Friday, 01 May 2015 03:29

Understanding Childhood Asthma

Written by  Sandra M. Gawchik, D.O.

It’s common and treatable, and yes, your child can enjoy an active kid’s life!

Sandra M. Gawchik, D.O. - Crozer-Chester Mecical CenterSpring is in full bloom. For most kids, this means sun, fun and outdoor sports. But for a child with asthma, it also means exposure to seasonal allergens—pollens from trees, grasses and weeds. And if that weren’t enough to trigger an asthma attack, mold is a constant presence in warmer months.

Plus, all those young equestrians at the Devon Horse Show are exposed to horse dander and dust in the stables and ring—even more triggers.

What is asthma? Asthma is a chronic condition caused by inflammation and narrowing of the bronchial tubes (passageways that allow air to enter and leave the lungs). It’s the same disease for adults as for children, and affects about 7 million American children, according to the Centers for Disease Control. Untreated asthma is a leading cause of school absenteeism and the leading cause of kids’ visits to the emergency room.

There are two types of asthma. Allergic asthma is caused by exposure to an allergen, such as pollen, pet dander, dust, dust mites, milk, eggs, peanuts or ingredients in certain medications. There’s often a family history of this type of asthma. Non-allergic asthma is caused by exposure to something that affects normal breathing, especially a viral respiratory illness, like a cold or flu.

Either type can be triggered by irritants like smoke or perfume, strong emotions, intense exercise or weather changes.

What are the symptoms of childhood asthma? Three of the most common symptoms are: 1) a change in normal breathing, such as coughing or wheezing, often interrupting sleep or play; 2) shortness of breath, chest tightness or rapid breathing (signs like the belly pumping hard or the pulling in of the muscles between the ribs or skin at the base of the throat); and before difficulty keeping up with other kids when playing.

If your child has asthma symptoms and repeated episodes of what’s been diagnosed as bronchitis or pneumonia, or is not responding to treatment for asthma (for example, repeated doses of oral steroids)—and is unable to sleep well, regularly attend school, run and play—then see an allergist. Allergists specialize in diagnosing and treating allergies and asthma.

Undiagnosed and untreated, childhood asthma can worsen as the lungs work harder and harder to breathe, posing a danger to growing lungs.

How is asthma diagnosed? The allergist will begin with a detailed medical history, including symptoms, medications and family history of allergies and asthma. Next come questions about the child’s environment at home and school (identifying triggers like household or school pets, smoking, dust, etc.), sleep patterns, school attendance and activities.

The doctor will perform a physical exam and, depending on the child’s age, a peak flow meter test or full lung function study, which involves blowing into a tube connected to a computer. Don’t worry, it doesn’t hurt! Allergy skin tests (skin pricks testing sensitivity to dander, dust, mold) may be done to identify specific allergies so triggers can be avoided.

How is childhood asthma treated? An effective treatment plan has several parts and is designed to treat symptoms and prevent asthma attacks. The allergist will explain how to identify and eliminate or control asthma triggers.

For a child with mild, intermittent asthma (symptoms less than twice a week), the doctor typically will prescribe a rapid-acting broncho-dilator medication (an inhaler) to be used to prevent or relieve the symptoms before or during triggers, such as vigorous exercise.

If that’s not sufficient, and the child has more frequent, moderate, severe or persistent asthma symptoms, then the doctor will prescribe additional medications to control airway inflammation.

Will my child outgrow asthma? Children with non-allergic asthma triggered by viral infections typically outgrow it by age 6 or so. Children with allergic asthma—including kids with food allergies and eczema—typically continue to have asthma as adults.

In either case, children with well-managed asthma can sleep through the night, regularly go to school and, yes, enjoy a full, active kid’s life—including running, playing and riding.

Sandra M. Gawchik, D.O., is the Co-chief of Allergy/Immunology at Crozer-Chester Medical Center and a Clinical Associate Professor of Pediatrics at Thomas Jefferson University Hospital. A board-certified allergist and pediatrician, Dr. Gawchik treats patients of all ages who have asthma and allergic conditions. 610-876-1249;