A B C D E F G H I J K L M N O P R S T U V W

ASTHMA IN CHILDHOOD

What is Asthma in Childhood ?

The windpipe (trachea) carries each breath of air to the lungs. The trachea divides into two and goes to each lung. Smaller and smaller tubes (airways) carry the air to the tiny spaces in the lungs where oxygen is absorbed into the blood. Asthma is a condition which narrows the small airways in the lungs and makes breathing more difficult. During an attack the muscles in the walls of the airways contract and make the airways narrower. The airways become inflamed and are made narrower still by swelling of its tissues and fluid secretions which line the wall of the tubes. Asthma in children can show itself in different ways: by wheezing (noisy breathing); a persistent cough, sometimes worse at night; coughing and wheezing each time the child gets a cold and by getting unusually out of breath, for example when doing sports. Some children only have these problems occasionally, while some have problems with their asthma every day. About one in 10 children have symptoms of asthma at some time.

How does Asthma in Childhood occur ?

A lot of things can provoke asthma. In children, colds and other viruses are a very common cause. Exercise, changes in the weather, cigarette smoke, excitement and stress may provoke attacks. Some children have an allergy which brings on an attack, such as house dust or house dust mites (microscopic insects that live in house dust), pollen, fur, feathers, certain medicines (including aspirin) and some foodstuffs. For many children there is no clear cause for their attacks.

Why does Asthma in Childhood occur ?

The tendency to asthma can run in families. Other members of the family may have asthma, hayfever or eczema. Asthma is caused by an over reaction of the body’s normal immunity (defence) against certain « foreign » agents.

Treatment Involved for Asthma in Childhood

Treatment will depend on how bad the symptoms are and how often they occur. The doctor will help identify whether anything appears to cause the attack. Allergy testing may not be very helpful in identifying the cause for asthma. There are a lot of different treatments for asthma and the doctor will try to suggest one which suits your child. Treatments will need to be changed every so often. Avoiding factors which trigger asthma If there is a factor which triggers an attack it is best to avoid it - for example, reducing dust in the house for a child who is sensitive to house dust mite, or avoiding animals if they provoke attacks. For many children this is impossible or else there is no obvious cause. Parents are often made to feel guilty by people who tell them that changing the child’s diet or their environment will cure the asthma. This is very rarely the case. However, if you smoke in the house, this is a good reason to give up!

Inhalers that relieve the symptoms, such as terbutaline and salbutamol. These relax the muscles in the airways, and relieve the narrowing. They can be given regularly or only when there is a problem. Your doctor may suggest starting treatment when your child gets a cold, to try to prevent an attack. If there is wheezing with exercise, the child can take some before they start. Inhalers that prevent attacks, like budesonide or beclomethasone (inhaled steroids). These act to stop the reaction that triggers an attack. These drugs must be taken regularly even when the child is well. They are given as an inhaler so that the maximum reaches the lungs and very little steroid is absorbed into the body. It is important that your child has an inhaler that suits them. Inhalers may give the medicine as a powder or as a liquid (aerosol).

Younger children find it difficult to breathe in and out to order, and need a “spacer”. A spacer is a large plastic bubble - the medicine is sprayed in at one end and the child breathes in and out through the other. Even very young children can manage this. Children need a lot of help and encouragement to take their inhalers regularly. For a bad attack of asthma medicine may be given through a machine called a nebuliser. This allows the child to inhale the medicine as very fine droplets. This is often given in the GP’s surgery, or in hospital. Your doctor may prescribe a short course of a steroid tablet (prednisolone). This will treat the attack and is not likely to produce side effects because it is only given for a few days.

During Treatment of Asthma in Childhood

In older children a machine for measuring the strength of a puff of breath can be used. This is called a peak flow meter. It gives a measurement of how much the airways are narrowed. Treatment may be changed if the reading is low. When should you call the doctor? If your child has a bad asthma attack, it is much better to call for help at an early stage. Your child should see a doctor urgently, if despite your treatment the wheeze or shortness of breath is getting worse.

After Treatment of Asthma in Childhood

Many children grow out of their asthma as they get older. Very few go on having severe attacks when they are adults.

If Asthma in Childhood is Left Untreated

If asthma is not properly controlled it interferes with normal activity and education. Children with very badly controlled asthma may not grow normally. If a very severe attack of asthma is not treated, the child could die. It is important to seek help if the child is getting increasing problems with their asthma.

Effects on Family of Asthma in Childhood

The diagnosis of asthma can cause a lot of worry to parents. Asthma cannot be cured but there are very effective treatments. Most children grow out of it. Encourage your child to take part in sports and normal activities.

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