Asthma in Children
Asthma in Children
If your child coughs often at night, becomes short of breath when running, or has a cough and wheezing that lingers for a long time especially after upper respiratory tract infections, asthma or airway sensitivity may lie behind these signs.
Asthma in children is a chronic airway disease that follows a course of repeated narrowing and inflammation in the airways. The signs may not look the same in every child. In some children wheezing and shortness of breath are the most noticeable complaints, while in others the only sign may be a long-lasting or repeating cough.
For this reason it is important that repeated breathing complaints in particular are evaluated by a specialist in child health and diseases.
How Is Asthma Recognized in Children?
Among the most common signs of asthma in children are the following:
- Repeated coughing
- Coughing that appears especially at night or toward the morning
- Wheezing or whistling breathing
- Shortness of breath
- A feeling of tightness in the chest
- Coughing or shortness of breath that starts after running and exercise
- A cough and wheezing that drag on after upper respiratory tract infections
One of the important features of asthma signs is that instead of staying at the same level all the time, they can appear in episodes.
For this reason, hearing normal lung sounds during the child's examination may not be enough on its own to rule out asthma. The episodes the child has had before, when the cough appears, whether the wheezing comes back again and again, and the situations that trigger the signs all matter for the diagnosis.
Is Every Cough a Sign of Asthma?
No.
A cough in children can have many causes, from infections to reflux, and from allergic conditions to different airway problems.
However, if the cough:
- Keeps coming back
- Becomes more noticeable at night or toward the morning
- Appears with running and exercise
- Comes together with wheezing or shortness of breath
- Continues for a long time after every upper respiratory tract infection
then an evaluation for asthma and airway sensitivity may be needed.
Why Does Asthma Develop in Children?
There is no single cause behind the development of asthma in children.
Genetic predisposition, an allergic makeup, viral infections the child has had and environmental factors can all play a part together.
In particular, asthma, allergic rhinitis (hay fever) or similar allergic conditions in the mother, father or siblings can raise a child's risk.
House dust mites, pollens, molds and animal-related allergens can trigger the signs in sensitive children. Exposure to cigarette smoke is also one of the important environmental risks for children's airways.
Which Children Have a Higher Risk of Asthma?
In the preschool years it is possible for children to have frequent upper respiratory tract infections and to wheeze from time to time during these infections. Not every child who wheezes will have asthma in later years.
Even so, the following are among the factors taken into account when the likelihood of asthma developing is evaluated:
- Repeated wheezing episodes
- Hospital visits because of severe wheezing or bronchiolitis
- A family history of asthma
- Atopic dermatitis or eczema
- Allergic rhinitis
- Wheezing that is also seen during periods without infection
- Allergic sensitivity being detected
How Is Asthma Diagnosed in Children?
Asthma in children is not a diagnosis made with a single blood test or a chest X-ray alone.
The child's detailed history and the physician's examination form the basis of the evaluation.
Information such as when the cough started, whether it appears at night, whether wheezing and shortness of breath keep coming back, its relationship with exercise, the infections the child has had, and the family history of asthma and allergy are all evaluated together.
Depending on the child's age and clinical condition, pulmonary function tests, allergy evaluations and other investigations may be used when they are considered necessary.
Because it may not always be possible to perform pulmonary function tests in younger children in particular, clinical follow-up can become even more important.
Can Asthma in Children Be Treated?
Yes. With suitable treatment and regular follow-up, asthma in children can largely be kept under control.
The aim of asthma treatment is not only to make the cough or the wheezing go away for a while.
The main goals are:
- To keep the child's complaints under control
- To prevent asthma attacks
- To keep night sleep from being disturbed
- To reduce unnecessary emergency room and hospital visits
- To keep the need for medication at the most appropriate level possible
And to make it possible for the child to carry on with school, play and daily life just like peers.
Put another way, the goal in asthma treatment is not to keep the child outside of life because of the condition; it is to control the condition so that the child can carry on with a normal life.
What Should Be Done in the Treatment of Asthma in Children?
Asthma treatment is not the same for every child. The treatment plan is built by evaluating the child's age, how often and how severe the signs are, the attacks the child has had, any accompanying conditions and the possible triggers.
When needed, inhaled medications that are delivered directly to the airways may be used in treatment.
Some of these medications are preventive treatments aimed at keeping the signs and attacks under control. Others are relief medications used to ease complaints when they appear.
Which medication will be used, when, for how long and with which device should be decided for each child individually.
Using inhaled medications with the correct technique is especially important in children for the treatment to work. Depending on age, a suitable spacer device or mask may be needed.
For this reason the family should not just be handed a prescription; they should also be shown how the medication is to be given.
Can Asthma Medication Be Stopped When the Child's Complaints Go Away?
The child's cough or wheezing going away may not mean that the condition has disappeared completely.
Complaints disappearing may show that the treatment has brought the condition under control.
For this reason, reducing or stopping a regularly used asthma medication should be planned with a physician's evaluation. A family stopping the treatment on its own decision can cause the signs to come back or an attack to develop.
Do Asthma Medications Cause Dependence?
Using the medications in asthma treatment regularly does not mean that these medications cause dependence.
Some asthma medications need to be used regularly for a certain period in order to work. How long the treatment will continue is evaluated by the physician according to how well the child's condition is controlled and the findings at follow-up visits.
Can a Child With Asthma Do Sports?
Asthma that is under control is not an obstacle to a child moving around and doing sports.
The aim is for children with asthma to play, take part in physical education classes and be physically active just like their peers.
However, if constant coughing, wheezing or shortness of breath appears during running or exercise, the treatment may need to be evaluated again.
What Should Be Considered at Home for a Child With Asthma?
One of the important parts of asthma treatment is identifying the environmental factors that make the child's signs worse.
In children with allergic sensitivity in particular, house dust mites, pollens, mold and animal-related allergens should be evaluated.
It is extremely important that the child is not exposed to cigarette smoke. Smoking next to the child or in a different room of the home should not be considered a safe option.
Rather than applying the same environmental measures for every child, it is a more accurate approach to determine which factors the child is sensitive to and to plan the measures accordingly.
Does Asthma in Children Go Away?
The answer to this question is not the same for every child.
In some of the children who wheeze along with infections, especially in the preschool years, the complaints may lessen or disappear completely as they grow. In other children, airway sensitivity and asthma signs may continue into later years.
Many factors, such as the child's family history, allergic makeup, how often wheezing happens and in which situations it appears, are important for the course of the condition.
For this reason it is not right to put off the evaluation of repeated breathing complaints with the thought that "it will go away as the child grows anyway."