Reading, Writing, and Wheezing? Not Necessarily

From the WebMD Archives

Sept. 19, 2000 -- For the millions of U.S. children who suffer from asthma and allergy attacks, going back to school may mean more than just homework and homeroom.

Thanks to substances commonly found in classrooms, including chalk dust, dust mites, animal dander from class pets or pet hair on other student's clothing, pollen, and mold, fall can bring on more asthma and allergy attacks. In addition, allergies to foods found in many school cafeterias -- including milk, eggs, peanuts, wheat, soy, and fish - affect 2 million U.S. children.

In a recent survey of children with allergies and asthma, 41% said they had as many as three attacks per month at school, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). And these attacks can take a toll on a child's education: U.S. children miss a total of about 2 million school days each year because of allergies, and 10 million days because of asthma, the AAAAI says.

But parents can make sure this school year is a productive one for their kids by making sure the children go to class equipped with a "school management plan" containing detailed medical information about what triggers their attacks, medications they need, and what school personnel should do in an emergency, experts tell WebMD.

The Milwaukee-based group says parents should schedule a meeting with teachers and the school nurse to discuss their child's condition; sit down with the child and go over the substances and conditions that trigger his or her attacks; and encourage the child to get help from a teacher if symptoms worsen. Parents also need make sure their children have their allergy/asthma medications and a peak flow meter -- a device that helps monitor breathing -- with them during the school day.

It's important that children who have been diagnosed with asthma follow the regimen prescribed by their doctors even when they're away from home, says Elaine Gonsior, MD, director of the allergy clinic and staff physician at Kansas State University Student Health Center in Manhattan and a member of the AAAAI's National Committee for Public Education.

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"If a child has allergies or asthma and seems to get worse during the school year, check for hidden triggers at school such as mold behind the chalkboard," Gonsoir suggests. "Or perhaps the child is sitting next to a child who has one or more cats, or maybe the school doesn't have air conditioning, so the windows are open and pollen is aggravating their allergies."

As attacks can also be triggered by exercise and stress, parents should also inform physical education teachers and coaches about asthma, and make sure they recognize warning signs of an attack, the AAAAI says.

And if their child is having difficulty with learning, alertness, or endurance, parents should consult a physician. These symptoms may be side effects of the child's condition or medications and may be eliminated with a medication adjustment.

If their children have food allergies, the AAAAI recommends that parents inform school cafeteria staff about what foods to avoid and suggest safe alternatives. Parents should also make sure that epinephrine is available and that the school's staff knows how to administer it. Epinephrine is a medication that is injected to open airways during extreme allergic reactions.

Parents can also take steps at home to keep children from having asthma or allergy attacks during the school day. Keeping up healthy lifestyle habits, including exercise, adequate sleep, and a healthy diet, is also essential in keeping attacks to a minimum, Gonsoir tells WebMD.

"If the parents smoke, they should not smoke in the house or the car," as smoke is a common trigger for both allergies and asthma, she says. "Sometimes a child is exposed to a trigger at home which doesn't manifest itself until later, at recess."

Some school districts are working with parents to try to help keep allergy and asthma attacks at bay. In New York City, for example, parents can fill out a form that allows children to carry their attack-preventing medications to class with them, instead of having them kept in the school nurse's office, says Karen Drezner, assistant director of the Childhood Asthma Initiative in New York.

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But for preventing attacks at school, "I think the most important thing is teacher education," Drezner says. "I used to be a teacher and it's amazing -- if you ask kids how many have asthma, a lot will raise their hands, and so many teachers just don't know who has it and what to do in the case of an attack."

Teachers and parents can help get the learning process started with an American Lung Association-sponsored program called Open Airways for Schools, Drezner says. This school-based program is aimed at teaching elementary school children how to manage asthma. It provides teachers and school nurses with instructional materials including lesson guides and handouts for both children and parents.

For more information about Open Airways for Schools, contact the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).

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