More children suffer from asthma than from any other chronic disease, with more diagnoses in the U.S., United Kingdom, and Australia than in any other countries. As the diagnosis rate slows in resource-rich nations, poorer countries show rising rates, with greater severity and more deaths. To understand the impact and treatment of this disease, start with its risk factors, symptoms, and diagnosis.
Who’s at risk for childhood asthma?
In the U.S., 8.3% of children develop childhood asthma, which costs $50 billion for annual medical treatment and ranks third on the list of reasons for childhood hospitalizations. In children under the age of 10, the disease affects more boys than girls, and 80% of asthma diagnoses come during a child’s first six years of life.
Genetics, viral infections, lung problems associated with premature birth, and environmental exposure can increase the likelihood that children develop asthma. Exposure to pollution, including tobacco smoke, also cranks up the risk factors, as do childhood stress and a family history of medical conditions such as asthma itself, allergies, and eczema.
During pregnancy, mothers who smoke, eat high-sugar diets, or consume less of certain nutrients, such as vitamin E, zinc, and certain fatty acids, can increase their babies’ likelihood of developing asthma. Confusingly enough, however, even kids who grow up away from pollution, with no smokers in their immediate family, can develop asthma, too. Unfortunately, medical science doesn’t fully know exactly how to reduce asthma risk factors.
How asthma behaves
With every breath, you inhale through your larynx to your trachea, and into your lungs through passages called bronchi. Closer to your lung tissue and smaller in size, the bronchi are called bronchioles, and these passages lead to little air sacs called alveoli that bring oxygen into your respiratory system and send carbon dioxide back out.
When these lung tissues become inflamed and swollen, they also get narrower, which constricts airflow and produces the distinctive symptoms of asthma. This airflow constriction isn’t a permanent condition; in fact, it’s almost always reversible.
Asthma also can increase the production of mucus in the lungs. Severe airway swelling restricts the oxygen level in the bloodstream and requires immediate medical attention.
Asthma causes coughing and wheezing, especially during sleep and early in the morning. Children with asthma also may report feeling breathless, or experience tightness, pressure, or pain in the chest, along with a stomachache.
Not all children who cough and wheeze when they catch a cold will develop asthma, but if they experience these symptoms after the age of three, they typically have asthma. Episodes of reversible airflow obstruction during bouts of coughing and wheezing can confirm the asthma diagnosis.
What triggers an asthma attack?
A cold or the flu that settles into the head or chest provides the most common trigger of an asthma attack. Outdoor pollution and the weather can cause or worsen asthma for many kids, with attacks more common in cold air, rain, wind, and when the barometric pressure rises or falls. Exercise-induced asthma pops up after or during prolonged, vigorous exercise. Pollens, dust, furry pets, mold, smoke from tobacco or vaping, and indoor pollution all can cause symptoms.
Diagnosing childhood asthma
A spirometry test measures air volume inhaled and exhaled, along with how fast you can breathe out. During the test, you take a deep breath through your mouth and exhale as hard as possible into a tube attached to a measurement apparatus.
Alternatively, a challenge test deliberately narrows the airways through exercise or with inhaled cold air or medication. Additional tests rule out other conditions, such as cystic fibrosis, acid reflux, allergies, and deficiencies of the immune system. For very young children, an asthma-medication trial facilitates a diagnosis, showing that reversible symptoms respond to treatment.
Bronchodilators quickly help relax the muscles around constricted airways. These medicines aren’t designed for regular long-term therapy, however. Instead, inhaled or oral doses of long-term control medications take care of ongoing treatment. For children with exercise-induced asthma, an extra dose of medicine can help avoid problems during sports and other vigorous activities.
Along with medication, children with asthma also benefit from efforts to clear away allergens and pollutants at home. An asthma diary records when and under what conditions the attacks occur, along with the severity of symptoms, helping spot treatable patterns. Regular checkups and periodic assessment of lung function help assure that medication levels match up well with treatment outcomes.
Staying ahead of asthma
In families of children with asthma, it’s critical to thoroughly eliminate all possible allergens and contaminants at home, administer medication correctly, and communicate with your pediatrician. These steps form the foundation of successful care plans that help children with asthma live full, enjoyable lives.
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