Childhood Asthma

Childhood asthma refers to the chronic inflammatory disorder of the airways and lungs that affect children.

Inflammation results from exposure to environmental triggers like

• pollen,
• dust,
• dander,
• or a respiratory infection.

Symptoms of childhood asthma affect the daily activities of the child including play, school, and even sleep.

If left untreated, childhood asthma may cause asthma attacks, which may be potentially dangerous.

The symptoms of childhood asthma often persist till adulthood. Treatment helps to manage the symptoms and to improve the quality of life. It also helps to prevent further damage to the lungs as the condition progresses. 

Symptoms of childhood asthma vary from child to child, and from episode to episode.

Some common possible signs and symptoms of this condition include

• Frequent spells of cough
• Lack of energy during playing
• Chest tightness or pain
• Wheezing or whistling sound during exhalation
• Shortness of breath
• Tightening of neck muscles
• Weakness

Shortness of breath often causes trouble in sleeping, particularly in small children.

Coughing and wheezing may also affect the quality of sleep.

Poor sleep affect their play time as they feel fatigued due to inadequate rest.

Respiratory infections like cold or flu worsen the symptoms like coughing and wheezing.

Recovery after the infection is also delayed. Children with this condition often feel weak or tired during play.

In small children, the main trigger for asthma is respiratory virus infection. As the child grows older, asthma may be triggered by allergies.

Many of the symptoms of childhood asthma resemble that of other respiratory conditions like infectious bronchitis.

Genetic and environmental factors, and certain respiratory infections are the main causes of Childhood asthma.

An overly sensitive immune system that produces an exaggerated response to certain triggers is also thought to be involved in the condition. The immune system responds to a trigger by causing swelling of the airways and increased production of mucus. In most of the cases the symptoms are generally delayed after exposure to the trigger. This makes the identification of trigger difficult.

Some common triggers of childhood asthma are

• Viral infections
• Environmental pollutants like smoke
• Allergy to dust mites, pollen, dander, and mold
• Exercise or physical activity
• Cold air

In some cases, no specific triggers can be indicated in the development of asthma. Some of the major risk factors for childhood asthma are

• smoke,
• allergic reactions,
• family history of asthma,
• increased air pollution,
• obesity,
• respiratory diseases,
• heartburn.

Making a diagnosis of Childhood asthma is done by performing several tests.

As the symptoms of childhood asthma are not specific, tests are suggested to rule out chances of other conditions with similar symptoms.

Moreover, certain conditions are associated with asthma, making diagnosis harder. In children older than 5 years, lung function test is recommended to confirm the diagnosis of asthma.

This test is taken at rest, after exercise, and after medication. It measures the amount of air in exhalation and the time taken for exhalation.

In children below 5 years of age, diagnosis is based on review of symptoms. In some children, diagnosis is made many months or years after observing the symptoms.

Allergy test is suggested in children with asthma caused by exposure to triggers. In this test, a small amount of allergen is pricked into the skin to check for signs of allergic reaction. 

Treatment of childhood asthma helps to reduce symptoms, disease flare ups, and the need for quick relief-inhalers as much as possible. It will also allow the child to indulge in their favorite physical activity without any restrictions.

Medications are based on age, symptoms, and triggers.

Preventive medications

Reduce the inflammation of the airways. They have to be taken every day for a long term to prevent flare ups, even when exposed to asthma trigger.

Corticosteroids like

• fluticasone,
• budesonide,
• ciclesonide

are used as inhalers for long-term. Leukotriene modifiers are oral medications for long-term protection from symptoms.

• Montelukast,
• zafirlukast,
• zileuton

are commonly prescribed leukotriene modifiers. Combination inhalers contain a long-acting beta agonists (LABA) and inhaled corticosteroids, and is recommended in cases that do not respond to other medications.

Theophylline is a medication used to keep the muscles of airways relaxed and to help in making breathing easier.

Quick-relief medications, or rescue medications

Open up the narrow passage way for improving breathing. It is prescribed during an asthma attack.

Short-acting beta agonists like albuterol and levalbuterol helps to open up the airway within minutes, and relieve the symptoms soon. Ipratropium is another quick-relief medication that helps to relax the airways and to improve breathing.

Oral and intravenous corticosteroids are also used as rescue medications to alleviate inflammation of airways. Immunomodulatory agents like mepolizumab is recommended in the treatment of eosinophilic asthma.

Allergy treatment

Is suggested specifically for asthma triggered by allergic response to triggers.

Omalizumab is a medication used in patients with allergies and severe asthma. This medication reduces the exaggerated response of the immune system to the triggers like

• pollen,
• dust mites,
• dander.

Antihistamines and decongestants, conventional allergy medications, are also helpful in controlling symptoms.

Immunotherapy is a method to desensitize the immune system to the trigger. The allergy shots in this method is given once a month for three to five years for effective control.

Having an asthma action plan is the best way to deal with childhood asthma. It helps to recognize the need for changing the dosage of long-term medications, check the response of the patient to medications, identify the signs of asthma attack, and to know when to seek medical care.

There is no standard way to prevent Childhood asthma other than controlling risk factors. Some steps that will be of help in preventing asthma include:

• Avoid smoking around the child
• Encourage physical activity
• Have regular checkups
• Ensure a healthy body weight
• Treat medical conditions that increase the risk of asthma

Many alternative treatment methods and remedies are suggested for the treatment of childhood asthma.

But almost all of them should be used with caution as more research is required to support the safety and efficacy of these methods.

Breathing techniques like

• Buteyko breathing technique,
• yoga, Papworth method

are worth trying to lessen the symptoms of asthma.

Acupuncture also is used to alleviate the symptoms of this condition.

Meditation, biofeedback, hypnosis and progressive muscle relaxation are different relaxation techniques that keep stress away, helping in reducing the symptoms of the condition.

Homeopathic remedies for childhood asthma depend on the specific symptoms.

• Chamomilla,
• pulsatilla,
• arsenic album,
• natrum sulph

are all prescribed in this system for airway inflammation and breathlessness. Herbal remedies are also suggested in reducing the symptoms of childhood asthma.

This includes

• beta-carotene,
• black seed,
• fish oil,
• magnesium.

Some simple lifestyle tips are of help in managing childhood asthma.

Dehumidifier is useful to maintain low humidity. Having a small-particle filtering system and cleaning the air conditioner regularly will prevent exposure to environmental triggers.

Reducing dust and pet dander decrease the normal triggers of asthma.

Cold air is also a trigger for asthma attack, and reducing the child’s exposure to cold prevents airway inflammation.

Having an asthma action plan helps to cope with the condition better. Keep the child’s caretakers, teachers, and helpers informed of the condition and the action plan.

Encourage the child to have medicines as a routine for long-term protection. Chat room, support groups, and message rooms provide opportunities to meet and discuss with parents of other children who are suffering from childhood asthma.

This will help the child to connect with others and also form a platform for parents to share their experiences and knowledge in coping with the condition.

There are several risks and complications associated with Childhood asthma.

Childhood asthma may cause permanent narrowing of the air passage, causing breathlessness and weakness. It affects the quality of sleep and cause fatigue.