Monday, September 14th, 2009

Helping Kids Catch their Breath

ASTHME-ENFANT-ILLUSTRATIONAsthma attacks are frequent among children making it one of the most common ailments of childhood.
Asthma is…
• An inflammatory condition of the airways caused by allergens, irritants and respiratory infections.
• It has many trigger factors that activate an over-reactive airway system.
• Is reversible and controllable (with only a few rare exceptions)

Symptoms of asthma:

Asthma is difficult to diagnose, especially in children less than five years of age. Asthma signs and symptoms include coughing, wheezing — a whistling sound made when exhaling — and shortness of breath, or any combination of these. But people often identify asthma as just wheezing, so they may miss the other signs or mistake them for a cold.

Coughing after running or crying, recurrent night cough are other symptoms. Infants who have asthma often have a rattly cough, rapid breathing and may have an excessive number of “pneumonias,” episodes of bronchitis or “chest colds.” Obvious wheezing episodes might not be noted until after 18 to 24 months of age. Since these symptoms can occur in other respiratory ailments other than asthma, it is advisable to rule out these possibilities. In a young child the discomfort of chest tightness may lead to unexplained irritability. It is much better to consult your paediatrician if your child complains of these symptoms

According to Dr. Krishan Chugh, HOD, Paediatrics, Gangaram Hospital, “Around 15 per cent children in Delhi suffer from childhood asthma. I prefer to call it a disorder rather than a disease because calling it a disease scares many parents.” 60 percent children are cured of the problem

According to Dr Chugh, an inhaler, as long as it is properly prescribed by a medical practitioner acts more as a friend of the kids. Patients do not become dependant on the inhaler, rather many of them are cured because of its use.

What usually triggers Asthma?
Episodes of asthma often are triggered by some condition or stimulus. Common triggers are:
• Exercise – Running can trigger an episode in over 80 percent of children with asthma. Bronchodilator medications used before exercise can prevent most of these episodes. Swimming seems to be the least asthma-provoking form of exercise.
• Infections – Respiratory infections frequently trigger severe episodes of asthma. Research indicates that viruses rather than bacteria produce these infections and Antibiotics do not help.
• Chronic sinusitis in childhood due to bacteria can be a very stubborn chronic trigger for asthma. Antibiotic treatment for 3 to 4 weeks or longer may be required to completely eradicate these infections. Asthma may also be triggered by an ear infection or bronchitis that would also require antibiotic therapy.
• Allergy – Allergic children suffer reactions to ordinarily harmless material (pollen, mold, food, animals).
• Irritants – Cigarette smoke, air pollution, strong odors, aerosol sprays and paint fumes are some of the common irritants..
• Weather – Pulmonary function studies demonstrate that breathing cold air provokes asthma in most children with asthma.
• Emotions – Emotional factors are not the cause of asthma; however, emotional stress can infrequently trigger asthma.

Asthma control

Asthma control involves life-style modifications. Knowledge about asthma and trigger factors is the first step in managing asthma.

How do you know your child is having a severe asthma attack?

Signs and symptoms indicating that your child is having a severe attack and needs immediate medical attention include the following:
• The child is breathing so hard that he has to stop in mid-sentence to catch his breath.
• The child is using his abdominal muscles to breathe.
• The child is widening his nostrils when breathing in.
• The child’s abdomen is sucked under his ribs when he breathes in.

Asthma Management Plan

All asthma patients, their parents and their doctors should put together a written contingency plan that outlines how to handle an asthma attack. This will allow you, your child and your child’s teachers and coaches to know exactly what to do the next time your child feels congestion in the chest.
 Warning signs of asthma attack. List specific symptoms that signal your child’s asthma attacks.
 Steps you and your child can take to manage an attack. Know ahead of time what medications you have on hand that you can use during an asthma attack. Write down what they are, where they’re kept and how to use them.

 How to recognize and handle a serious attack. List criteria for determining the degree of your child’s breathing difficulty. Learn what medication needs indicate a serious attack, List instructions for using medications specifically for serious asthma attacks. Keep on hand the phone number of your child’s doctor.

 When emergency care is needed and what to do. Write down the warning signs of a life-threatening asthma attack. List emergency phone numbers and the location of the nearest hospital.
Asthma attacks become worse at night. Here are a few tips to help ease those long nights:
 Many medicines can cause irritability and sleeplessness. Talk to your child’s doctor about changing your child’s medication schedule to help avoid these side effects.
 Prop up your child’s pillows to keep mucus from draining into his throat which causes coughing.
 Use a washable security blanket and wash it weekly. Cover mattresses in plastic casings and wash sheets once a week in hot water. Remove carpeting from your child’s room.
 Make your home dust free and smoke free.
 Steer clear of caffeine which is present in many foods, drinks, and medicines.

Recommendations
Children with asthma may be deficient in certain nutrients, such as vitamin B6 (Pyridoxine), vitamin C, magnesium, manganese, and selenium. Supplementing these nutrients with a multi-vitamin may help in managing asthma.
If exercise induces an asthma attack in your child, recent research says taking a 2000 milligrams of Vitamin C an hour before exercise can reduce asthmatic bouts.
Incorporate fresh fruits, whole grains and vegetables in the diet of your asthmatic child.
Inhaling a muscle-relaxing medication such as Salbuterol can relieve an acute asthma attack immediately by opening the bronchial tubes. However, it offers only symptomatic relief.

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