The ABCs Of Paedatric Asthma In Little Ones

Do You Think Your Child Is Showing Signs Of Asthma?

Growing up has become increasingly challenging for kids due to rising pollution and abrupt weather changes. Who would have thought that what was once a common lung disease in adults would become significant in children under the age of five? Childhood asthma is one such example.

Asthma can occur in infants and toddlers and can start as early as 6 months of age. Common allergens in the air like dust, pollen, smoke, etc irritate the airways as they move into the lungs. The irritants cause inflammation of the airways, making it difficult to breathe. Chronic inflammation snowballs into asthma.

Breathing issues due to asthma typically occur as "episodes" or attacks that can be reversed. There is no cure for childhood asthma, and some people experience symptoms well into adulthood. But with the right care, you and your child can manage the symptoms and protect the developing lungs.

When It Is More Than Just A Cough: Signs And Symptoms Of Childhood Asthma

As a parent, a teacher or a caregiver it is advisable to be aware of these signs and symptoms of paediatric asthma to be able to seek emergency care when needed:

• Wheezing: Wheezing is a high-pitched whistling sound produced when breathing heavily. You might hear this sound while your child is playing, sleeping, or engaging in other strenuous activities.
• Coughing: Young children with asthma may have an irritating, persistent cough round the clock. The cough may worsen with exercise or exposure to dust.
• Rapid breathing: Your child may look like he is having trouble catching their breath.
• Chest tightness: Deep breathing may become strenuous and contract the abdominal muscles due to the tightness of chest.
• Trouble sleeping: Coughing and wheezing may keep the child up at night. Poor sleep ruins their general health and mood.
• Fatigue: Poor sleep and strenuous breathing cause fatigue or exhaustion.

You may notice one or more symptoms, which may become severe with time. Consult a paediatrician in such cases to avoid complications.

Can Childhood Asthma Be An Emergency?

A severe attack may require immediate hospitalization. If your child is gasping for breath, the stomach sinks in with every breath or has an uncontrollable cough with breathing sounds and mild chest pain, then it is likely to be a medical emergency. It is best to avoid an asthmatic emergency to prevent any permanent damage to the lungs. The best way to do it is to avoid the triggers of childhood asthma.

The Triggers Of Childhood Asthma

It can be challenging to pinpoint the exact cause of a child's asthma because it is multifactorial. Sadly, there isn't a single pathological test to find the exact trigger.

Exploring any potential allergens in the vicinity is the best way to detect the trigger; some of these are:

• Viral infections of the nose, throat, and lungs often exacerbate asthma in children; an episode of cold (caused by the rhinovirus or influenza virus), pneumonia, or sinusitis (inflammation of the sinuses).
• Allergens: Seasonal allergens (tree, weed, and grass pollens) and recurring allergens (mould spores, cockroaches, rats, mice, dust mites, and pet dander)
• Irritants like air pollution, chemicals, cold air (in winter), strong odours, or smoke (tobacco smoke from smoking parents, relatives and others)
• Stress often leads to breathlessness and tightness of the chest. Issues at home or at school, peer pressure, anxiety, and aerobic exercises can cause episodes of childhood asthma.

Risk Factors

Factors that could heighten the likelihood of your child developing asthma include:

• Exposure to tobacco smoke, including prenatal exposure.
• Past allergic reactions, such as skin reactions, food allergies, or allergic rhinitis (hay fever).
• Family history of asthma or allergies.
• Residing in an area with elevated pollution levels.
• Obesity.
• Respiratory conditions like chronic nasal congestion, sinus inflammation, or pneumonia.
• Gastroesophageal reflux disease (GERD).
• Male gender.
• Being of Black or Puerto Rican descent.

Get Your Child Tested: Diagnosis And Symptoms Of Asthma In Children

When you reach the doctor's office, your child's asthma symptoms may have subsided. You, as a parent, play a crucial role in making your doctor aware of the situation. In most cases, the diagnosis will be based on your recollection of the events of an asthma attack. These includes a description of the signs and symptoms, any potential triggers and a family history of the disease.

Diagnostic tests include:

• Children above 5 years of age are subjected to PFT (Pulmonary Function Testing)
• Diagnosing asthma in children between 6 months to 36 months (3 years) is challenging. The Asthma Predictive Index is a clinical tool that can be used below 3 years of age. Risk is determined by a combination of major criteria (doctor-diagnosed parental asthma) and minor criteria (doctor-diagnosed allergies, and wheezing without viral infections)
• Blood tests to check for increased immune cells (IgE, Eosinophils) that react to any allergen.
• Spirometry
• Skin prick test

Managing Asthma In Young Children: Tips For Parents And Caregivers

Childhood asthma does need medication apart from home care; they are prescribed as per the child's weight and age.

1. Bronchodilators (an example is Albuterol):

You can administer asthma medications to your child (between the ages of 6 months and 3 years) using a home nebulizer (breathing machine). The nebulizer converts liquid asthma medications into a mist that the child inhales through a mask that fits over his nose and mouth. The breathing cycle lasts up to 10 to 15 minutes and can be given as per the doctor's recommended dosage.

2. Low-dose inhaled steroid

The next step is a low dose of an inhaled steroid or montelukast (Singulair) for immediate relief. The doctor may decrease the medicine in case of no episodes for at least three months.

Complications

Asthma can lead to various complications, such as:

• Severe asthma attacks necessitating emergency treatment or hospitalization.
• Long-term decrease in lung function.
• Absences from school or difficulties in keeping up with academic work.
• Disrupted sleep patterns and fatigue.
• Symptoms that hinder engagement in play, sports, or other activities. 

Prevention

Prevent asthma attacks by planning ahead and avoiding triggers:

• Limit exposure to triggers: Help your child avoid allergens and irritants that can trigger asthma symptoms.
• No smoking around your child: Tobacco smoke is a strong risk factor and trigger for asthma attacks.
• Encourage physical activity: Regular exercise, when asthma is well controlled, improves lung function.
• Regularly see your child's healthcare provider: Keep check-ups and address any signs of uncontrolled asthma.
• Adjust treatment as needed: Asthma changes over time, so consult with the healthcare provider for necessary modifications.
• Maintain a healthy weight: Obesity worsens asthma symptoms and poses other health risks.
• Manage heartburn: Control acid reflux to prevent aggravation of asthma symptoms.

Conclusion

Many chronic diseases, including asthma, have benefited from a coordinated management strategy and treatment plan that extends beyond the clinic and into our daily lives. As a parent, be aware and protect your child from any triggers for their asthma. To protect your child's developing lungs, it's critical to seek medical attention if you notice any asthmatic signs or symptoms in children aged 6 to 36 months. With smart management, most children with asthma can lead healthy and active lives.