Your child and asthma

Posted on 18 July 2013

If your child is battling to breathe, and can’t run and play like other kids without coughing, there’s a good chance she may be suffering from childhood asthma, says Dr Graham Poole, a paediatric pulmonologist at Mediclinic Milnerton.

Who suffers from childhood asthma and what causes it?
Usually, children older than three have childhood asthma. They also have a strong personal and family history of allergies. The usual symptom is a wheezing chest, but a chronic nighttime or exercise-induced cough is also a very common and under-rated symptom. The causes of asthma are multifactorial. Genetics can play a role, but environmental exposure to various triggers such as inhaled allergens, aerosolised toxins (air pollution) are equally as important. These factors lead to increased airway responsiveness and the narrowing of smaller airways, which leads to obstruction of airflow when exhaling. This produces the tightness and wheeze.

What are the symptoms to watch for?
Commonly a cough, especially at night or during exercise, a tight, wheezing chest and the associated symptoms of allergy: a chronic runny or blocked nose, itchy eyes and eczema.

What tests are used to diagnose asthma?
The diagnosis is made on history and clinical examination. Supporting tests like a chest X-ray may show large lung volumes (air trapping). Allergy tests such as a skin prick test and monitoring blood IgE levels may identify possible agents likely to trigger the symptoms. In children over six years, a lung function test may also be necessary to show measurable airflow obstruction and reversibility after use of a bronchodilator.

What treatment can we expect?
Treatment will depend on the severity of your child’s symptoms. There are two groups of patients, who require different treatment approaches:
(a) Those with only an intermittent cough/wheeze only require a reliever (bronchodilator) pump (inhaler), to be used only when the chest is tight.
(b) Those with persistent symptoms will need both a reliever and a preventer pump. The latter usually consists of a long-acting bronchodilator combined with a low-dose steroid and the dosage will depend on the severity of the symptoms.

Are there any other treatments that are non-drug-related that can help relieve my child’s condition?
The best therapy is prevention. Avoiding known allergens – inhaled or ingested – environmental triggers like indoor smoking or moulds, outdoor air pollution (smog) and cold damp conditions greatly reduces the risk of severe attacks and the need for prolonged intensive drug therapy.

Will my child ever grow out of it?
With the appropriate therapy and compliance to it, most children’s symptoms can be controlled and a great proportion may outgrow it completely, especially if their wheezing is triggered by viral infections early on in life.

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Published in Children up to 12

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