What is asthma?
Asthma is a chronic lung problem and is the most common long-term illness in children. There is no cure for asthma, but with proper management and control, children can live normal, active lives.
Asthma can cause the inside of your airway to become swollen and inflamed and the muscles around the outside of the airway to be sensitive or “twitchy”. Asthma can also cause airways to produce a thick mucus. When children are exposed to certain conditions or triggers, the swelling/inflammation will increase and the muscles will tighten, making it harder to breathe. Your child may also cough up some thick mucus.
Signs and symptoms of asthma
The most common symptoms of asthma include:
- coughing (especially a pro longed cough after an illness),
- shortness of breath,
- chest tightness, and
- difficulty breathing with excretion or exercise.
The symptoms can range from mild to severe. Asthma symptoms may be different for children as well different for an individual child from one episode to the next.
Symptoms of an asthma attack may include one or more of the following:
- severe shortness of breath,
- rapid shallow breathing or
- sucking in the skin at the base of the neck or just below the base of the ribs.
If your child is having an asthma attack:
- Stay calm.
- Follow your child’s asthma action plan.
- Give your child their “Blue” Ventolin inhaler. Remember your child’s “Blue” inhaler should start to work in 10-15 minutes and should last for four (4) hours. If there is no improvement after the first 10-15 minutes, make sure the “BLUE” inhaler isn’t empty and that your child used proper technique when taking the inhaler.
- Monitor your child’s symptoms. If they persist more than 10-15 minutes with no improvement after giving the “BLUE” inhaler, seek emergency attention.
Management of asthma
Each child will have a specific asthma management plan to ensure they can enjoy normal, active lives. When developing this plan, the health-care team will conduct an assessment of the child’s environment, identify possible triggers in the environment or in the child’s life and discuss with you how to avoid and/or decrease risk of exposure to triggers.
Avoiding triggers play an important role in managing your child’s asthma. Triggers are things that can make your child’s asthma worse. It is important to know what your child’s asthma triggers are and whenever possible, to remove or avoid them.
- Common cold:
- One of the most common asthma triggers for children is the common cold. Since the common cold is most common trigger, we recommend children and their families get a yearly flu shot.
- Cold air
- Before going out into cold weather make sure you child has a scarf that covers the mouth and nose.
- Exercise or play inside on cold days.
- Cigarette smoke
- Do no not smoke inside the house or car. Remember that cigarette smoke sticks to your clothes, so wear designated smoking clothes when possible.
- If someone in the household smokes, try to quit.
- Wood/oil/cooking smoke
- When cooking, make sure to use a fan vented to the outside.
- Avoid fireplaces, woodstoves and campfires.
- Have heating ducts cleaned on a regular basis.
- Frequently clean moldy areas with soap and water.
- Reduce humidity by using fans and dehumidifiers. Humidity levels in the house should be below 50%.
- Fix leaks in the plumbing or roof immediately.
- Weather changes
- Emotional stress
- Pet dander
- Reduce contact with pets as much as possible.
- Keep pets out of the bedroom.
- Use an air purifier.
- Keep windows and doors closed during peak season.
- Consult with your physician regarding use of an allergy medication or nasal spray.
- Hire a professional exterminator and keep your child out of the house while chemicals are being used.
- Dust mites
- Use dust mite proof mattress and pillow covers.
- Reduce clutter and stuffed animals in your child’s bedroom.
- Wash and dry bed linen weekly on a hot cycle (do not use an outside clothesline).
- Remove carpet where possible, especially in your child’s room.
- Vacuum and dust child’s room weekly.
- Keep humidity level below 50%. Dust mites do not survive in a dry environment.
- Strong smells (e.g., paint, perfumes, air fresheners, cleaners.)
- Gastrointestinal (GI) reflux
- Air pollution
- Check your local air quality index.
- Keep your child indoors when air quality is poor.
- Keep the windows in the car and home closed.
- Aspirin (ASA, acetylsalicylic acid) and Ibuprofen can cause asthma symptoms.
- Make sure there are no words like ibuprofen, aspirin, ASA or acetylsalicylic acid on the labels of the medication you give your child.
After review of possible triggers and environmental assessment, the health-care team will discuss medications that may help to manage your child’s symptoms. There are two types of inhaler medications that are used to manage asthma: reliever and controller medications.
- Used during an asthma attack or before exercise.
- Work quickly to relax the muscles around your child’s airways when they become tight.
- Should be accessible to your child at ALL TIMES.
- Are often referred to as your “Blue puffer”.
- Should always be used with a spacer unless your device is a turbuhaler.
Ventolin® is the most common type of reliever. Upon use, Ventolin should start to work in 10-15 minutes and should last for four (4) hours. If your child is using Ventolin more than four (4) days a week, or finds that the Ventolin is not lasting 4 hours, it could be a sign that your child’s asthma is not well controlled. In this case, please contact your doctor.
- MUST be used daily, either once or twice a day depending on what your doctor recommends.
- MUST be taken even when your child is well.
- Contains a steroid to reduce inflammation and mucus inside the airways.
- Can cause a yeast infection in your mouth called thrush. To reduce risk of thrush ALWAYS use a spacer with a puffer and rinse the mouth with water after each use.
- Takes 2-4 weeks to start to work.
- NOT effective for treating an asthma attack; your “blue puffer” should be used to treat an asthma attack.
Asthma action plan
Once you and your health care team decide on the appropriate medications to manage your child’s asthma, an asthma action plan may be developed. An asthma action plan is a written care plan that you and your doctor mutually agree upon, to help control your child’s asthma. Your doctor will help you select the right medication(s) for your child’s symptoms and outline when and how to use them. Always follow dosing instructions carefully and contact your health-care team if you have any questions.
Improper inhaler technique is a common cause of poor asthma control. Please view the resource handouts for more information.
Asthma control questionnaire
The following questions may assist you in determining your child’s health.
- Is your child’s asthma in good control?
- Does your child have a daytime cough that is less than 4 times days per week?
- Does your child have a nighttime less than 1 night per week?
- Is your child’s physical activity normal? (Are they able to keep up with other children their own age without becoming short of breath, coughing, and wheezing or experience chest tightness?)
- Is your child’s asthma flare up mild or infrequent?
- Has your child had any absences from school or work because of trouble breathing?
- Is your child using their blue puffer (Ventolin, Bricanyl) less than 4 times per week?
If you answer YES to all the above questions, your child’s asthma is controlled.
If answer NO to any of the above questions, contact your physician to discuss your child’s asthma action plan.
(Canadian Thoracic Society Guidelines 2018)