Asthma in children: What parents should know

In the U.S., according to the Centers for Disease Control and Prevention, asthma affects 6.5% of children and for some, it can be life-threatening. There is no known cure for asthma, which means that lifelong awareness, understanding and management of this condition is vital for a young patient’s quality of life.

Causes and symptoms

“Asthma is a disease of the lungs that involves two main components: bronchospasm and inflammation of the airway. Bronchospasm happens when there is a sudden constriction or tightening of the muscles surrounding the airways,” said Dr. Christina Johns, a pediatric emergency medicine physician and senior medical adviser for PM Pediatric Care, a leading pediatric health care provider network that has recently partnered with Ann and Robert H. Lurie Children’s Hospital of Chicago.

“Kids with asthma tend to have hypersensitive airway tissues, which react to various triggers and irritants. Essentially, bronchospasm is an exaggerated response that can cause the airway lining to become inflamed and thus constricted,” Johns said.

When this happens, it may become difficult for air to flow in and out of the lungs. As a result, a child may experience coughing and shortness of breath — the typical symptoms of asthma. The most well-known sign is wheezing, but many children with asthma may also describe having a tight feeling in the chest, as well as signs of respiratory distress such as nasal flaring and rapid breathing rate.

Triggers and management

Asthma exacerbations, or “attacks,” can be triggered by various factors such as allergens, respiratory infections, exercise, cold air, smoke, pets or other irritants in the environment. Some people are more sensitive to certain triggers than others, so the experience of asthma varies from person to person. Change of seasons tends to bring on more environmental triggers, so symptoms can worsen during these times of year.

Because asthma often starts in childhood, it’s important for affected kids to be their own health agents — to be knowledgeable and proactive about their condition early on with the support of their parents and caregivers. It’s a good idea to teach children about the following:

• Signs and symptoms of asthma exacerbations.

• Appropriate response to an asthma exacerbation (asthma action plan).

• Self-advocacy skills — speak up when you start to feel symptoms!

• Personal triggers and how to minimize them.

“It’s also important to stress the importance of abstaining from smoking or vaping to children, as these actions will exacerbate the disease. Households with high respiratory sensitivity may benefit from not owning pets,” said Johns.

“Children who wheeze regularly may be prescribed some controller medicines. Inhaled corticosteroids are commonly used. These should be used daily as they are preventive medicines, unlike albuterol and others, which are used as rescue medications during an acute exacerbation.”

Emergency response and care

In the best-case scenario, when a child gets diagnosed with asthma, their pediatrician works with the family to create an asthma action plan — a detailed, personalized document that outlines the appropriate response if an asthma episode occurs. Following this plan is crucial for the well-being of the child. All of the child’s caregivers should receive copies of the asthma plan and be ready to act in case of emergency.

Sometimes, an asthma attack can be mild with no signs of respiratory distress, but it’s always smart to start by sitting the child upright and checking the ABCs:

• Airway: Make sure that nothing is obstructing their breathing.

• Breathing: Check for normal breathing by watching the chest rise and fall, listening for breath sounds, and feeling for airflow at the nose or mouth.

• Circulation: Check for a pulse and signs of circulation, such as skin color and temperature.

After assessing the ABCs and the child’s level of alertness, administer nebulizing treatment/rescue medicine according to the child’s asthma action plan. This would usually be done via a nebulizer machine or an inhaler; remember to use a spacer for the most effective treatment.

Seek immediate medical attention at an emergency center or urgent care, such as PM Pediatric Urgent Care, in case of the following:

• No rescue medication is available on hand.

• The ABC (airway, breathing, circulation) check fails.

• The child is exhibiting signs of severe respiratory distress, such as:

≻Severe difficulty breathing, wheezing, persistent coughing that doesn’t improve with medication.

≻Pale or blue lips or fingertips.

≻Difficulty speaking; inability to speak in complete sentences.

≻Worsening symptoms.

Learn more

Knowledge and awareness are keys to proactively managing asthma in children and adults. The CDC website, www.cdc.gov/asthma, has an expansive information page for asthma.

Additionally, check out PM Pediatric Care’s blogs on respiratory distress signals and managing chronic conditions, such as asthma, which can be found at pmpediatriccare.com/blog.

• Children's health is a continuing series. This column was provided by Ann & Robert H. Lurie Children's Hospital of Chicago. PM Pediatric Care, a national pediatric health care leader operating the largest pediatric urgent care network in the U.S., and Ann & Robert H. Lurie Children’s Hospital of Chicago, the largest independent academic pediatric medical center in the Chicagoland area, are partnering to serve area families with best-in-class urgent care for children and young adults.