Keys to managing childhood asthma

Asthma is one of the most chronic serious diseases in children and adolescents, affecting nearly nine million children under the age of 18. Fifty to 80% of children with asthma develop the symptoms of asthma before the age of 5.

Children suffering from asthma also miss more than 10 million school days each year due to complications of the disease. Asthma symptoms can result in poor academic performance, anxiety and further isolation from peers if not properly taken care of by an allergist/immunologist.

Asthma occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten and extra mucus is produced, causing the airways to narrow. The result could range from a frequent tendency for a cough to wheezing to severe difficulty in breathing. In some cases, breathing may be so labored, that an asthma attack becomes life-threatening.

The most common form of asthma among children is allergic asthma. In this form, otherwise harmless allergens, such as dust mites, cat and dog dander or other environmental allergens, can trigger an asthma attack. In addition to allergy symptoms brought on by exposure to these allergens-watery eyes, sneezing and itching-asthmatics can experience severe airway constriction. If left untreated, the disease can escalate to dangerous proportions, even resulting in trips to the emergency room to restore normal breathing.

Asthma also can have a non-allergic component and be triggered by cold, dry, polluted air or exercise. The variety of triggers, both allergic and non-allergic, that lurk all around us makes asthma nearly a universal risk for millions of people

Who is at risk to develop asthma?
Children whose immune systems are not fully developed are most at risk for developing the disease. However, there are no clear markers to predict who will develop asthma and who won't. Studies have shown that factors associated with the onset of asthma symptoms in children include:

* Infants and young children who wheeze with viral upper respiratory infections.
* Allergies. The relationship between asthma and allergies is very strong. If your child has allergies, be on the alert for potential signs of childhood asthma
* A family history of asthma and/or allergy
* Prenatal exposure to tobacco smoke and allergens

How do I know it's asthma?
Asthma can be a tricky disease to pinpoint for a number of reasons. There are other respiratory ailments with overlapping symptoms, and some children can seem symptom free for long periods of time but then experience intermittent asthma "attacks." If you think your child might have asthma, get him/her examined and tested by an allergist/immunologist.

Children with asthma cough, wheeze and experience chest tightness and shortness of breath. However a chronic cough may be the only symptom of asthma and a child does not have to wheeze to have asthma. Children with reactive airway disease, recurrent bronchitis or wheezy bronchitis probably have asthma.

Watch for the key symptoms that can clue you in to seek the advice of an allergist/immunologist. These include:

* Coughing. This could be constant or just intermittent. Not all children who have the disease exhibit symptoms each and every day
* Wheezing or a whistling sounds audible when your child exhales
* Shortness of breath or rapid breathing. This may or may not be associated with exercise
* Chest tightness. A young child may say his/her chest "hurts" or "feels funny"
* Fatigue. Your child may slow down, stop playing or become easily irritated
* Infants may have problems feeding and may grunt during suckling
* Older children may avoid activities such as sports or sleepovers
* A child may have problems sleeping because of nighttime coughing or difficulty breathing

Asthma symptoms are often worse in the morning and late at night. In between asthmatic episodes symptoms have been known to disappear or improve but that does not mean the asthma has gone away. Symptoms can be brought on by a number of different triggers such as: respiratory infections, exercise, stress, cold air and outdoor allergens such as pollen, mold, animal dander or dust mites.

Patterns of asthma symptoms are important. Pay close attention to when the asthma occurs. Does it occur:

* At night or early morning?
* During or after exercise?
* Seasonally?
* After laughing or crying?
* When exposed to possible asthma triggers at home, school or daycare?

No two children have exactly the same asthma symptoms or outcomes. It is a very individualized disease. The best way to determine if your child does have asthma, is to look and listen for clues or symptoms. If you suspect that your child might have asthma, take your child to an allergist/immunologist for a proper diagnosis. Allergists/immunologists are specialists who are specifically trained to manage the prevention, diagnosis and treatment of allergies and asthma.

For any child with asthma, the severity of the disease can change over time and it may result in a severe asthma exacerbation, or attack. If your child has asthma, it's important that an allergist/immunologist defines the severity because proper treatment will differ depending the classification.

Asthma management for children
Currently there is no cure for asthma. But for most children, asthma can be controlled with appropriate management and treatment. While asthma is a chronic illness, it should not be progressively debilitating disease. When appropriate treatments and careful avoidance measures are practiced, children with asthma can participate in regular activities.

Asthma and allergies
Most children with asthma also have allergies. Allergy testing is recommended for children with persistent asthma who are exposed to perennial indoor allergens. Allergy testing can be helpful for diagnosing relevant allergic factors that may contribute to asthma severity. This will help identify and prioritize recommendations for controlling exposure to allergens.

When allergies and asthma do strike, early treatment is essential. If allergies, and especially asthma, are left untreated and allowed to progress unchecked, permanent damage can be done to the airways. This makes it difficult to bring the condition under control and improve quality of life for the patient.

Research has proven that early treatment does prevent further progression and control allergies and asthma. For children, early treatment could mean the difference between sitting on the sidelines at soccer games and fully participating with their team.

It is important for your child to avoid his/her triggers, work with an allergist/immunologist to create a management plan, and take appropriate medications as prescribed. Together, you, your child and an allergist/immunologist can work to ensure that asthma does not take control.