Asthma in children and infants

Asthma is the leading cause of chronic illness in children. It affects as many 10%-12% of children in the United States and, for unknown reason, is steadily increasing. Asthma begin at any age (even in the very elderly), but most children have first symptoms age 5.

Asthma in children and infants

Haw can I tell if my child has asthma?
Not all children have the same asthma symptoms, and these symptoms can vary from episode to episode in the same child. Possible sing and symptoms in children include:

- Frequent coughing spells, which may occur during play, at night, or while laughing or crying
- A chronic cough (which may be the only symptom)
- Less energy during play
- Rapid breathing (intermittently)
- Complaint of chest tightness or chest "hurting"
- Whistling sound when breathing in or out -- called wheezing
- See-sow motions in the chest from labored breathing. These motions are called retractions
- Shortness of breath, loss of breath
-Tightened neck and chest muscles
- Feelings of weakness or tiredness

While these are some symptoms of asthma in children, your child's doctor should evaluate any illness that complicates your child's breathing. About half of infants and toddlers with repeated episodes of wheezing whit shortness of breath or cough (even thought these illnesses usually respond to asthma medications) will not have asthma by the age of 6. Because of this, many pediatricians use terms like "reactive disease" or bronchiolitis when describing such children (instead of lebeling them as asthmatic).

How common is asthma in children?
Asthma is the leading cause of chronic illness in children. It affects as many 10%-12% of children in the United States and, for unknown reason, is steadily increasing. Asthma begin at any age (even in the very elderly), but most children have first symptoms age 5.

There are many risik factors for developing childhood asthma. These include:
- Nasal allergies (hay fever) or eczema (allergic skin rash)
- A family history of asthma or allergies
- Frequent respiratory infections
- Low birth weight
- Exposure to tobacco smoke befor or after birth
- Beging raised in a low-income environment

Why is the rate of asthma in children increasing?

No one really knows the exact reasons why more and more children are developing asthma. Some experts suggest that children spend too much time indoors and are exposed to more and more dust, air pollution, and secondhand smoke. Some suspect that children are not exposed to enough childhood illnesses to direct the attention of immune system to bacteria and viruses.

How is asthma in children diagnosed?

Asthma in children can often be diagnosed based on medical history, sympptoms, and a physical axam. Keep in mind that oftentimes when you take your infant or older child to the doctors with asthma symptoms, the symptoms may by gone by the time the doctor evaluates the child. That's why parents are key in helping the doctor understand the child's signs and symptoms of asthma.

- Medical History & Asthma Symptom Description: Your child's doctor will be interesed in any history of breathing problems you child may have had, as well as a family history of asthma, allergies, a skin condition called aczema, or other lung disease. It is important that you describle your child's symptoms--cough, wheezing shortness of breath, chest pain, or tigtness--in detail, including when and how often these symptoms have been occuring.
- Physical Exam: During the Physical examination, the doctor will listen to your child's heart and lungs and look for sing of an allergic nose or eyes.
- Tests: Many children will also have a chest X-ray and for those ages 6 and older, a simple lung function test called spirometry. Spirometry meausures the amount of air inthe lung and how fast in can be axhaled. The results help the doctor determine hoesever the asthma is. Other tests may also be ordered to help identify particular"asthma triggers" for your child's asthma. These tests may include allergy skin testing blood tests (IgE or RAST), and X-rays to determine if sinus infections or gastroesophageal reflux disease (GERD) are complicating asthma. Learn more about diagnosing asthma. A new asthma test that meausures the amount of nitric oxide in thebreat (eNO) may now be available in your community.

What's the asthma treatment for children?
Avoiding triggers, using medications, and keeping an eve on daily asthma symptoms are the ways to control asthma in children of all ages. Children with asthma should always be kept away from all sources of smoke. Proper use of medication is the basis of good asthma control.

Based on your child's history and the severity of asthma, his or her doctor will develop an Asthma Action Plan and give you a written copy. This plan describes when and how your child should use asthma medications, what to do when asthma gets worse (falls into the yellow or red zones), and when to seek emergensy care for your child. Make sure you understand this plan and ask your child's doctor any questions you may have.

Your child's written Asthma Action Plan is important to successfully controlling his or her asthma. Keep it handy to remind you of your child's caregiver and/or school teacher has a copy of the Asthma Action Plan, so they will know how to treat the child's symptoms if he or she should have an asthma attack away from home.

My child is only a toddler. How do I give my him asthma medications?Infants and toddlers may use the same type of asthma medications as older children and adults. Inhaled steroids may be key to managing infants with chronic asthma or wheezing. Howewer, the medications are give diffrent to children under 4 yerars of age (such as aith an asthma nebulizer and mask), and with lowet daily doses.

The latest asthma guidelines recommend a stepwise approach for managing asthma in children 0-4 years of age. This includes the use of quick-relief madications (such as albuterol) for intermittent asthma symptoms. A low-dose of an inhaled steroid, crymolyn, or Singular is the next step up. Then the intensity of the asthma treatment is focused on controling thier asthma. If the child asthma is controled for at least three months, your child's doctor may decrease the madication or "steo down" the asthma treatment. Consult with your asthma specialist for exakt madications and dosages.

Depending on your young child's aga, you may use inhaled asthma medications, or liquid medications delivered with an asthma nebulizer, also know as a breathing machine. A nebulizer delivers asthma madications by changing them from a liqid to a mist. As a mist, your child will breathe the madications trough a face mask. These breathing treatments usually take about 10-15 minutes and may be give up to four times a day. Your child's doctor will tell you how to give your child breathing treatmens.

Depending on thier age, your child may be able to use a metered dose inhaler (MDI) with a spacer. A spacer is a chamber that attaches to the MDI and holds these burst of medication. This allow your child to breathe the medications into his lungs at his own pace. Talk with your child's doctor about your child using an MDI with a spacer.

What are the goals of treaning my child's asthma?
Asthma can't be cured, but it can be controled. The goals of asthma treatment for you child are listed below. If your child is unable to achieve all of these goals, you should contact your child's doctor for advice. Your child should be able to:

- Live an active, normal life
- Prevent chronic and troublesone symptoms
- Attend school every day
- Perform daily activites, play, and engage in sports without difficult
- Stop urgent visit to the doctor, emergency departament, or hospital
- Use and adjust madications to control asthma with little or no side affects

By learning about asthma and how it can be controlled, you take an important step toward managing your child's disease. Work closely with your child asthma care team to learn all you can about asthma, how to avoid asthma triggers, what asthma madications do, and how to correctly give the asthma treatments.

Will my child outgrow asthma?
So much is unknown about infant lung function and asthma. At this time, many experts believe that if an infant or toddler has three or more episodes of wheezing (usually due to respiratory viruses), The child has a 50/50 chance of developing asthma in his life. If the child has a strong family history of asthma, exposure to secoonhand smoke, and other ris factors for asthma, the child has a greater chance of developing it. Asthma therapy will not reduce this risik.

In addition once a person's airways sensitive, they remain that way for life. Howewer about 50% of children experience a noticable decrease in asthma symptoms by the time they become adolescents, therefore appering to havy "outgrown" thier asthma. About half of these children will develop asthma symptoms again as adults. Unfortunately, there is no way to predict whose symptoms will decrease during adolescence and will return later in life.

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