Asthma In Children

If your child has asthma, you have come to the right place. Here you will be able to clear your doubts about your child’s asthma and learn that your child can have a happy, healthy and active life despite asthma. Yes, your child can do everything a normal child does - attend school regularly, eat ice cream and even play active games. That’s because asthma can be fully controlled with the right treatment. So please do not worry if your child has asthma. Just click on our film “Asthma par Vijay” and see how parents and their children together beat asthma successfully.

Click here for FAQs, or click on the questions numbered below.

1. Is my child’s cough asthma?

Cough is the most common symptom seen in children with asthma. It is an attempt to remove mucus, irritating substances and infections from the respiratory tract. Coughing in children can be distressing and can have a major impact on your child’s sleep, school performance and most importantly, it can interfere with the simple joys of childhood.

Most asthmatic children will have cough as a prominent symptom followed by wheezing rather than breathlessness. However, asthma symptoms are not the same for every child. One child may show several symptoms like wheezing, chest tightness, and fatigue, whereas another may only cough and not have breathlessness.

It is important to know that if there is repetitive and persistent cough and wheezing, it is a strong case for asthma. However, cough may be because of various other reasons also. Most children suffer from brief and repeated episodes of coughing (for a week or two) due to viral upper respiratory tract infections, such as the common cold.

Chronic cough (which lasts for more than 3 – 4 weeks) should be a cause of concern as it may be an indicator of asthma. Cough related to asthma will usually have the following pattern:

  • Recurrent cough
  • Persistent cough
  • Cough which is usually not accompanied by fever
  • Cough that increases in night and
  • Cough that increases with physical activity

Unfortunately, in most cases, coughs are treated with cough suppressants and antibiotics rather than searching for the underlying cause. If asthma is not treated correctly and on time, it could cause irreparable lung damage in children. Please see your doctor immediately and share your family history, since asthma could be hereditary. Your doctor will be able to diagnose whether the cough is because of asthma or some other reasons. If your child is over six years, a Peak Flow Meter will be recommended. Please watch out for your child’s triggers.

2. What are the symptoms to look out for in my child?

The usual symptoms of asthma are:

Coughing: A cough that doesn’t go away and is often worse after exercise, playing and at night.

Wheezing: A whistling sound that’s usually heard when breathing out.

Shortness of breath: Breathlessness, i.e a feeling that you can’t get enough air in or out of your lungs. Breathing out is especially tough.

Tightness in chest: A constricted feeling in the chest, like someone is squeezing or sitting on it.

Other symptoms:
Disturbed sleep due to coughing at night.
Breathlessness while exercising.

Please note: Asthma symptoms vary from child to child. Some may have all the symptoms while others may have only coughing or wheezing. Most often, a cough is treated just as a cough, but the underlying reason for a cough that comes and goes often could be asthma. Also, asthma is mistakenly called as “wheezing bronchitis’ or ‘’ allergic bronchitis’’. If you feel your child’s cough and symptoms are not getting better despite treatment, discuss the possibility of asthma with your doctor and share your child’s and your family history correctly with the doctor. This will help you get the correct treatment for your child, faster.

3. How do I know if my child has asthma?

Your child may have asthma if he or she feels a tightness in the chest, has trouble breathing, coughs and wheezes. These are called asthma symptoms. You may notice that these symptoms get worse when your child gets sick or exercises or comes in contact with a pet or has food that does not agree with him or her. These are called triggers. Do keep a watchful eye on your child’s symptoms so that you can explain them correctly to the doctor. Besides examining your child, the doctor may also suggest some medical tests for your child. The Peak Flow Meter test is recommended for children of 6 years and over.

4. What is asthma?

Asthma is a chronic (long duration) disease that causes the airways - the tubes that carry air in and out of your lungs - to become swollen. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience tightness in chest, breathlessness, coughing and wheezing, especially early in the morning or at night. Wheezing is a whistling sound you hear when your child breathes in and out. Click here to see what happens in asthma.

5. What are asthma triggers?

Triggers are the things that can start your child’s asthma attack or make it worse.Triggers are everywhere. Your home, the school, the playground can be full of triggers.

Some common asthma triggers for your child could be:

  • Dust and smoke
  • Pollen from plants
  • Chalk dust in school
  • Change in weather
  • Strong emotions such as laughing and crying
  • The hair of furry animals and bird feathers
  • Physical exertion and exercise

Your child may have just one trigger or you may find that several things act as triggers. Once you know what triggers your child’s asthma, it is important to take steps to control these triggers. When you remove triggers from your home or keep your child away from triggers that are outdoor, you help your child stay healthy and have fewer asthma attacks. Do work with the doctor to identify your child’s asthma triggers.

Please note: This is not an all inclusive list of triggers. If your child has asthma, youhave to watch your child’s trigger and tell your child to avoid contact with them. Always consult your doctor if you have any doubts about your child’s triggers, symptoms and treatment.

6. Is there any way to measure my child’s asthma?

Yes. If your child is above 6 years of age, your doctor may use a simple instrument called a Peak Flow Meter which measures how well your child can blow air out of the lungs. Just as you have a BP instrument to check blood pressure and the Glucometer for diabetics, the Peak Flow Meter is like a thermometer for asthma. Your child will be asked to blow into the mouthpiece of the device, and the reading is taken to check the lung power. If your child has asthma and there’s a drop in the reading of the Peak Flow Meter, it means that your child’s asthma is not well controlled and he or she is likely to get an attack in the near future or within days. This is like an early warning signal to increase the dosage or the number of times your child should take your Controller medication. When the Peak Flow Meter reading is normal, it suggests that your child’s asthma is under control. This simple test can be done in the clinic or at home without any pain or inconvenience to your child.

If your child is older or a young adult, your doctor may also ask for a Spirometry Test to be done.

A Spirometry Test is a more sensitive and sophisticated test which detects the signs of asthma early. The Spirometer is used to measure how much air your child’s lungs can hold and how efficiently the air moves into and out of the lungs. In other words, it gives you a good indication of your child’s lung power and gives you accurate details about your child’s breathing capacity. The lab or the doctor conducting the test will give you a printed graph of your reading, just as you get a graph when you do your ECG test.

7. What are the medicines the doctor will prescribe?

There are two main types of asthma medication. They are called Controllers and Relievers/Rescuers and they work in different ways. A Controller protects your child’s air tubes by making them less sensitive to asthma triggers which cause coughing and breathing difficulties. Make sure that your child takes the Controller regularly just as you make sure he brushes his teeth daily. Please remember - a Controller does not give immediate relief. However, if used over prolonged periods of time, it helps control asthma better and prevents further attacks, thus reducing the need for Reliever medicines.

A Reliever will give your child instant relief. It relaxes the muscles in your airways and helps the air tubes open wider so air can go in and out easily, and your child can breathe easily. Please remember – a Reliever should be used only when your child suffers from coughing and breathing difficulties. It usually acts for a maximum of 4-6 hours. Always ensure your child carries the Reliever medicine to school, to the playground, and yes, especially on camps and other outings.

It is best you ask your doctor which is the Controller and which is the Reliever medicine and mark it on the pack.

8. Can my child's asthma be treated?

Yes, the good news is that your child’s asthma can be treated successfully with inhalation therapy. There are two main kinds of medicines. They are called Controllers and Relievers and they work in different ways.

A Controller is used to keep your child from having an asthma attack. It protects your child’s air tubes and prevents them from getting irritated and swollen. It helps make the air tubes less sensitive to asthma triggers which cause breathing difficulties. Your child will have to take the Controller medicine every day. Just as your child brushes his teeth daily to prevent tooth decay, and washes his hands before eating to avoid germs, so also taking a Controller is a good habit which will keep your child’s asthma under control.

A Reliever or a Rescuer is used to stop an asthma attack. It should be used only when your child suffers from coughing and breathing difficulties. This medicine relieves these problems quickly by opening up the air tubes so air can go in and out more easily. Make sure that your child always carries the Reliever medicine at all times, yes, even to school, the sports field, when on a family outing or holiday too, just in case it is suddenly needed. Your doctor is the best person to guide you regarding your child’s medicine.

9. Why should my child take inhalers when there are tablets and syrups available?

In most developed countries like the USA and UK, inhalers have succeeded in replacing tablets and syrups, because it is the most effective, safest and also the most cost efficient way to control asthma.

Most patients in India still believe that taking a medicine orally (tablets and syrups) is the right and proven way to treat any disease. However studies have shown that the best way to take asthma medication is by inhalation. Tablets and syrups which have to be swallowed, take time to act as they have to pass from the stomach to the bloodstream and finally to the lungs. Whereas inhalation is quicker because the drug is delivered directly to the place where it is required, i.e, the lungs.

Just as you would put eye drops in the eyes if your child has an eye infection, and ointment on the skin if there is a cut, so also, inhalation is the short cut that reaches your child’s lungs directly and takes care of the problem.

Besides, in oral therapy, you need a larger dose in milligrams (almost 40 times more than in inhalation therapy) which means greater side effects. In inhalation, the drug is in micrograms and since very little medicine is allowed to reach any other part of the body, your child will have lesser side effects.

10. Are the medicines safe for my child? What about side effects?

Yes, inhaled medicines are safe for your child. All medicines carry a risk of side effects in some people. But there are enough scientific studies to prove that the main asthma medicines used today are very safe, and have no serious side effects. In fact, they can be safely used in pregnancy and when breast feeding too.

Most Controller treatments contain steroids and taking them by inhaler means that a much lower dose of the steroid is used. Also, because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body. Thus side effects are less.

Your child’s Controller will usually contain a corticosteroid, but it’s safe. Corticosteroids are a copy of the steroids that are produced naturally in our bodies. Thus it is a very safe and effective treatment for asthma. Don’t worry, these are not the same steroids that are misused by some athletes and body builders. Not all inhalers contain steroid, some contain a quick relief drug.

It is advised to use the inhaler before your child brushes his or her teeth and rinse the mouth afterwards. Using a spacer device also helps reduce the chances of side effects.

11. What can I as a parent do for my child’s asthma?

It is important that you know your child’s trigger and make sure you do your best to avoid them.

Here are some tips to help you control your child’s asthma:

  • Keep the mattress and pillow clean and dust-free.
  • Wash the blankets on the beds every two weeks in hot water.
  • Vacuum the carpet every week or keep the floor bare.
  • Limit the number of stuffed toys in the room and wash and dry them regularly.
  • Avoid keeping furry and feathered pets in your main living areas.
  • Make sure your child takes medication correctly and regularly as per doctor’s advice.
  • Make sure you know which the Controller medication is and which the Reliever medication is.
12. Can I prevent my child from having asthma?

As a parent, you can help prevent your child from having an asthma attack. In many cases, asthma is hereditary, but it is also caused by triggers. If you are aware of which allergen or trigger causes asthma symptoms in your child, you can avoid the attack coming on. For eg, keep pets away if your child is allergic to fur. Don’t dust the house when your child is at home if your child is allergic to dust mites. Don’t expose your child to stuffed toys since they trap dust. If you must, then wash and dry them in the sun regularly. Watch out for damp areas in your home. Watch out for food allergies. Don’t allow anyone who smokes to do so at home since the smoke gets trapped in the carpets and curtains. As a parent, it is important that you are sensitive to your child’s triggers.

13. How did my child get asthma? Will my other children get it?

Asthma is the most common chronic disease among children. In many children, the tendency to develop asthma is there right from birth. Asthma runs in families but many people with asthma have no other family members affected. Just because one child has asthma, it does not mean that the others will get it.

Asthma is not infectious. So your child did not catch asthma from anyone else and no one else at home or at school can get infected from it.

14. Will my child outgrow asthma?

As their airways expand when they grow, some children may outgrow their asthma as they approach their teens or even earlier. In others, attacks could persist or stop for a few years and then start again. But only your child's doctor can decide when it's okay to stop the medicine. If you stop the medicine too soon, your child could have a serious attack which could damage your child's lungs.

15. Can my child exercise?

Yes, your child can do the things a normal child would do. Many parents stop their child from taking part in physical activity and sports thinking that it will help their asthma. But that’s not the right thing to do. You should encourage your child to take part in normal sports because it will help your child’s overall health. Once your child is taking the controller medicine regularly you don’t have to worry. Some asthmatic children even benefit by taking their Reliever/ Rescue medicine before exercising. There are lots of famous sportspersons who have not let asthma stop them. From cricketers and basket ball players to swimmers and Olympic athletes. Consult your doctor before your child takes part in physical activities or takes up any sport.

16. Does emotional stress play a part in my child’s asthma attack?

Yes, excitement, anger, frustration can aggravate an attack in an asthmatic child. Family problems may also make your child’s condition worse. If you as a parent have a positive and confident attitude, there’s no reason why your child’s asthma cannot be kept in check.

17. Should my child go on a special diet?

There’s no need for your child to be on a special diet. It is a misconception that an asthmatic child should not have chocolates and ice cream and do the things a normal child would do. However, if you notice that certain types of foods like eggs, nuts, shell fish, artificial colouring…make your child’s asthma worse, avoid them completely. In infants, breast feeding helps to build up immunity to diseases.

18. What should I do when my child starts going to school?

Most importantly, you should teach your child not to panic. It’s also important that you do not hide your child’s asthma from the teacher. Discuss the triggers, symptoms and treatment with the teacher. Make sure that your child carries the necessary medicines to school daily. Always keep a spare Reliever handy. And don’t forget to give the school teacher written instructions about what to do in an Emergency.

19. Is it safe for my child to go on school trips?

Yes, as long as the asthma is under control. Your child must carry the prescribed medicine including the Reliever/Rescuer medicine for a severe attack. Do make the accompanying teacher aware about your child’s asthma and treatment. Always keep spares, i.e. extra packs of Reliever medicine around. And most importantly, teach your child to take the Controller medication regularly.

20. Will steroids stunt my child’s growth?

No, steroids will not stunt your child’s growth. Studies show that children using inhaled corticosteroids will reach normal adult height, although it may cause some delays in their growth early on. It is possible that uncontrolled asthma could lead to growth retardation and other problems. It is important to work with your child’s doctor to treat your child’s asthma in the best way.

In fact, if a child is given oral steroids i.e. tablets and syrups, the child could have a growth retardation problem since the amount of drug inside is more and it is circulated all over the body through the blood stream. But when these steroids are inhaled, just the correct and precise amount of medication reaches the lungs directly. Don’t worry, the steroids in asthma inhalers are NOT the same as the anabolic steroids used by some athletes to build muscle.

21. Will smoking affect my child’s asthma?

Yes, smoking could be a trigger for your child and start off your child’s asthma or even aggravate it. Secondary smoke could be dangerous to your asthmatic child. So for your child’s sake, and yours as well, please quit smoking. Please request family members to smoke outdoors, for otherwise the smoke could linger in carpets, curtains, sofas for a long time, and cause the child discomfort.

22. My child doesn’t have asthma, but he suffocates heavily with cough after he returns from playground. Could it be asthma?

It's quite possible that your child is suffering from exercise-induced asthma. He needs to be examined by your doctor immediately.

23. No one in my family has asthma, yet my child has got it. Why?

While asthma is mostly hereditary, it is not necessary that one should have asthma in your family for your child to get asthma. If your child is exposed to triggers and has sensitive lungs, he could get an asthma attack. Some triggers are: dust mites, pets, pollen, exercise, cigarette smoke, pollution, stress.

24. How will I know that my child is suffering from asthma and not any other disease?

If your child has symptoms like tightness in the chest, breathlessness, cough and wheezing, which occurs mostly at night or early morning, or while playing or even when laughing or crying, and there is a family history of asthma, then your child could most probably be suffering from asthma. Very often, a cough is treated as a cough, but the underlying reason for recurrent cough, could be asthma. As a parent, do keep a watch on your child’s persistent coughing and breathlessness, and the triggers that start it. Take your doctor’s advice.

25. Can I breastfeed if I have asthma?

Yes, you can. You can breast feed your baby even if you are an asthmatic. Because asthma is not a transmitted disease it does not transfer through breastfeeding. So this is not going to have any effect on your child.

Besides, the inhaled medication is so safe it can safely be used when pregnant. Also, breast milk contains protective factors that can reduce the risk of developing asthma. Pregnant women and breastfeeding mothers all over the world use inhaled medication quite safely.

26. Should pets not be allowed at home if my child has asthma?

No pets please. Since animal fur and dander are common risk factors and triggers for asthma, it is advisable not to keep pets or to allow them into the living areas and bedroom. You could explain this to your children and keep fish as pets instead.

27. What should I do if my child has an asthma attack?

If your child has been regular with the Controller medicine and the triggers are avoided, then the chances of having an asthma attack will be low. However, in case of asthma attack, make your child:

  • Sit up upright – do not lie down. Try to stay calm and relaxed. Loosen child’s clothing.
  • Without any delay, take the Reliever medicine in the dosage recommended by the doctor
  • Then wait for 5 minutes. If there is no improvement, take additional doses of the Reliever medicine as advised by your doctor.
  • If your child still does not get relief, call the doctor immediately. Do not exceed the dose of the Reliever medicine without consulting the doctor.
28. What are the Emergency Warning Signs to look out for?

There are times when you need to take your child to the hospital and give him urgent care right away. Some parents know their child is having a medical emergency with asthma if he or she:

  • Is breathing in a different way: faster, or slower, or more shallow than usual.
  • Is coughing or wheezing and can’t stop.
  • Has bluish fingernails or lips.

Ask your child’s doctor what emergency signs to look for to help you know when your child is having a medical emergency with asthma. It is important that you stay calm.

29. Will my child ever have a normal life at home and in school?

Yes! With your doctor’s advice and right treatment and your own love and care, you can look forward to a normal life for your child in every way.

  • Coughing and breathlessness completely under control
  • No need to miss school or studies.
  • No need for you to miss work attending to your child.
  • Can play and exercise
  • Undisturbed sleep
  • No expensive and traumatic emergency visits to the hospital
  • Normal growth and development
30. Can asthma be cured?

Currently there is no cure for asthma. However, for most children, asthma can be controlled with the right management and treatment. While asthma is a chronic (of long duration) illness, your child can lead a normal, healthy, active life with proper medication.

31. Can a child die of asthma?

Unfortunately, yes, one can die of asthma. According to a WHO update, the annual worldwide deaths from asthma have been estimated at 2,50,000.

Death can occur if the asthma is not diagnosed in the first place or if the patient did not have a Reliever near at hand when having an attack. One of the best ways to identify a child at risk of death is, one who is taking lots of bronchodilator inhaler (more than ten puffs per day, or requiring two or more inhalers per month), as this shows their asthma is out of control. Any child who has to visit the hospital for frequent nebulisations is also at risk.

Most deaths from asthma are preventable. So please take the management of your child's asthma seriously.

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