Children With Asthma

BY GREGORY DWORKIN, MD

Asthma is a chronic illness that affects many children by causing their breathing tubes to periodically become smaller than normal, making it difficult for them to breathe. The problems that occur with asthma are due to spasm of muscle around the small airway, and especially due to swelling and inflammation of the airway in the chest. Just as you can have trouble breathing through your nose with a cold, it may become difficult to move air through your chest because of the smaller than usual airway.

Children who are younger than five can have a related condition, known by many names (such as transient wheezing of infancy or reactive airways disease) that they are likely to grow out of by the school-age years but which will cause similar problems, especially in the fall and winter season with colds and viruses.

The signs and symptoms of asthma include recurring or persistent cough either at night, with exercise, with colds, exposure to cigarette smoke or with allergy exposure (especially for school-age children). Many children will also wheeze, which is the sound of turbulent air moving through the narrowed breathing passages of the chest, often heard only with a stethoscope, and usually heard or felt on breathing out. Wheezing is not the same as the “rattle” one can feel with a chest cold by putting the hand on the chest or back of your child (which is caused by mucus moving through the large airways).

There are many treatments now available for asthma which include wet inhalers, powdered breathing medicines and, sometimes, pills. However, all of the medicines fall into two broad categories: preventers and relievers. Examples of preventers are cromolyn and inhaled steroids (at a low enough dose to be safe). Examples of relievers are albuterol and oral steroids (at a low enough dose to be safe).

It is important for your child to take the medicines as prescribed to prevent breathing problems before they start, and an annual influenza shot is also recommended if you need to take daily preventers for asthma (don’t forget that what makes a “bad” flu season is if you or your child gets the flu).

Any child with asthma can participate in sports with the right medicines, and we have many Olympic athletes with asthma who have won gold medals. The school nurses in Newtown, thanks to the American Lung Association and a grant from Danbury Hospital, have been trained to recognize the signs and symptoms of asthma.

Ask your doctor if you have further questions about this condition, including concerns about medication side effects, diagnosis or treatment plans. Asthma is a very treatable condition, and all asthmatic children should have a normal quality of life.

Gregory Dworkin, MD, is Danbury Hospital’s chief pediatric pulmonologist and a medical adviser to Open Airways For Schools, a program in elementary schools in the Danbury area.