Childhood Asthma Management
Goals for controlling managing childhood asthma are twofold:
1. To control asthma with proper medications, to avoid triggers, and to follow an exercise program so that the child is not hindered by recurrent asthma symptoms.2. To foster emotional heath so the child thinks of himself or herself as a healthy person, not a sick one, and is confident of his or her ability to confront challenges and succeed.
Managing childhood asthma requires reliance on parental observation of asthma symptoms and on spirometry (breathing tests), an objective way of evaluating the child's airway function.
It is essential that children be protected from irritants and triggers including dust, mold, and pet dander as well as non-specific irritants such as tobacco smoke. The chronic irritation to the airways may make asthma difficult to control. Studies have documented that children who live in a home with a smoker have more respiratory infections.
Choices of medications and methods of dispensing them differ between adults and children. In the past, oral medications were commonly used in young children. However, oral medications are more likely to produce side effects than inhaled medications. Parents should consult with an allergy/asthma specialist to ensure their child is getting the most effective medication.
In pre-school age children, a nebulizer is often required for effective administration of inhaled medications. Home nebulizers dispense inhaled medications by mask to those who are too young, or unable to use inhalers. When children are of school age, they may be able to use metered-dose inhalers with special chambers to maximize medication delivery to the lungs. Regular use of a peak flow meter is also an important part of asthma management.
A child's compliance with an asthma management program is important. Preadolescent children need more parental/care giver supervision to make sure medications are taken. However, older children should be able to take responsibility for asthma management.
Parents tend to want to restrict a child's physical activity to prevent wheezing. But once a child is on proper medication, aerobic exercise needs to become part of the child's daily regimen. Aerobic training may improve airway function. Children should be encouraged to participate in normal activities.
For the vast majority of children, asthma can be controlled with proper medication and management. While asthma is a chronic illness, it is not progressively debilitating, and normal lung function can be preserved. It is very possible for a child with asthma to have normal endurance and even excel in athletics. Many Olympic athletes have asthma.
One of the key ways parents and caregivers can help children manage asthma is to educate and inform ALL children regarding asthma and how it works.
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