Managing asthma in children | Tips to control asthma symptoms

Asthma is a relatively common chronic lung disease that can develop even in infancy. This chronic condition has become increasingly common in the past decade. It is believed that the increase in air pollution, environmental smoke etc. might have contributed to the rising incidence of this problem. It is believed that in India, approximately 6% of children have asthma, this statistic may not be accurate as even today, a large number of cases go unreported or undiagnosed. In this article, we will learn about Asthma in children, how to identify its early signs and the best ways to manage this condition in children.

What is Asthma?

Asthma is a chronic condition which causes inflammation in the airways and lungs, especially when you inhale any “triggers”. Triggers are any stimuli which can increase the inflammation in the lungs and airways, making it difficult or impossible to breathe. These triggers range from inhaling pollen, infections, second-hand smoke etc.

Asthma can affect people of any age; however, childhood asthma has unique challenges associated with it. This is because the “patient” (child) does not really understand the condition to take precautions and care that adults with the condition would. It can also decrease the quality of life of the child as it can severely limit their lifestyles such as participation in play and sports. It can also interfere with their normal sleep. Hence as parents, it is extremely important to know the early signs of the condition and get the proper care to keep the symptoms under control. Asthma attacks can be extremely dangerous and might require hospitalisation.

What causes Asthma in children?

Causes of asthma in children is still quite unclear. Research suggests that it could be a combination of genetic and environmental factors such as inherited allergies, parents with asthma, ethnicity, any infection affecting the airways during childhood, second-hand smoke inhalation, air pollution etc. Underlying conditions such as childhood obesity, GERD also have been linked to childhood asthma.

How to identify asthma in children?

One of the main challenges with childhood asthma is that the child himself/herself will be unable to identify the symptoms or early signs of asthma. Many children will start showing signs of asthma before the age of five. Here are some of the early symptoms of asthma in children that you should watch out for:

• Coughing
• Wheezing (sounds like a high pitched whistling sound every time the child exhales)
• Shortness of breath
• Tightness or discomfort in the chest
• Difficulty in sleeping

These symptoms will worsen when the child is exposed to any triggers. Such instances are called asthma “flare-ups”. These triggers can be any of the following and vary from child to child:

• Infections in the respiratory system such as common cold
• Exposure to allergens such as dust, pollen, fur etc
• Physical exertion or play
• Feeding in infants
• Exposure to secondhand smoke or other air pollutants
• Crying or laughing
• GERD (heartburn or acid reflux)
• Change in weather

In some cases, you may have to rush your child to the hospital for emergency treatment. If you notice the following signs, take your child to the emergency room immediately:

• Gasping for air
• Trouble speaking due to difficulty in breathing
• Breathing in so hard that the tummy goes in

Is there a cure for asthma?

Asthma is a chronic condition, and treatment protocol is aimed at managing the symptoms and flareups. This includes:

• Treatment for inflammation in the airways with regular medication to avoid asthma attacks or flareups.
• Short-acting medications which are also called short-acting bronchodilators are used to provide immediate relief from the symptoms of asthma. Their effects usually last between four to six hours. In case the child has only mild symptoms of asthma, this may be the only treatment needed.

If the child becomes overly dependent on short-acting medications and has to consume them too often, long term medications can be used to manage the symptoms over time. These include inhaled corticosteroids, leukotriene modifiers, long-acting beta-agonist, cromolyn and oral corticosteroids. Consult your child’s paediatrician before giving your child any type of medication, long term or short term.   

Most of the aforementioned medications are generally administered via metered-dose inhalers. You can use attachments such as a valved holding chamber with a mask or a nebulizer to make it easier for your child to use the inhaler.

Read: Vaccinating your child – What you need to know?

Steps to control asthma symptoms in children

For parents with asthmatic children, managing symptoms of asthma as well as preventing future flareups can be quite difficult. It is also extremely important to take steps during childhood itself to stop further inflammation of the airways and lungs. The following tips can help you stay ahead and let your child live and play to the fullest:

Create an asthma action plan

An asthma action plan will help you react faster and better to any asthma symptoms as and when they manifest. Your child’s paediatrician is the best person to help you come up with this plan. The plan should include step by step instructions about the short-term and long-term medications and when to take them, things to do between flareups, how to identify and manage triggers as well as how to identify when a trip to a hospital is required.

Monitor and record symptoms, flareups and treatment

Diligently recording asthma attacks as well as the treatments that your child is undergoing will help you identify what triggers your child’s asthma as well as what form of treatment is working best for him/her. These records will also help your child’s doctor determine whether short-term medication or long-term medication is best suited for your child. The record should include:

• Time, duration and circumstances of any flareup
• How your child responds to the asthma treatment
• Any the side effects that your child experiences because of the asthma medication
• If there are any changes in your child’s sleeping pattern or activity levels

Minimise exposure to triggers

Identifying and minimising exposure to all the stimuli which trigger an asthma attack in your child is perhaps one of the most essential aspects of long-term management of asthma. Taking into account the environmental factors in play whenever your child experiences an asthma attack can help identify if they are triggered by dust, pollen, animal fur, smoke, infection etc. In some cases, excessive crying or laughing can also cause an attack. The following steps can help you minimise this risk:

• If you have a pet, clean all surfaces thoroughly for fur and dust
• Teach your child to wash hands regularly to minimise the chance of getting infections
• Teach your child about what to avoid
• Remove any chemicals such as cleaning products that might act as an irritant

As your child grows older, teaching them what to stay away from, how to react to asthma attacks and precautions to take is extremely important. You can also do an allergy panel to identify what other allergens can be harmful for your child. Routine visits to the paediatrician would help in monitoring your child’s condition and prevent it from becoming worse. You can book a consultation and a comprehensive health check-up for your child under the care of our paediatric experts at the CK  Birla Hospital, Gurgaon.

Read: What makes kids picky eaters and what may help them get over it