Childhood Asthma

Childhood asthma is a condition in which there is inflammation of the airways causing the symptoms of airway obstruction. A child with a family history of allergy, a child who is more prone to recurrent upper respiratory tract infections, and a child with a weak immune system are more prone to get this. Exposure to environmental allergens, smoke, and exercise triggers the development of symptoms.

There are 3 types of childhood asthma one is, recurrent wheezing in early childhood, which is mainly triggered by common viral infections of the respiratory tract, and the second type is chronic asthma associated with an allergy that persists into later childhood and often adulthood, 3rd type of childhood asthma typically occurs in females who are obese and undergo earlyonset puberty.

The child presents with difficulty in breathing. Early diagnosis and treatment are important as they can cause severe respiratory difficulty. Bronchodilators, corticosteroids with precautions, and anti-allergic medicines should be used to reduce the symptoms. Avoiding exposure to allergens and dust should be done to reduce the occurrence of symptoms.

Childhood Asthma: Causes

Various factors play an important role in the development or trigger of childhood asthma. These include −

• Hereditary − It is seen that asthma runs in families from generation to generation. Children having a family history of asthma are more susceptible to developing the condition.

• Environmental Factors − Getting exposed to some environmental factors can provoke or increase the symptoms of asthma in children. These can include −

• Allergens − Allergens such as dust mites, pet dander, mold, and pollen.

• Polluted air − Exposure to air pollution, such as vehicle smoke and industrial wastes

• Respiratory tract infections such as the common cold and flu

• Exposure to smoking

• Children with a history of allergies, eczema, and gastrointestinal reflux disease are more prone to develop asthma.

• Lifestyle factors such as the child being obese, having less physical activity, and maintaining a poor diet can also contribute to childhood asthma.

Childhood Asthma: Symptoms

Children with childhood asthma present with symptoms following symptoms which include −

• Difficulty in breathing which is more after exposure to allergens or irritants and during physical activity

• Cough which is more in the night or the early morning. Cough can be dry or productive.

• Wheezing, is a sound similar to whistling during breathing produced by a child because of the flow of air through the narrow airways

• Discomfort in the chest, the child may feel tightness in the chest

• Child presents with increased breathing and respiratory rate in more than the normal

• Extra effort has to be put in by the child to breathe hence the child may feel tired and weak.

• Sleep disturbances can be present because of the difficulty in breathing

Childhood Asthma: Risk Factors

The risk factors of childhood asthma include −

• Family history of asthma

• Exposure to environmental stimulating factors such as air pollution, pollen, dust mites, pet dander, mold, and tobacco smoke can increase the risk of developing childhood asthma.

• Children living in urban areas with high levels of air pollution, or who are exposed to second-hand smoke.

• Children suffering from recurrent respiratory infections, such as the common cold, and flu during infancy or early childhood are more susceptible to developing asthma later in life because the respiratory infections can damage the airways

• Children who are overweight

• Children under stress, anxiety, or other psychological factors can alter the immune system making them more susceptible

Childhood Asthma: Diagnosis

The diagnosis of childhood asthma is done based on the following −

Clinical Examination

Complete examination of the child, abnormal sounds are heard over the chest when heard with the stethoscope while breathing. The doctor will perform a physical examination to check for signs of asthma.

Lung Function Tests

• Spirometry − In this test, the child is asked to blow into the device called a spirometer and measure how much air the child can breathe in and out and how fast they can do it. It measures lung function.

• Peak flow meter − In this, the device measures how fast the child can blow air out of their lungs. The child will blow into a small handheld device called a peak flow meter, and the device will record their peak expiratory flow rate (PEFR).

• Bronchoprovocation test − In this test, a small amount of a substance that can trigger asthma symptoms such as methacholine is made to inhale by the child. Then the child's lung function is monitored before and after the test to see if there is a significant decrease in lung function.

• Allergy testing − In this test, asthma symptoms occurring after being triggered by the allergen are seen. Skin prick testing or blood tests to check for specific allergen antibodies are done.

History of similar complaints in the family, any type of respiratory infections, similar complaints in the past, and any allergy history should be asked for.

Childhood Asthma: Treatment

The treatment of childhood asthma includes −

• Inhaled bronchodilators − Bronchodilators given through an inhaler or nebulizer relax the muscles around the airways, helping to breathe with less difficulty. These give immediate relief during asthma attacks and can also be used as a preventive medication before exercise or exposure to triggers.

• Inhaled corticosteroids − Corticosteroids help by reducing inflammation in the airways. Both bronchodilators and corticosteroids can be given combined and are used in moderate to severe asthma symptoms.

• Leukotriene modifiers − These act by blocking the action of leukotrienes, which are mediators in the symptoms of asthma.

• Immunomodulators such as omalizumab can be used. These act by reducing the body’s immune response to the allergens such as omalizumab hence helping to prevent asthma attacks.

• Allergen immunotherapy, in which the child is exposed to smaller amounts of the allergen over time, by this child’s immune response to that particular allergen is reduced over time.

Lifestyle modifications such as avoiding the triggers, maintaining a well-balanced diet, regular exercise, and proper use of inhalers can also help the child.

Childhood Asthma: Prevention

Childhood asthma is prevented by the following measures −

• Maintain cleanliness at home, the home should be free of dust, mold, and other allergens.

• Use of hypoallergenic pillows and mattress covers, as well as bedding that is resistant to allergies.

• Avoid being exposed to air pollution both inside and outside.

• Avoid being around tobacco smoke during the child's early years, both before and after birth.

• Breastfeeding has been demonstrated to be protective against childhood asthma and should be continued for at least the first six months of a baby's life.

• All the immunizations required for the child should be advised on time.

• A healthy nutritious diet should be given to children regularly

• On-time management of a child's allergies and asthma symptoms should be done

• Children should be made to stay away from irritants like pollen, and dander from pets, and other irritants.

• The proper method of using the inhaler should be thought to the child

Conclusion

Childhood asthma is the inflammation of the airways causing obstruction hence making it difficult for the child to breathe properly. Symptoms are triggered by allergens, dust, air pollution, and exercise. Family history and recurrent respiratory infections make the child susceptible to asthma.

Identification and treatment of asthma should be done to prevent complications. It is a recurrent condition that gets triggered by various factors, hence the triggering factors should be avoided.