Breathing Easy... When Your Child has Asthma
Feb 18 '03 (Updated Feb 19 '03)
The Bottom Line Childhood Asthma is to be taken seriously. With proper management, children with asthma can live a "normal" life.
How it all started
I still remember quite vividly the first real serious bout with asthma that my son had. It was well after midnight and my husband and I rushed him in to the ER. Growing up afflicted with Asthma, myself; I knew the signals all to well. My baby was having an asthma attack, of the worst kind possible. What had seemed like a small cold earlier in the day had now been exacerbated to the point where he was seriously struggling with each breath. He was terrified, as I was I - but I needed to remain calm. That 2am ER trip signified just the beginning of many late-night visits for us as we struggled with many upper respiratory and ear infections as well as allergies and ultimately the diagnosis of Childhood Asthma for our son.
Your kid has what?
Looking at our boy, he is no different than any other "typical" two-year-old. On the surface he is a happy, healthy, boisterous toddler who keeps his parents hopping between attending swimming lessons, play-dates, MOMS club functions and more. He loves to play, and play hard he does. Its often hard to believe that this same little Wiggler is the one who requires frequent (daily) treatments from a nebulizer machine for possibly years to come.
You are not alone
If your child has been diagnosed with asthma, know that you are not alone. According to the American Lung Association, nearly 4 million children (under the age of 18) have had at least one asthma attack. In fact, asthma is considered to be one of the most chronic childhood diseases and one of the most common causes for absenteeism in schools. Yet, despite asthma being practically a household word there are still so many unknowns about the disease, and there is no cure.
There is no cure for asthma, but do not think that asthma is a curse. As a child, I was often left out of activities deemed too strenuous because I have asthma. I was picked on and made fun of because I had to use an inhaler and couldn't keep up with other kids. It wasn't until I was in my late teens that I got a grip around my asthma and went on to live a so-called normal life. Now, that my son has asthma, I take a much different approach based on both education - and my own experience with this sometimes debilitating condition.
Controlling Childhood Asthma
Disclaimer: I can only speak for my own experience, as an asthmatic myself, and as the mother of an asthmatic child. I'm not a doctor, nor do I have a medical background. Asthma is a serious condition and if you suspect your child is asthmatic then please seek the proper medical attention. The intention of this essay is to share my experience, as a mom and and an asthmatic myself, to help educate others dealing with childhood asthma. Its my hope that this essay will help other parents know that they are not alone and deal frankly with the fears, feelings and facts of childhood asthma.
Identify Triggers
The key to understanding your child's asthma is to first identify the triggers which set off their asthma attack(s).
Asthma triggers can include any (or all) of the following:
-Allergies
-Air Irritants like dust mites, pollution, animal fur/hair/dander
-Weather Conditions - cold/brisk air, pollen, humidity
-Mold
-Foods (commonly things like milk or wheat)
-Infection/Illness
-Exercise
-Emotions
-Stress
-Sleep
Once you identify your child's triggers you will be one step closer to controlling their attacks. To help you figure out their trigger(s) you should try keeping a journal. Writing down all of your child's activities, food intake, and weather/environmental conditions can help you narrow down what is causing your child's breathing difficulties. In our case we found that there were many factors including both physical and environmental ones.
Some of our triggers include:
-Weather - during times of high pollen counts, it is the worst. It is also bad during extreme cold/brisk conditions.
-Illness - Anytime my son has a cold/flu or ear infection he is prone to asthma attacks
-Certain Foods - We have learned to be very watchful of many dairy/milk products - the exceptions being yogurt and cheese
-Emotions/Stress/Overtired - When my son is upset in any way he may work himself up to the point of an attack. If he is overtired, he is more vulnerable to such an event.
Precautionary Measures - Creating an Asthma-Friendly environment
Depending on your child's asthma you will want to take steps to change the world around them. Nearly 3/4 of all childhood asthma cases are also linked to allergies of some kind. Allergies to animal hair/fur or dander are common and if that’s your case, the doctors may suggest you do away with your family pet. Other common allergies are to things like dust mites, mold, and pollen in the surrounding air. Changing your child's bedding frequently, washing their hands often, and cutting back on the number of stuffed animals in their close quarters are all things you can do to help kids with asthma breathe easier.
Cigarette smoking is an absolute no-no for around kids with asthma. Even if someone in your household smokes outside of the home, they are still bringing in harmful irritants on their clothing, hair and hands which can make your asthmatic child very sick. The time to quit smoking has never been better. My husband did smoke for many years, and outside of the home. But when our son was diagnosed with asthma it was all the more reason for him to quit, and he did. When your child has asthma, do not allow anyone to smoke around you or in your home, no matter how cold it is outdoors.
You can improve the quality of air in your home by doing a number of things. Between the seasons, have your furnace and air ducts cleaned and any filters changed. During the warmer months, use air conditioning instead of opening windows. Use a vacuum cleaner that has a HEPA filter. When you vacuum, make sure your child is in a different room of the house. Likewise, keep your child indoors and with the windows down when your lawn is being mowed. Last but not least, invest is a quality air cleaner with HEPA to run inside your home. I've given some recommendations for a vacuum and an air cleaner that we've had good results with at the bottom of this essay.
Treating Childhood Asthma
When your child has asthma you may find yourself faced with all sorts of intimidating equipment.
The Tools of the Trade
Chances are if you have a young child with asthma then you will need to use a nebulizer to help deliver your child's medication. A nebulizer is small machine, which plugs right into your wall. It has a cup in which you pour your child's medicine in a liquid form and it attaches to a mouthpiece or mask (covering their nose and mouth) through which your child will breathe in their medicine.
Some other equipment you might encounter will include:
Peek-Flow meter - This is a small plastic tube with a sliding gauge on it. The doctors may want to have your child breathe in this meter at various times of the day or during times when they are having asthma troubles to track your child's progress/management and the effectiveness of medications. A low peek flow reading is usually a signal of an impending attack.
Inhaler with a Spacer - A spacer is a tube which can be attached to a pump inhaler to help deliver your child's asthma meds into their lungs where they belong and not into their mouth. Our inhaler has both a spacer and a mask on it, which covers my son's mouth and nose - because he is too small to work one that uses just a mouthpiece.
Exploring Which Medications Work For Your Child's Asthma
It might take a while for you to find which medications work for your child. Over the past year we have tried several different types of medications, doses, as well as delivery methods. By far the most effective medication for my son has been the use a nebulizer on both an as-needed and daily basis.
Asthma medications fall into a few categories:
Preventative/Maintenance - If your child has frequent asthma attacks and symptoms you will most likely be put on some type of maintenance plan to help keep their asthma under good control. Maintenance meds are ones that your child will need to take on a daily/regular basis. These drugs are long acting in effect and are delivered over time. Their purpose is to help keep your child's airways open and reduce the quantity and severity of asthma attacks.
We use two maintenance drugs. In our case we use a daily dose (via nebulizer) of an inhaled anti-inflammatory gluco-corticosteroid by the name of Pulmicort which is for asthma kids 12 months and older. It takes about 7 minutes each day with the nebulizer machine, but those 7 minutes make a world of difference for us. Once my son hit the 2 years old mark, he also started a daily dose (via a chewable pill in the evening) of montelukast sodium or Singulair.
Rescue
These are the drugs you will more commonly associate with asthma. Rescue meds do just that - they come to the rescue when your child is having an asthma attack. They are fast acting and the effects of the drugs wear off quickly.
The most common rescue meds are bronchodilators, such as albuterol delivered via an inhaler or nebulizer. When my son is having troubles with his asthma, difficulty breathing, or a severe attack we give him albuterol through our nebulizer as needed. During some of the more severe asthma attacks and respiratory infections, my son will also take oral doses of prednisone, or get a high dose of prednisone (a corticosteroid) delivered via shot.
Living with Childhood Asthma
When your child is diagnosed with asthma, know that it is not a life sentence. With good control, your child can lead a pretty much "normal" life (whatever "normal" is, anyhow).
Once you've identified what triggers your child's asthma, you will have an easier time of eliminating or reducing those triggers from child's daily life. Then, create a healthy environment for them free of triggers. This doesn't mean your child has to live in a bubble, or stay at home all the time. Be realistic, know and accept that your child's asthma makes them susceptible to more colds and seasonal illnesses than other kids. Washing your hands, and your child's hands frequently will help things significantly - especially when you've been out in public/congested places like the mall or around other kids.
Though some asthma is exercise induced, your child can and should still stay physically active and at a healthy weight. Swimming happens to be the activity that is most often recommended for children with asthma, this is because swimming does not produce any bronchial hyperactivity. Infants who have been diagnosed with asthma can use submersion in water as a form of respiratory therapy. My son has been swimming since the age of seven months and does not let his asthma stop him, one bit.
Don't forget that there is an emotional component to asthma. When your child is struggling to breathe it is very upsetting and scary for a parent to watch. Your child is scared too, and in many cases not able to communicate their fears to you. The first thing that you might be drawn to do as a parent is freak out, but this is the worst possible thing to do. Your job as a parent is to help gain good control over the situation. Stay calm and be reassuring to your child. Help them relax and let their medications take effect. This might mean using a movie or a book to help distract your child while you deliver a nebulizer treatment. Other methods of relaxation may include music, aromatherapy, visual imagery, and even imaginary play.
Don't be afraid to talk about your child's condition and let others know that they may or may not be requiring some special help. Teach your family members and any babysitters how to operate your nebulizer in case of emergencies. Its always really important to be prepared in case of emergencies. Watch your child and their triggers and be sure that those around you know they are asthmatic and can also be aware of it. Educate those people who spend the most time with you and your child, including their friends, about asthma. My best friend, and her 4-year-old in particular have had a lot of questions about my son's (his buddy's) asthma. When my son suffered some asthma symptoms in their company, his friend was just as (or perhaps more) upset about what was going on. I shared some children's books on asthma (The ABC's of Asthma and The Lion who had asthma) with him, and it’s made a world of difference.
Being realistic about setbacks is a must. A child with asthma will be sick more often than other kids. I know a lot of people will say things like, "Oh, he's sick again!", which can make you feel like a horrible parent. All kids get sick sometimes - it just happens that your asthmatic child is more susceptible to respiratory, sinus and ear infections. Take these sicknesses seriously, even "common colds" because they can turn into a nightmare very quickly. Keep up with any medications you require for maintenance/prevention. I am so used to giving 7-10 minutes a day with the nebulizer, its built into our daily routine.
Last but not least, you may wonder if your child's asthma will ever get better or go away. The good news is that many cases of childhood asthma disappear or lessen in severity as a child's respiratory system matures. My son's asthma may or may not go away. My own asthma nearly disappeared during my pregnancy due to hormonal changes. I won't hold my breath that my son's asthma is going to disappear overnight. But I can and will pray that some day he will breathe easier without relying on so many medications. In the meantime, we try to take things one day at a time - maintain a positive outlook and take good control of what we realistically can.
My Asthma Related Reviews
Holmes Harmony Air Purifier HAP675C
Hoover WindTunnel Bagless Vacuum
The Lion Who Had Asthma
References
American Lung Association
http://www.lungusa.org/asthma/ascchildhoo.html
Childhood Asthma Foundation
http://www.childasthma.com/
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