Watching a child with asthma struggle to breathe is terrifying and heartbreaking. I've seen it as a doctor more times than I can count, and it never gets easier. I've experienced it as a mother too; my older son had asthma and would cough and have trouble breathing when he exercised. I worried about him every time he went to swim practice in elementary and middle school and so wished there was something I could do to make the problem go away.
About one in ten kids has asthma, according to the Centers for Disease Control and Prevention, and those numbers are higher in urban areas and among some ethnic groups. But a diagnosis doesn't have to be a daily challenge for your child. In the 20 years I've been a pediatrician, we've come a long way in understanding and treating asthma. Working with their doctor, parents can do a lot to help their children.
When airways act up
To understand the condition, you need to know what lungs look like inside. They aren't big bags that fill with air when we breathe, as I used to think when I was a kid. They are more like sponges, solid structures made up of lots of tubes, called airways. The airways start out big with the trachea, commonly known as the windpipe, and then branch out into smaller airways, called bronchioles. As we breathe, the air goes down into the tiniest airways, where it gets really close to the blood -- and the oxygen from the air gets transferred into the blood.
When a child has asthma, those airways get irritated and swollen, usually as a reaction to something, and the air can't get in. The more irritated and swollen they are, the harder it is for him to breathe, leading to an asthma attack. There are drugs called fast-acting or "rescue" medications that relax the muscles that constrict the airways, and others known as controller medications that try to reduce the inflammation. Sometimes the symptoms go away easily, with medication or rest or avoiding whatever is triggering them. But in other cases they persist, and kids need additional treatment or even to go to the hospital.