Asthma in Children: A Guide for Parents

Understanding Asthma

Asthma, a chronic respiratory condition, is one of the most prevalent chronic diseases affecting children worldwide, including Canada. In a study conducted during 2011-2012, approximately 3.8 million Canadians were diagnosed with asthma. Children and youth were found to have a 62% higher proportion of diagnosed cases compared to adults. Asthma triggers inflammation, swelling, and narrowing of the airways when exposed to specific stimuli, making it difficult to breathe. Triggers may include catching a cold, inhaling pollen, or encountering other irritants. This non-communicable and non-curable condition varies in symptoms from occasional coughing to severe breathlessness. While it can persist into adulthood and lead to lung damage, effective treatment can manage symptoms and prevent harm to the lungs. The exact cause of asthma is complex, likely involving both genetic and environmental factors.

Which Children are more likely to have asthma and how to reduce it?

Certain factors elevate the risk of asthma in children:

• Secondhand Smoke Exposure: Avoid exposing children to secondhand smoke, especially during pregnancy.
• Genetics and Ethnicity: Genetic predisposition, family history, and ethnicity (e.g., Black and African Americans, Puerto Ricans) contribute to vulnerability.
• Obesity and Allergies: Obesity and allergies increase the likelihood of asthma.
• Respiratory Infections: Frequent viral respiratory infections during early childhood can raise the risk.
• Gender and Pollution: Boys are more prone to childhood asthma as compared to girls, where girls are more prone to asthma in their teen years. Living in areas with high air pollution amplifies the risk.
• Indoor Pollution: Indoor pollutants like solid cooking fuels and dust can trigger asthma.
• GERD: Children with Gastroesophageal Reflux Disease (GERD) are at an increased risk.

Diagnosing Childhood Asthma

A medical doctor diagnoses asthma based on a physical exam, medical history, chest x-rays, and pulmonary function tests. Parents should consult a healthcare provider right away if their child experiences:

• Persistent Cough: Coughing that's continuous, intermittent, or linked to physical activity.
• Prolonged Wheezing: Wheezing sounds during breathing.
• Shortness of Breath: Rapid breathing or complaints of chest tightness.
• Bronchitis or Pneumonia Episodes: Repeated instances of bronchitis or pneumonia.

Identifying Asthma Triggers

Asthma triggers worsen symptoms. Common allergens, like dust mites, molds, pets, and pollen, can cause allergic reactions in the airways. Non-allergic asthma can be triggered by cold air, certain medications (mostly NSAIDs, for example Ibuprofen), tobacco exposure, and air pollution. Exercise-induced asthma, provoked by physical activity, often occurs during cold seasons.

Managing Asthma

Collaborate with your healthcare provider to establish an effective treatment plan for your child:

• Trigger Avoidance: Minimize exposure to allergens and triggers. For example, if your child is allergic to cats, limit exposure to them.
• Control Medications: These reduce symptoms and airway inflammation.
• Quick Relief Medications: Provides relief during asthma attacks; inhalers are commonly used.
• Lifestyle Changes: Encourage regular physical activity if symptoms are controlled. Maintaining a healthy weight can reduce medication needs.

Asthma's Outlook in Children

Many children outgrow asthma, but relapses are possible in 1 out 4 children. Children with severe asthma may retain it into adulthood. Risk factors for persistence and relapse include female sex, development of asthma at a younger age, and sensitivity to household dust mites. Although asthma-related deaths occur, most are preventable with treatment. A favorable prognosis depends on access to treatment and adherence to the treatment plan.

Summer Safety and Heat Warnings

As summer approaches, it's crucial to stay aware of heat-related health concerns. High temperatures can pose risks, especially for children and infants. Here are some summer safety tips:

• Stay Hydrated: Ensure your child drinks plenty of fluids to prevent dehydration.
• Limit Outdoor Play: During peak heat hours, limit outdoor activities to prevent heat exhaustion.
• Protect from the Sun: Use sunscreen, hats, and lightweight clothing to shield from harmful UV rays.
• Cool Indoor Spaces: Create cool environments at home to escape the heat.
• Recognize Heat Warning Signs: Be vigilant for symptoms of heat-related illnesses like heatstroke and heat exhaustion.

References:

1. Merck Manuals - Asthma in Children
2. Mayo Clinic - Childhood Asthma
3. MedlinePlus - Asthma in Children
4. Journal of Applied Pharmaceutical Science - Asthma
5. Health-InfoBase Canada - Asthma Blog

Authored By:
Dr. Alireza Sarmadi
Family Physician
Iran