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Health News
Asthma in Kids—Know it Better
If your child has been diagnosed to have asthma recently, you will find thisinformationextremely helpful. Here we bring some particularly important facts about childhood asthma which will help you in managing your child’s health better, as well as demystifying some common myths.

Asthma is a disease of children too.

It is commonfor people to think that children can not have asthma. They have always associated asthma with elderly people; coughing,wheezing, using inhalers and sometimes becoming extremely sick.Asthma is a curable disease of airways which is not uncommon in children. Refusing to accept the diagnosis delays symptom relief and places the child at risk of emergency hospitalization.

What is asthma?

In asthma,the child develops narrowing of airways because ofexcessive response to common infections and allergens. Children may have recurrent cough with periods of normalcy in between, episodes of wheezing requiring nebulization, sometimes severe enough to require hospital admission. Parents feel that simple cold goes to chest easily and takes time to get better. Many a times, children will have only night cough or exercise limitation only.

Why my child?

Children develop symptoms of asthma both due to underlying genetic makeup and triggerby environment. In most cases, parents are not aware of family members having asthma or other allergic tendencies and hence deny family history. Hence it occurs because of combination of genes and environment which make them prone to mount an exaggerated response to environmental triggers.

How do I suspect that my child has asthma?

In the early phase, most asthmatic episodes are treated as respiratory infections by parents as well as treating pediatrician; it is difficult to differentiate between two. Later when child presents with recurring symptoms like cough, difficulty in breathing, tightness of chest, night cough, symptoms exaggerated by exercise, recurrent wheezing needing nebulization, one must suspect asthma and take necessary steps to confirm the diagnosis.

Are there ways to confirm asthma in my child?

Yes, children with suspected asthma need specific tests which help in diagnosis of asthma. In children older than5 years, lung function tests are performed to measure lung capacities. They confirm reversible narrowing of airways, and the severity of asthma. Allergy testing for common allergens is also recommended;this may give us idea about triggers for asthma attacks. Newer tests like FENO helps in assessing asthma control on follow up.

In younger children, diagnosis of asthma is mainly based on symptomatology and not on specific tests.

How can I control asthma of my child?

Diagnosis (and accepting the diagnosis) is the first step to any cure. Asthma can be controlled extremely well in most children once we accept the diagnosis and are ready for long term preventive care. Mainstay of preventive care (treatment) involves low dose aerosolized medicines which act directly on lungs – popularly known asInhalers.

Your pediatrician will prescribe 2 types of inhalers—preventer and rescue. Preventers need to be given daily for at least 6-12 months; these control the allergic tendency so that frequency as well as severity of asthmatic episodes are reduced.Rescue inhalers are used to handle acute symptoms.

Effective use of Inhalers requiresknowledge of medication plan, symptom monitoring and demonstration by a trained counselor on when and how to use inhalers. They must be prepared to recognize and handle emergencies.Once symptoms get better, medicines are gradually tapered based on clinical assessment by treating specialist.

Can we prevent asthma attacks?

We can prevent most of the asthma attacks by avoiding triggers and complying well with medicines; but not all exacerbations can be avoided. Exposure to common irritants like dust, pollution,smoke must be minimized. Avoid using perfumes and strong deodorants. Allergens may be identified by allergy testing. Besides the recommended vaccines, flu vaccines may be taken periodically.

Can asthma be completely cured?

Asthma is a result of gene-environment interaction. Effectivecomplete cure wouldbe possible only if we can remove the culprit genes and the triggering environment!

But we can control symptomsalmost completely, if we use the medicines as advised and avoid allergens as feasible. According to global experts(GINA), goal of treating asthma is to improve the quality of life in terms of reducing frequency of symptoms as well as emergency visits, and improving sleep quality, participation in sports etc.

The most promising thing about asthma in kids is that most get better with time and outgrow their asthmatic symptoms. Till the child outgrows asthma it is our joint duty,as parents and doctors, to control their symptoms and make sure they can enjoy a near normal life.

Dr Neetu Gupta and Dr Prameela Joji

Pediatric Intensivists and Allergy Asthma Specialists
KIMS HEALTH, Trivandrum

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