Many Ways To Manage Childhood Asthma

Many parents of children with asthma may have the best of intentions, but they are not fully informed about solutions when they try to protect their kids from allergens, notes a report in the Journal of Allergy and Clinical Immunology.

For example, instead shutting windows to keep out pollen, parents may turn to expensive air filters or fancy vacuums to manage the problem.

"Parents are very enthusiastic about doing something, but a lot of times they were using techniques that didn't make sense considering their children's asthma triggers," says study author Dr. Michael Cabana, a pediatrician at the University of Michigan.

Dr. Cabana and his colleagues interviewed 896 parents of children with asthma. Of the 1,788 steps that were taken by parents to reduce problems for their children, only about half were generally considered effective in preventing attacks, the researchers report.

Asthma a Leading Problem In the US

About 17 million people in the US have been diagnosed with asthma, with children accounting for about 5 million of the cases.

Asthma is the leading, serious, chronic illness among children in the US. Asthma accounts for 14 million absences from school each year, and it is the third-ranking cause of childhood hospitalizations under the age of 15.

The good news from the study is that about 80 percent of the parents knew at least one substance that "triggered" their child's asthma, and four-fifths of those took steps to help their children, Dr. Cabana says.

However, the Michigan researchers also found that one-quarter of the parents surveyed reported that at least one family member smoked but nothing had been done to mitigate the child's exposure to tobacco smoke.

In many cases, the parents turned to devices such as air filters, which are not as effective as other steps they could have taken, Dr. Cabana says.

"You might have parents who describe their triggers as being an outdoor allergen, and they're replacing mattresses and putting on special mattress covers or pillow encasings," he notes. "They aren't helpful for outdoor allergens, but they are helpful for dust mites."

In a small number of cases, the parents took actions that could actually be harmful, such as running a humidifier in a household where a child is allergic to dust mites. According to the authors, a dehumidifier is a better choice.

Dr. Katharine Woessner, an allergist at Scripps Clinic in San Diego, agrees that humidifiers can spell trouble. Parents "think if they add more moisture to the air that will be helpful.

"But the more humidity there is in the environment, the higher level of dust mites and more potential of mold spore contamination," Dr. Woessner says.

Pets, Plants, Carpets - Finding the Triggers

In addition, parents are often reluctant to give up beloved pets. And, many do not realize that over-watered houseplants and carpets can be breeding grounds for allergens.

"For kids, what's going on in the environment has a huge impact on their asthma," she says, especially since children appear to be spending more time indoors watching TV and playing video games.

Dr. Robert Zeiger, head of allergy research with Kaiser Permanente in San Diego, says that physicians can help educate parents about ways to protect their children from asthma triggers.

For example, it is important for parents to realize that viral infections - not environmental triggers such as dust or pollen - contribute the most to the asthma problems of children under age five, he says.

"Between the ages of five and 20, probably up to 90 percent of children who have asthma on a persistent basis have it related in large measure due to allergies," he notes.

The researchers say that "parents do look for information and support to take better care of their children's asthma. Parents may spend more time being exposed to advertisements for consumer products than they do discussing their children's asthma with their provider.

"As a result, parents may need guidance in placing such marketing information in proper clinical context," they write.

So, what should you do if your child has asthma?

"Before making major changes to the house, before ripping up the carpet, or making a major investment in a new air system, it's important to consult your physician," he says.

Always consult your child's physician for more information.

Online Resources

American Academy of Pediatrics

Centers for Disease Control and Prevention (CDC)

National Heart, Lung, and Blood Institute

National Institute of Allergy and Infectious Diseases

National Institute of Child Health & Human Development

National Institutes of Health (NIH)

October 2004

Many Ways To Manage Childhood Asthma

Asthma a Leading Problem In the US

Pets, Plants, Carpets - Finding the Triggers

All About Asthma

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All About Asthma

Asthma is a chronic, inflammatory disease in which the airways become sensitive to allergens (any substance that triggers an allergic reaction).

Several things happen to the airways when a child is exposed to certain triggers:

• The lining of the airways becomes swollen and inflamed.
  
  
• The muscles that surround the airways tighten.
  
  
• The production of mucus is increased, leading to mucus plugs.

All of these factors will cause the airways to narrow, thus making it difficult for air to go in and out of a child's lungs, causing the symptoms of asthma.

The exact cause of asthma is not completely known. It is believed to be partially inherited, but it also involves many other environmental, infectious, and chemical factors.

After a child is exposed to a certain trigger, the body releases histamine and other agents that can cause inflammation in your child's airways.

The body also releases other factors that can cause the muscles of the airways to tighten, or become smaller.

There is also an increase in mucus production that may clog the airways.

Some children have exercise-induced asthma, which is caused by varying degrees of exercise. Symptoms can occur during, or shortly after, exercise.

Each child has different triggers that cause the asthma to worsen. You should discuss this with your child's physician.

The changes that occur in asthma are believed to happen in two phases:

• An immediate response to the trigger leads to swelling and narrowing of the airways. This makes it initially difficult for your child to breathe.
  
  
• A later response, which can happen four to eight hours after the initial exposure to the allergen, leads to further inflammation of the airways and obstruction of airflow.

Symptoms of asthma may include:

• coughing (either constant or intermittently)
  
  
• wheezing (this is a whistling sound that may be heard while your child is breathing)
  
  
• trouble breathing or shortness of breath while your child is playing or exercising
  
  
• chest tightness (your child may say his or her chest hurts or does not feel good)
  
  
• fatigue
  
  
• nighttime cough
  
  
• noisy breathing
  

The symptoms of asthma may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.