Asthma In Children: Living With Asthma

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Living With Asthma

You can control the impact asthma has on your child's life by following your asthma plans consistently. A management plan can reduce inflammation to prevent long-term damage to your child's lungs and decrease the severity, frequency, and duration of asthma attacks. Your child may have difficulty following the plan because of its many different factors.

To help you and your child remain consistent in following your asthma plans:

• Educate yourself and your child about asthma. By doing so, you can learn to control symptoms and reduce the risk of your child developing asthma attacks. This questionnaire can help you and your child determine what you already know about asthma and what you may need to discuss with your doctor.
• Understand your child's barriers and solutions. What may prevent your child from following his or her plan? These may be physical barriers, such as living far from your doctor or pharmacy, or emotional barriers, such as having undiscussed fears about the condition or unrealistic expectations. Discuss your child's barriers with your doctor and work to find solutions.
• Develop goals that relate to your child's quality of life. Being able to measure success gives your child greater motivation to follow asthma plans consistently. Decide together what you want to be able to do. Have symptom-free nights? Be able to exercise on a regular basis? Feel secure in knowing you both can deal with an asthma attack? Work with your doctor to see if your child's goals are realistic and how to meet them.

Your child's asthma plans generally consist of the following:

• Seeing your child's doctor regularly to monitor the asthma. The frequency of checkups depends on how your child's asthma is classified. Doctors recommend checkups about every 6 to 12 months for intermittent or mild persistent asthma that has been under control for at least 3 months; every 3 to 4 months for moderate persistent asthma; and every 1 to 2 months for uncontrolled or severe persistent asthma. Bring your asthma plans to the appointments.
• Following your child's daily asthma treatment plan. The plan helps you prevent or slow development of the long-term effects of asthma and describes which medications to take every day. A daily treatment plan also may include an asthma diary where you and your child record his or her peak expiratory flows, symptoms, triggers, and quick-relief medication used for asthma attacks. This valuable tool helps your doctor manage your child's asthma. A daily asthma treatment plan is often combined with an asthma action plan.
• Following your child's asthma action plan. This contains directions for the management of asthma attacks at home. It helps you better control your child's asthma attacks by being aware of symptoms and knowing how to make quick decisions about medication and treatment. See an example of an asthma action plan (What is a PDF document?) .

For more information on how to monitor and treat asthma, see:

Asthma: Taking charge of your asthma.

Asthma: Using an asthma action plan.

To effectively manage your child's asthma and use his or her daily asthma treatment and action plans, you will have to know how to monitor peak airflow and identify asthma triggers and see that your child takes his or her asthma medication correctly.

Monitoring peak expiratory flow

It is easy to underestimate the severity of asthma symptoms. You and your child may not notice symptoms until your child's lungs are functioning at 50% of their personal best measurement. Measuring peak expiratory flow (PEF) is a way to keep track of asthma symptoms at home and to know when your child's lung function is becoming worse before it drops to a dangerously low level. You can do this with a peak flow meter. This test can easily be done (with practice) by most children age 5 and older. For more information, see:

Asthma: Measuring peak flow.

Identifying asthma triggers

A trigger is anything that can lead to an asthma attack. A trigger can be:

• Irritants in the air, such as tobacco smoke or air pollution.
• Substances to which your child is allergic (allergens), such as pollen or animal dander.
• Other factors, such as a viral infection, exercise, stress, or dry, cold air.

If your child can avoid triggers, he or she may decrease the chance of having an asthma attack. And, in the case of allergens, avoiding triggers will help control inflammation in the bronchial tubes. For more information, see:

Asthma: Identifying your triggers.

If your child has asthma triggered by an allergen, taking antihistamine medication may help him or her manage the allergy and thus limit its effect on asthma.

Taking asthma medication

Taking medications is an important part of asthma treatment. But because your child often has to take many different medications, it can be difficult to remember to take them. To help you and your child remember, understand the reasons people don't take their asthma medications, and then find ways to overcome those obstacles, such as taping notes on the bathroom mirror.

Most medications for asthma are inhaled. With inhaled medications, a specific dose of the medication can be given directly to the bronchial tubes, avoiding or decreasing the effects of the medication on the rest of the body. Delivery systems for inhaled medications include metered-dose and dry powder inhalers and nebulizers. A metered-dose inhaler (MDI) is used most often.

Many doctors recommend that every child who uses a metered-dose inhaler (MDI) also use a spacer , which is attached to the MDI. A spacer may deliver the medication to your child's lungs better than an inhaler alone, and for many people is easier to use than an MDI alone. Using a spacer with inhaled corticosteroids can help reduce their side effects and result in less use of oral corticosteroids.

If your child is younger than 3, he or she may not be able to use an MDI alone but, with assistance, may be able to use an MDI with a mask spacer. Most school-age children can use an MDI. If your child is having difficulty using an MDI with a spacer, he or she can use a nebulizer. Work with your doctor to find the best delivery system for your child.

It is important to keep track of the inhaler doses and discard the inhaler when your child has used the number of doses indicated on the package labeling. This not only prevents your child from having an empty inhaler when he or she might need medication, but it also prevents your child from inhaling only propellant after the medication has run out. For more information, see:

Asthma: Using a metered-dose inhaler.

Asthma in children: Helping a child use a metered-dose inhaler and mask spacer.

Asthma: Using a dry powder inhaler.

More tips for managing your child's asthma

To manage your child's asthma:

• Maintain a daily routine. Make treatment part of normal, daily activities to help your child adjust to the condition and take responsibility for managing treatment. Your child could, for example, get used to taking medicine before brushing his or her teeth.
• Check your child's symptoms. If your child is old enough to understand the process, teach him or her what symptoms to watch for and how to check the peak expiratory flow. Help your child understand how to follow daily treatment and action plans.
• Inform others in your child's life about asthma. Inform the principal, school nurse, teachers, and coaches at your child's school that your child has asthma. Give the staff a copy of your child's asthma action plan so that they can help your child to take his or her medication and will know what to do during an asthma attack. Your child should be encouraged to participate in exercise and sports. Asthma, when well controlled, should not prevent your child from participating in sports and other physical activities.

It is important to treat your child's asthma attacks quickly. If your child does not improve soon after treating an attack, talk with a doctor.

• During attacks, stay calm and soothe your child. This may help your child relax and breathe more easily.
• Don't underestimate or overestimate how severe your child's asthma is. It is often hard to know how much breathing difficulty a baby or small child is having. Seek medical care early for babies and small children with asthma symptoms.

Last updated:	March 22, 2007
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Harold S. Nelson, MD - Allergy and Immunology
Editors:	Susan Van Houten, RN, BSN, MBA, Denele Ivins