Treating Asthma in Children
Step 2 -- Anticipating and Preventing Asthma Flare-Ups
Patients with asthma have chronic inflammation of their airways. Inflamed airways are "twitchy" and tend to constrict (or narrow) whenever they are exposed to a trigger (such as infection or an allergen). Some children with asthma may have increased inflammation in the lungs and airways every day without knowing it. Their breathing may sound normal and wheeze-free when their airways are actually narrowing and becoming inflamed, making them prone to a flare-up. To better assess a child's breathing and determine risk for an asthma attack (or flare-up), breathing tests may be helpful. Breathing tests measure the volume and speed of air as it is exhaled from the lungs. Asthma specialists make several measurements with a spirometer, a computerized machine that takes detailed measurements of breathing ability.
Another way to know when a flare is brewing is to look for early warning signs. These signs are little changes in a child that signal medication adjustments may be needed (as directed in a child's individual asthma management plan) to prevent a flare. Early warning signs may indicate a flare hours or even a day before the appearance of obvious flare symptoms (such as wheezing and coughing). Children can develop changes in appearance, mood, or breathing, or they may say they "feel funny" in some way. Early warning signs are not always definite proof that a flare is coming, but they are signals to plan ahead, just in case. It can take some time to learn to recognize these little changes, but over time, recognizing them becomes easier.
Parents with very young children who can't talk often find early warning signs very helpful in predicting and preventing attacks. And early warning signs can be helpful for older children and even teenagers because they can learn to sense little changes in themselves. If they are old enough, they can adjust medication by themselves according to the asthma management plan, and if not, they can ask for help.
Step 3 -- Taking Medications As Prescribed
Developing an effective medication plan to control a child's asthma can take a little time and trial and error. Different drugs work more or less effectively for different kinds of asthma, and some drug combinations work well for some children but not for others.
There are two main categories of asthma medications: quick-relief medications (rescue medications) and long-term preventive drugs (controller medications) (see Treatment of Asthma). Asthma drugs treat both symptoms and causes, so they effectively control asthma for nearly every child. Over-the-counter drugs, home remedies, and herbal combinations are not substitutes for prescription asthma medication because they cannot reverse airway obstruction and they do not address the cause of many asthma flares. As a result, asthma is not controlled by these nonprescription drugs, and it may even become worse with their usage.