Doctor Reza - The Specialist in Treatment of Childhood Asthma

What Is Childhood Asthma?

Asthma is a condition that affects the airways (bronchi) of the lungs. The airways become narrower than normal. This causes the typical symptoms. When it affects children less than 12 years old, it is called childhood asthma.

It is the most common chronic condition in children in developed countries.

Asthma runs in some families, but many people with asthma have no other family members affected.

Risk Factors for Children
  • Viral infections, which keep recurring - they pick up from either adults at home or from other children in nursery, crèche or school
  • Pollution - especially in polluted cities, like Kolkata. Indoor pollution, where present, also aggravates the disease
  • Cigarette smoke
  • Family history - of either asthma itself or allergies and eczema
  • Stress - very important in the modern era, especially with parents wanting children to perform better in school and indirectly/directly causing harm.

However, not every child with asthma will have such a background.

Symptoms Of Asthma in Children
  • Wheezing
  • Chest tightness
  • Breathlessness
  • Chronic dry cough
  • Waking up at night because of the above
  • Breathlessness on exercise or on playing games
  • Recurrent coughs and colds
  • Repeated blocked and runny nose leading to a cough, which refuses to go away and the child is stressed due to the cough.
Cause Of Asthma in Children

Asthma is caused by inflammation (swelling) in the airways. The inflammation irritates the muscles around the airways and causes them to squeeze (constrict). This causes narrowing of the airways. It is then more difficult for air to get in and out of the lungs. This leads to wheezing and breathlessness. The inflammation also causes extra mucus to be produced, which causes cough and further obstruction to airflow.

What Worsens Asthma Symptoms in Children (important to identify and treat/prevent)
  • Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
  • Respiratory infections, such as common cold, coughs and chest infections
  • Physical activity (exercise-induced asthma)
  • Cold air and changes in atmospheric pressure
  • Air pollutants and irritants, such as smoke, cigarette smoke and pollution. You have to be extra careful if you are living in polluted cities like Kolkata, New Delhi, Manila, Jakarta, etc.
  • Strong emotions and stress, even laughing, may trigger symptoms
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • House dust mite – This is a tiny creature that lives in mattresses and other fabrics around the home
  • Certain food – this is uncommon and not thought to be a trigger in most cases.
Diagnosis

Requires a detailed diagnosis of the background and precipitating factors. The chronological sequence is important to differentiate it from other diseases, which resemble asthma in children.

A thorough clinical examination followed by some tests help.

A Peak Flow Meter may be advised to help confirm that symptoms are due to asthma.

Lung Function Test with reversibility will be done to confirm the diagnosis - especially in children above the age of 5, although some smart kids as young as 3 can do the test, where all they have to do is blow into a tube.

A routine chest x-ray and some blood tests may help.

What is a Peak Flow Meter? The peak flow meter is a small device that you blow into. It measures the speed of air that you can blow out of your lungs. If you have untreated asthma, then typically you will have low and variable peak flow readings.

Treatment of Childhood Asthma
  • Inhalers (Very safe, Very effective) - Inhalers deliver a small dose of medicine directly to the airways. They are of two types:
    1. Reliever inhalers (Salbutamol) – take as and when required. The medicine in reliever inhalers relaxes the muscle in the airways. This makes the airways open wider and symptoms quickly ease. If you often need a reliever inhaler (once a day or more), then you should take a ‘preventer inhaler’. THEY DO NOT TREAT ASTHMA.
    2. Preventer inhalers (steroids) - take daily. The medicine in preventer inhalers is usually a steroid. Steroids work by reducing the inflammation in the airways. It takes 7-14 days to build up its effect. So it will not give any immediate relief of symptoms. The minimum dose of these inhalers is to be used so that growth is not affected.
  • Tablets or liquid medicines to open up the airways (used infrequently) - Tablets or liquids are sometimes prescribed, which contain similar medicines to those in the reliever inhalers. Most people do not need these, as inhalers usually work well and cause fewer side effects. In a small number of cases, they are prescribed in addition to inhalers if symptoms are not fully eased
  • Steroid tablets - A short course of steroid tablets is sometimes needed to control bad attacks of asthma. Steroid tablets are good at reducing the inflammation in the airways. Some people worry about taking steroid tablets. However, a short course of steroid tablets (a week) usually works very well and has few side effects.
Goals of Asthma Management in Children

TO HAVE A HEALTHY CHILD WHO PLAYS AND STUDIES AND GROWS NORMALLY BUT HAS MINIMUM SYMPTOMS OF A VERY LOW DOSE OF SAFE AND EFFECTIVE MEDICINES.

MONITORING OF A CHILD WITH ASTHMA -

REGULAR VISITS TO THE CHILD SPECIALIST EVEN WHEN NO SYMPTOMS ARE PRESENT AND EARLY VISITS WHEN EVEN MILD PROBLEMS OCCUR.

Remember
  • The dose of the preventer inhaler may need to be increased if you have a cough or cold
  • If exercise or sport causes symptoms, then a dose of reliever inhaler just before the exercise usually prevents symptoms
  • For many children, Asthma is variable with some good and some bad spells. Some people are worse in winter months, others in summer
  • There is no cure for Asthma but I, your pulmonologist, can keep you well
  • Children with Asthma will benefit from a smoke-free home - stop smoking, if your children have Asthma.
Important Note

It is the job of your asthma specialist to train you, in such a way so that you can manage your asthma yourself, safely and effectively.

** This site is for patient information only **