What is asthma, and what can I do about it?

Think of children you know who have a "sensitive" body part. Some children have skin which is very sensitive to inflammation, and they get rashes easily. Other children have "sensitive" allergic eyes, and the smallest amount of dust makes their eyes red and teary.

Children with overly-sensitive lungs and lung passages have asthma. These children start to have cough, wheezing, and trouble breathing when something (a virus, pollen, mold, dust, smoke, an allergy, an animal, etc.) triggers inflammation in their lungs. "Inflammation" is just what it sounds like - red, irritated, swollen tissue. The lung inflammation causes air passages to shrink down, making it hard to move air in and out of the lungs.

Asthma affects about 7% of American children and is a very serious disease. It causes millions of lost school and work days for children and their parents, and costs billions of dollars a year in prescriptions, doctor visits, and hospitalizations. In America, even now with modern treatment, children die every year from asthma attacks.

Asthma often runs in families, although some children with asthma have no family history of it. Children with sensitive skin or eczema (called atopic dermatitis) or sensitive allergic eyes or nose (called allergic conjunctivitis and rhinitis) have a tendency to have sensitive lungs as well. Children who live with cigarette smokers have worse asthma and are hospitalized three times as frequently as children with asthma whose parents don't smoke.

Asthma flare-ups or "attacks" can be scary to watch. Sometimes, they are so severe that children need oxygen and must be hospitalized. However, asthma attacks are preventable if patients take preventive medication. In fact, some children with severe asthma never have to go into the hospital, because they take daily medications to prevent asthma. It is important to realize that children with asthma are not "cripples." Many medal-winning Olympic athletes have asthma, but they take adequate medication to control their asthma.

Medicines which treat asthma can be divided into two groups:

  • Daily preventative medications, which include:

o   Low-dose steroid inhalers (like Flovent and Pulmicort)

o   Anti-inflammatory inhalers (like Cromolyn)

o   Anti-inflammatory tablets (like Singular)

o   Slow-acting bronchodilators; which are medicines that open up tight air passages (like Serevent)

o   Medications which combine two of these products

  • Treatment of flare-ups, which include:

o   Fast-acting bronchodilators like albuterol

o   High-dose oral steroids which cut down on inflammation, like prednisone

As you might expect, the "preventive" medications aren't enough during a flare-up. And "flare-up" medications, even if used daily, don't prevent future attacks; they only help treat the current one.

Children with mild asthma might need only one of the preventive medications daily to keep their asthma under control. Children with severe asthma might need all four types of preventive medication (from group one) to keep them out of trouble.

Inhaled medications are a wonderful advancement in asthma medicine. However, to be effective, children must use them with spacers or chambers. Just holding the "puffer" close to the mouth and squirting it - usually most of the medicine ends up in the air or on your face. Spacers or chambers help the medicine end up where it belongs -- in the lungs. Read our page on how to properly use an inhaler.

Some asthma medications come in an inhaled powder form. Read our page on how to properly use a dry powder inhaler.

Some parents want to know why their child needs to take asthma medications every day, when the child has attacks only a few times a year. Reason: preventive daily medicines are better for children than "heavy-hitting" medications, such as high-dose steroids and frequent breathing treatments. Also, asthma attacks can damage the lungs permanently, and so it is best to prevent them in the first place. It can be difficult to take medication every day, even if your child is breathing well, but it is much better than watching a child suffer from shortness of breath during an acute attack. Even once a year is too much! One reason children get into trouble with asthma is that they stop taking their preventive medication because they feel fine. Don't let your child wind up in the hospital because of this.