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Asthma and Allergies in Children

Asthma and Allergies in Children

Asthma and Allergies in Children

Asthma affects over 5 million U.S. children and allergies over 50 million, making these two chronic illnesses the most common of childhood diseases. Parents and other family members can help their children by learning to recognize the first signs of an asthma attack or allergic reaction. Identifying these signs and symptoms allows parents or caregivers to administer medications to attenuate the effects of asthma or allergic flare-ups in their child. Additionally, parents must understand and avoid the environmental triggers, such as irritants and allergies, which cause their child to suffer an attack as well as develop a solid understanding about medications and how to use them.

Pediatric Asthma

What Is It?

Children suffering from asthma attacks have reported feeling as if an extremely heavy weight were bearing down on their chest, difficulty filling lungs when inhaling and emptying lungs when exhaling. Environmental irritants or allergies cause the bronchial tubes to constrict and the mucus membranes lining them to swell and secrete copious amounts of mucus, causing the labored breathing commonly associated with an asthma attack.

Symptoms

In addition to the labored breathing, children with chronic asthma may cough and wheeze, present with recurring infections of the upper respiratory system or pneumonia. These symptoms manifest in different ways depending on the child's age and the severity of the attack. Infants may become agitated and cry when trying to nurse or take a bottle. Toddlers and young children may cough and wheeze during physical activity, particularly outdoors. Upper respiratory infections exacerbate asthma symptoms, making them more noticeable.

Diagnosis

Asthma is difficult to diagnose in young children. Pediatricians can sometimes make a valid diagnosis by listening to the child's chest, but utilize tests that provide more concrete information when available. Older children can participate in diagnostic breathing tests, such as spirometry and peak flow measurement tests. A new test is available that measures the level of nitric oxide in a child's breath. High levels of nitric oxide indicate that the lungs are working below capacity and that the asthma is not well controlled.

Treatment Options

Non-pharmacologic Method

The success of this method requires vigilant avoidance of common asthma triggers, especially those known as triggers for an individual child. Allergens are common triggers and include pet dander, dust mites, mold, cockroaches, and various seasonal pollens. Environmental triggers include cigarette smoke, pollution, cold and dry air, organic compounds used in household cleaning products, and fragrances.

Pharmacological Approach

Properly controlled asthma symptoms allow children to engage in normal social and physical activities with minimal effects. Children who suffer from occasional asthma symptoms take medications for short periods. Those who have frequent or chronic symptoms need daily controller medications. Fast acting inhalers, usually containing albuterol, are used only as needed to provide quick relief to tightness of the chest and other acute asthma symptoms. Controller medications do not work to relieve symptoms; they control the asthma on a daily basis to reduce the frequency of symptoms. Children who awaken two times per month or more with symptoms should take controller medications. Controller medications include inhaled corticosteroids, inhaled nonsteroidals, and leukotriene receptor inhibitors. Doctors often prescribe these medications in combination for the most effective asthma symptom control.

Pediatric Allergies

Although not all asthmatic children have allergies, most children with asthma symptoms also have allergies. The body responds to allergen exposure by releasing histamines, which often irritate airways, bringing on asthma symptoms. The body's allergic response also results in common allergy symptoms, such as red and itchy eyes, sneezing, runny nose, skin rash, or a combination of these. Seasonal pollens, dust mites, pet dander, and cockroaches are common allergens known to elicit an allergic response in sensitive people.

Diagnosis of Allergies

Pediatric allergists can perform a series of skin tests to determine a child's individual sensitivities. Pediatric pulmonologists can diagnose allergy-induced asthma and collaborate with other pediatric specialists to draw up an allergy-asthma management plan for the child.

Treatment of Childhood Allergies

Trigger avoidance represents the easiest and most effective way to prevent allergic reactions in the sensitive child. However, sometimes trigger avoidance and basic allergy medications do not work. In these cases, the child will receive allergy shots once or twice per week. The shots help the body build up immunity, over time, to specific allergens. The dose of allergen is gradually increased over several months. The resulting immunity attenuates the body's response to allergen exposure.
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