Posted on: September 22, 2014
Managing Childhood Asthma
by Lynne Quittell, MD
The soft wheeze or whistle as a child breathes. The chin tucked and chest pinched as he coughs incessantly. These are signs of childhood asthma, a maddening, frightening condition for kids and parents — and a leading cause of ER visits for children. While in the past asthma has been difficult to treat and manage, advancements in medications and methods have allowed doctors and families to tame this potentially dangerous condition in children.
The reasons why a child develops asthma can be murky. Potential triggers can be allergies, exposure to secondhand smoke, or a family history of asthma. Premature babies who spend time on a ventilator appear to be at higher risk.
The reason a child struggles to breathe is that the airways can easily become inflamed, muscles that support the airways can constrict, and mucus production can increase. Some kids will have exercise-induced asthma while others may find allergy season to be the source of troubles. Even a sudden change in temperature or a rise in humidity can set off an attack.
Parents and children should work with their doctor to develop a treatment and medication plan. This is the aspect of asthma treatment that has really changed over the years. The medications have improved greatly. We teach children and parents to recognize the earliest signs of an attack, and encourage them to treat symptoms promptly — before they worsen. I like to use the analogy of smoke in the kitchen… You wouldn’t just let it go — you’d address it immediately. Asthma is the same: Stop the attack before the symptoms become more difficult to control.
When setting up a plan, a doctor must take into consideration the child’s triggers and needs. During the spring or fall allergy season, some children will require a daily preventive medication to minimize airway inflammation, while others may be okay using an inhaler to treat occasional flare ups linked to exercise. The next step is managing more serious flare ups, and then knowing when to seek emergency help. No one leaves my office without a written treatment plan. “It’s one of the most important aspects of asthma care.
Children whose asthma isn’t responding to treatment can benefit from pulmonary exercise program, similar to what is offered at Northern Westchester Hospital. An effective program would involve exercise and respiratory therapists who would create a program for your child to help him or her build physical strength and exercise capacity. The plan should be specifically tailored to your child’s needs and include education and advice for caregivers. The goal? To get your child to the point where they can play and partake in activities with their peers, without limitations.
With the excellent treatment available, I expect my patients to be able to take part in all age-appropriate activities with no restrictions.
Lynne Quittell, MD, is a pediatric pulmonologist who specializes in pediatric asthma at Northern Westchester Hospital
Did you know…
Asthma affects 7 million children under the age of 18.*
*Centers for Disease Control and Prevention