How is asthma in children different?

Asthma in Children

Asthma can be diagnosed at any age. Asthma, when diagnosed at an early age is known as childhood onset asthma. Asthma is one of the leading causes of long-term illness in children and for unknown reasons the rate is steadily increasing. Children who are diagnosed with asthma early in life might stop showing symptoms after puberty. It is possible for the symptoms to be seen again later in life at any stage. Also, there are cases where people are diagnosed with asthma for the first time in old age.

What Makes a Child More Likely To Develop Asthma

Causes of asthma in children can be for various reasons. The most common cause of asthma in children below the age of 5 is upper respiratory viral infections such as a common cold. The risk factors and common triggers for developing childhood asthma are:

1. Allergies such as Eczema (allergic skin rash)or nasal allergies (hay fever)
2. Airway infections such as cold, pneumonia, and sinusitis
3. Exposure to triggers such as smoke or tobacco before or after birth
4. Frequent respiratory infections
5. Family history of asthma, atopy or allergies
6. Living in an area with higher air pollution
7. Obesity

Asthma Symptoms in Children

All children may not have the same symptoms because asthma symptoms vary from person to person. Symptoms can vary in each child from episode to episode as well. The patterns of experiencing the symptoms are also different for each asthmatic child. Most asthma symptoms occur at night and these are also called nocturnal symptoms which cause loss of sleep. Even for a child with stable asthma the quality of sleep diminishes, and it can affect the daily activities and performance of a child at school. Asthma can be characterized as severe or mild, and the doctor shall be able to examine this after diagnosis. The symptoms of asthma in children include:

1. Frequent coughing spells, which may occur while playing, laughing, or at night or right after waking up. Coughing may be the only symptom.
2. Difficulty in performing daily physical activities while at play, or running, climbing stairs, etc
3. Rapid breathing
4. Chest tightness
5. Wheezing (whistling sound) while breathing in and out
6. Shortness of breath (Dyspnea)
7. Tightened neck and chest muscles
8. Feelings of weakness or tiredness

These symptoms can be effectively managed after the diagnosis of asthma which will also help the doctor to prescribe the medications for further treatment.

Diagnosis of Asthma in Children

Asthma is typically diagnosed with some tests that measure the flow of air in the lungs, but younger children may not be able to complete these tests as it requires the person to blow hard into a tube. Skin or blood tests can be recommended by the doctor to check whether the child has allergies that may trigger asthma symptoms.

An early asthma diagnosis is important for the treatment of young children with respiratory symptoms. It might not be possible to diagnose children with conventional tools. Diagnosis can be difficult for children below the age of 5, but in late childhood (7-10 years) spirometry and Impulse oscillometry test can be reliable and help as a diagnostic tool.

1. Spirometry is a simple and widely available tool for testing the lung’s function. A person blows into a machine that measures how fast he or she can breathe out and how much air he/she can hold in their lungs. This test helps to know the air holding capacity of the lungs, and how well is a person’s breathing function. This is one of the most reliable ways to diagnosing asthma and it can be used to test other lung diseases as well. It takes approximately 10 minutes for the test and sometimes it is repeated after taking the puffer medications. For someone who is already diagnosed with asthma, spirometry can be useful to determine if the current treatment is working. 
2. Impulse Oscillometry (IOS) provides a rapid measure of airway impedance. For this test, the patient needs to perform simple tidal breathing manoeuvres that require less effort and co-operation than spirometry. It can be used in the diagnosis and management of asthma in children. Also, this test has much greater sensitivity to detect airways obstruction.

Treatment for Asthma in Children

The aim of asthma treatment is to control asthma symptoms and manage life better with asthma. However, it is necessary to get control over symptoms with minimum medications’ side effects for children.

• Taking Medicine

  Quick-relief medicines (fast-acting medicine) help to open up the airways and make it easier for a child to breathe. Controller medicines (long-term control medicines) help to daily control and prevent asthma symptoms.

• Using an Asthma Inhaler

  Asthma inhalers help to deliver medicine into the lungs, through the inhaled route. Inhalation is the most effective way to deliver medicine to the lungs. To make it easier for children to use inhalers, a spacer can be used with it. With metered dose inhalers, a spacer can be attached to the inhaler that holds the mist of medicine in one place (between the inhaler and mouth). A spacer will let the child breathe in when he or she wants and this can effectively deliver medicines directly to the lungs. Another type of inhaler known as dry powder inhaler contains powder that needs to be quickly inhaled deeply and needs no spacer.

• Using a Nebulizer

  For children below the age of 5 it can be difficult to use inhalers. An easier way to take asthma medicine for these children is by using a machine called a nebulizer. This machine turns liquid medicine into a mist for a person to breathe in.

Management of Asthma in children

An asthma action plan is the first step towards managing asthma symptoms for asthmatics and it plays a significant role in management of asthma in children. This sheet includes the guidelines for emergencies, the contact of parents/caregiver of the child, contact of the nearest hospital etc. This action plan must be shared with the day care giver and teacher of the child. The sheet will also include the medications or asthma inhaler used for the purpose of relieving asthma symptoms of the child. Here are some additional tips that can help in preventing and managing asthma symptoms in children:

1. Know the asthma triggers and avoid them
2. The child must get flu shots every year
3. Children can take part in daily activities, like sports by always keeping the inhaler with them
4. Use and adjust medications to control symptoms with few or no side effects
5. Don’t let anyone smoke in the house or the car
6. Clean carpets and bedding to keep away dust mites
7. Keeps pets away from the child’s bedroom, and use the air filter or humidifier
8. Get regular pest control done in the house
9. Do not use scented cleaning products or candles
10. The child must take controller medications every day
11. Use a peak flow meter to monitor asthma symptoms at home
12. Keep updating the asthma action plan under doctor’s guidance as to when necessary

Once the airways of the lungs of a child become sensitive, they stay that way for life. Parents can try to learn about asthma and how to control it so that they can take the essential steps towards managing their child’s condition. Parents can closely work with the doctor to plan their child’s asthma action plan and make sure that their child’s asthma is effectively managed and controlled. 

To know more read about management of asthma.