.

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