Asthma: An Overview

What is asthma?

Asthma is a condition that affects your child’s lungs. The most common signs of asthma are wheezing, coughing, and trouble catching your breath. These signs can also occur with other health problems. Therefore, at first, it might be difficult for your doctor to make a diagnosis of asthma, espe­cially in babies and young children.

Asthma may affect your child’s lungs for the rest of his life. Sometimes your child will feel better. Other times your child will feel worse because of the asthma.

For in-depth information about asthma, please see the AboutKidsHealth Asthma Resource Centre

When your child’s asthma becomes a problem

When your child’s asthma becomes a problem, his airways get much narrower. When this happens, your child has problems getting air in and out of his lungs.

Narrowing of Airways in Asthma
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During an asthma attack, the muscles around the airways get tight. The airways become narrow, making it hard to breathe.

Three things happen to narrow the airways when your child has a problem with asthma:

  1. The lining on the inside of the airways gets thick and swells. You will hear this called inflammation.
  2. The muscles around the airways get tight. You will hear this called bronchospasm or bronchoconstriction.
  3. The airways make a lot of clear, thick liquid called mucus. This mucus is thicker than normal and may block the airways.

Helping your child feel better

There are some ways that you can help your child feel better:

  • Learn more about your child’s asthma by reading this page, reading other resources on asthma, and asking your doctor questions.
  • Make sure that your child takes all medicines exactly as your child’s doctor tells you to.
  • Know what triggers your child’s asthma and try to stay away from these things. Triggers are things that make your child’s asthma worse.

Triggers make your child’s asthma worse

Triggers are things that make your child’s asthma worse. Every child with asthma is bothered by different triggers. Work with your child’s doctor to find out which triggers bother your child, and how your child can stay away from these triggers.

These are some common triggers:

  • infections, such as colds and flu
  • cigarette or tobacco smoke
  • wood and oil smoke
  • things that cause allergic reactions
  • pets
  • air pollution
  • humid weather
  • cold weather
  • medicine, such as ASA (Aspirin) or ibuprofen
  • strong odours or sprays
  • exercise

Asthma medicines

Medicines for asthma can keep your child’s lungs healthy and keep your child’s asthma from getting worse. These medicines do not cure asthma, but they can help keep your child’s lungs healthy.

Many of the medicines that your child may take for asthma are breathed in. The medicines that are breathed in are called inhaled medicines. Some of the best inhaled medicines for asthma are called corticosteroids.

Inhaled medicines have been shown to be very safe in children with asthma. Your child can use them for years and grow to a normal adult height.

After taking an inhaled medicine, your child should rinse the mouth or take a drink of water or juice. This helps stop any thrush in the mouth.

The main types of inhaled medicines that your child may take for asthma are called controllers and relievers.

Controller medicines for asthma

A controller is a medicine that stops the lining in the airways from swelling. Your child will have less swelling and mucus when he uses a controller every day. Examples of inhaled controller medicines are beclomethasone (Qvar), budesonide (Pulmicort), budesonide plus formoterol (Symbicort), ciclesonide (Alvesco), fluticasone (Flovent), and fluticasone plus salmeterol (Advair). An example of a pill form of controller medicine is montelukast (Singulair).

Your child should take a controller every day, even if he seems well. Make sure your child keeps using the controller until your doctor tells you it is OK to stop.

Reliever medicines for asthma

A reliever helps treat the signs of asthma such as a cough or wheeze.

A reliever relaxes the muscle that goes around the airway. When the muscle relaxes, the airway opens. When the airway opens, your child will be able to breathe more easily. Examples of reliever medicines are salbutamol​ (Airomir or Ventolin) and terbutaline (Bricanyl).

Your child should use a reliever when he is having problems with asthma. When your doctor says your child is better, he should stop using the reliever every day. Your doctor may tell your child to use a reliever before he exercises.

Early warning signs that your child’s asthma is getting worse

Problems with asthma can start slowly over hours or days. The small changes that happen in your child’s body when he is having problems with asthma are called early warning signs.

Early warning signs are different for each child. You may find that they are not easy to see. Here are some common early warning signs.

Things that you can see or hear in your child

  • a cough that will not go away
  • coughing until vomiting
  • coughing at night
  • wheezing
  • trouble catching his breath
  • tired soon after beginning to play or exercise
  • breathing faster than usual
  • grumpy, cranky, out of sorts
  • signs of a cold
  • sneezing

Things that your child may tell you

  • “I’m tired.”
  • “My chest hurts.”
  • “It is hard to breathe.”
  • “There’s a funny noise (wheezing) when I’m breathing.”

What you should do if your child has any early warning signs

If you see any of these early warning signs, follow the action plan that you made with your doctor.

If you do not have an action plan, talk to your doctor about making one.

Danger signs that your child’s asthma is getting worse

If your child has any of the danger signs listed here, make sure you follow the action plan that you made with your doctor.

  • unable to stop coughing and vomiting
  • having trouble talking
  • feeling unusually sleepy, difficulty waking him up
  • lips or skin looking blue
  • skin sucking in (indrawing) on the neck or chest as your child breathes

Have your child take his reliever medicine just as your child’s action plan says to.

Go to the nearest emergency department, or call an ambulance.

Asthma and exercise

Your child with asthma can be active and play sports. All children should play and exercise. Your child needs to stay fit and needs to play with other children.

Exercise can make some children’s asthma worse

We know that exercise can make some children’s asthma worse. Children can get the warning signs of asthma during exercise or after exercise.

There are things your child can do for his asthma while exercising:

  • Your child will have less problems with exercise if he is taking regular controller medicines.
  • Make sure your child always starts and ends any exercise with easy, gentle exercises. These are called warm-up and cool-down exercises.
  • Your doctor may tell your child to take his reliever medicine before exercising. Remember, a reliever medicine helps treat the signs of asthma such as a cough or wheeze. If your child uses this medicine 15 or 20 minutes before exercising, it may make the warning signs of asthma less.
  • If your child’s asthma gets worse when he exercises, your child should exercise for a short time and take breaks in between exercises.
  • If your child starts to wheeze while exercising, he should stop the activity. Your child should then follow the action plan that you made with your child’s doctor.

Important things to remember

Even when your child seems better, he may have swollen airways for 6 to 8 weeks or longer after his asthma was a problem. Your child should keep taking his controller medicine.

You should follow the action plan that you made with your doctor. The action plan is a written plan that tells you and your child what to do every day to manage the asthma. This plan also explains what to do if your child’s asthma gets worse.

You can help stop another problem with asthma if you try to keep your child away from the things that make his asthma worse (asthma triggers).

If your child is 6 years or older, ask your doctor about a “blowing” test for asthma called pulmonary function testing. This test is used for diagnosis and monitoring of asthma.

In an emergency

See a doctor right away if:

  • reliever medication does not work, or last for 4 hours OR
  • your child is not improving after 2 or 3 days, OR
  • your child is getting worse

Go to the nearest emergency department if:

  • your child is unable to eat, sleep, or speak due to symptoms, OR
  • your child’s breathing appears jerky, or is sucking in at the throat or below the ribs, OR
  • extra reliever medication does not work

Key points

  • The most common signs of asthma are wheezing, coughing, and trouble catching your breath.
  • When your child’s asthma becomes a problem, his airways get much narrower and he has trouble getting air in and out of his lungs.
  • Make sure that your child takes all medicines exactly as your child’s doctor tells you to.
  • Find out what triggers your child’s asthma and help your child stay away from these things.
  • If you see any early warning signs that your child’s asthma is getting worse, follow the action plan that you made with your child’s doctor.
  • Danger signs of asthma include trouble talking, unusual sleepiness or trouble waking up, lips or skin looking blue, and skin sucking in on the neck or chest as your child breathes. If you see any of these signs, have your child take his reliever medicine. Go to the nearest emergency department or call an ambulance.

Sharon Dell, MD, BEng, FRCPC

Bonnie Fleming-Carroll, RN, MN, APN

Colleen Wilkinson, RN, MS

10/16/2009
 




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