Asthma is a very common chronic illness in children. Fortunately many children with asthma will outgrow their illness and their need for medication. Until they do, and for the few who have more serious asthma, it is important to understand:
Many infants will have episodes of wheezing, often called bronchiolitis, sometimes associated with an RSV infection. Only some of these infants will go on to be diagnosed as having asthma. Making a diagnosis of asthma can be tricky and time-consuming because kids with asthma can have very different patterns of symptoms. For the typical child with asthma a common cold will trigger an asthma attack with obvious wheezing and shortness of breath. Other times a child simply has a chronic night time cough but is fine during the day. Another child might have chest colds that last too long. Some children and adolescents only have obvious symptoms with exercise (EIA). Many children, especially if they do not have a family history of asthma and allergies, often outgrow their asthma.
Many children with asthma also have eczema. Some go on to develop allergies as they get older. Kids with a family history of asthma, allergies, worse symptoms, may continue to have problems with attacks of wheezing requiring more intensive monitoring and medications.
All children with asthma should be able to participate fully in all activities of childhood and adolescence.
Their asthma should be controlled such that they sleep well at night, don’t miss school days due to prolonged colds or asthma attacks, can concentrate well while at school, and can be competitive in sports and other extra curricular activities if that is their wish.
Seattle Children’s Hospital and the American Academy of Pediatrics both have websites with excellent resources and more detailed information about asthma, including sections for kids and teens and informative handouts.
See glossary, below, for definitions and explanation of highlighted words/phrases in this document.
Frances Chalmers MD
DCFS Region 3 Medical Consultant
Action Plan: This one page has information to treat the child’s asthma. The plan is personalized for each child.
Asthma: A chronic respiratory condition with repeated bouts of wheezing treated with inhalers. Some people only have chronic cough, especially at night. It’s harder to breathe out when you have asthma.
Bronchiolitis: Wheezing in an infant, usually caused by a virus. RSV is an example. Often, bronchiolitis does not respond to asthma medications.
Controller Medication: This kind of asthma medicine is used to prevent future attacks. Controller medicine is taken every day regardless of symptoms. They make it less likely that a trigger will lead to an asthma attack. Your child’s doctor will explain when your child needs to use this medicine and when to stop it. Most of the time controller meds are a form of steroids that go into the lungs directly (by inhaler). Other controller medications include Singulair and Cromolyn.
Eczema: a chronic skin condition with dry skin that itches then becomes red and irritated when scratched. It is treated with skin moisturizers and topical steroid creams. It may be associated with allergic conditions in children.
EIA: This is a condition where the child or adolescent wheezes during or after exercise. It is often prevented by using an inhaler or puffer a short time before exercise. Some people have stand alone EIA, others have other times when they get asthma symptoms.
Immunotherapy: This is also known as allergy shots. This treatment is provided by an allergy specialist. The child is gradually “desensitized”. They gets shots containing bigger and bigger amounts of what they are allergic to. This usually tricks the immune system into gradually ignoring that substance.
Inhaler: Also called a puffer. This device turns compressed asthma medicine into a mist that is breathed directly into the lungs. It holds about 200 puffs or doses. Both albuterol and steroids come as inhalers. The name on the cylinder and the color of the cap help distinguish which is which. Young children attach a spacer to the inhaler to get more of the medicine into their lungs. Even infants can be treated with inhalers with a spacer and a mask.
Mask: This is a plastic/rubber device that attaches to the mouthpiece end of a spacer and fits over a child’s mouth and nose to help small infants get more of the puffed asthma medicine.
Nebulizer: This is a little box/device that is an air compressor to which one attaches tubing and a medication chamber. The liquid medication is put into the chamber and when the machine is turned on it turns the liquid into a mist that is then breathed in by the patient.
Prednisone: An oral form of steroid given for 3-5 days to treat a more serious asthma attack. Used for this short period of time, this steroid treatment has few serious side effects.
Puffer: See inhaler.
Reliever Medication: This type of asthma medicine is used to treat an asthma attack. It is typically some form of albuterol and is given by inhaler/puffer or nebulizer.
RSV: Respiratory Syncitial Virus, a wintertime virus that causes a wheezing illness in infants. It can be very serious in the very young or premature infant. It can cause very tiny infants, less than 6 weeks old, to stop breathing. There is a vaccine for RSV called Synagis that is given to high risk infants (premies and infants with congenital heart disease). Older children and adults just get common cold symptoms from the RSV virus.
Spacer: This is a plastic cylinder with a mouth piece on one end and a place to attach a puffer/inhaler on the other end. It is used to help people get more of the puffed asthma medicine into their lungs.
Thrush: White patches on the tongue and insides of the cheeks, sometimes seen as a side effect of using inhaled steroids. Thrush can be prevented by rinsing the mouth after each inhaled steroid dose.
Triggers: These are things that tend to cause an asthma attack. Examples are dust mites, mold and mildew, pollens, grasses, animals (especially cats). Although foods are less likely to be a problem, milk and soy can cause wheezing in infants.