Asthma In Children: What Happens

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What Happens

Asthma often begins during childhood or the teen years and may last throughout your child's life.

At times, the inflammation found in asthma causes your child's airways to narrow and produce mucus, resulting in asthma symptoms such as shortness of breath.

The airways narrow when they overreact to certain substances. These are known as asthma triggers and may include:

• Substances your child is allergic to (allergens, such as dust mites or animal dander). Allergens cause long-term (chronic) inflammation and may cause asthma symptoms.
• Environmental factors, such as smoke or cold air. Environmental factors may lead to a tightening of the muscles that line the bronchial tubes (bronchospasm), which can trigger asthma symptoms.

What triggers asthma symptoms varies from child to child. When asthma is triggered by an allergen, it is known as allergic asthma.

When asthma symptoms suddenly occur, it is known as an asthma attack (also called an acute episode, flare-up, or exacerbation). Asthma attacks can occur rarely or frequently and be mild to severe.

It can be difficult to know how severe your child's asthma attack is; this is important, because severe attacks may require emergency treatment. However, in most cases you can take care of your child's symptoms at home with an asthma action plan, which is a written plan that tells you which medication your child needs to use and when you should call a doctor or seek emergency treatment.

Asthma is classified as intermittent, mild persistent, moderate persistent, and severe persistent. Children with:

• Intermittent, mild persistent, and frequently, moderate persistent asthma often have symptoms only after being around a trigger.
• Intermittent asthma usually need medications only during an asthma attack. In intermittent asthma, the child is well and without symptoms in between infrequent attacks with symptoms.
• Mild persistent or moderate persistent asthma need to take medications daily to control the long-term inflammation in their airways. These children are at risk of asthma attacks that may become severe.
• Severe persistent asthma have symptoms almost all of the time. Their symptoms need to be treated daily. These children are at increased risk for severe, life-threatening asthma attacks known as status asthmaticus.

Asthma can have a great impact on your child's life. Even mild asthma may result in changes to the airway system (airway remodeling) and speed up and worsen the natural decrease in lung function that occurs as we age.³ Loss of lung function in asthma appears to start early in childhood.⁴ Asthma also may increase the risk of a partial collapse of lung tissue (atelectasis) or a collapsed lung (pneumothorax).

Sometimes asthma does not respond to treatment because children are not taking their medications, not taking them correctly, not avoiding triggers, and otherwise not following their daily treatment plan or asthma action plan. It is very important that you and other caregivers make sure your child is following his or her treatment and action plans to prevent worsening asthma and an increased risk of death.

By following asthma plans, most children with asthma can live a healthy, full life.

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