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Pediatric asthma

Alternative Names:

Asthma - pediatric

Treatment:

You and your child's pediatrician or allergist should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms. You should also have an emergency plan that outlines what to do when your child's asthma flares up.

MEDICATIONS

There are two basic kinds of medication for the treatment of asthma:

Long-term control medications are used on a regular basis to prevent attacks, not for treatment during an attack. Types include:

Sometimes a combination of steroids and bronchodilators are used.

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

Although these are the same medications used to treat adults, there are different inhalers and dosages especially for children. In fact, children often use a nebulizer to take their medicine rather than an inhaler, because it can be difficult for them to use an inhaler properly.

Children with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms.

A child who is having a severe asthma attack should be immediately seen by a doctor. The child may need to stay in the hospital, and may be given oxygen and medicines by an intravenous line (IV).

ELIMINATING TRIGGERS

You and your family can help control a child's asthma by helping get rid of the indoor triggers that make symptoms worse.

Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry smoke residue in and on their clothes and hair -- this can trigger asthma symptoms.

Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms -- this helps reduce the possibility of cockroaches, which can trigger asthma attacks. Bedding can be covered with "allergy proof" polyurethane-coated casings to reduce exposure to dust mites. Detergents and cleaning agents in the home should be unscented.

All of these efforts can make a significant difference to the child with asthma, even though it may not be obvious right away.

AIRWAY MONITORING

A peak flow meter is a simple device that you can use at home to monitor lung function. The meter can help you see if an attack is coming, sometimes even before any symptoms appear. This allows you to take preventative measures. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of the child's personal best results mean a moderate asthma attack is occurring or going to occur, while values below 50% suggest a severe attack.

However, many children under age 5 can't use a peak flow meter well enough to make the numbers useful, so their asthma must be managed by an adult who needs to watch carefully for the asthma signs. The age 5 "cutoff" is somewhat random, however, and can be adjusted based on the abilities of the individual child. It's a good idea to start using peak flow meters before age 5 to get the child used to them, but not to actually rely on them too much for monitoring the child's condition.

Expectations (prognosis):

With proper treatment and a team approach to managing asthma, most children with asthma can live a normal life. Asthma, however, can be a life-threatening disease. It is important for families to work together with health care professionals to develop a plan to properly care for the child.

Complications:

The complications of asthma can be severe. Some include:

Calling your health care provider:

Call your health care provider if you think that a child has symptoms of asthma. It is very important for asthma to be diagnosed and treated early in order to reduce the risk of complications. If your child is having trouble breathing or having an asthma attack, seek medical attention immediately.

Peak flow meter

Peak flow meter

Lungs

Lungs

Normal versus asthmatic bronchiole

Normal versus asthmatic bronchiole

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