Childhood Asthma Overview
Waiting to Inhale
Your child gets winded easily or makes a whistling sound when exhaling. Colds seem to linger for weeks. Or there's that cough that never quite goes away. Sound familiar? If so, your child could have asthma. This chronic inflammatory condition of the airwaysthe tubes that bring air to the lungsmakes it hard to breathe in and out.
In asthma, the airways become inflamed and swollen when they come in contact with certain triggers. Kids with nonallergic asthma may be sensitive to irritants such as cigarette smoke or cold air, while kids with allergic asthma may react to those triggers as well as to allergens such as seasonal pollens and dust mites.
Whatever the form of asthma, it is characterized by constriction and inflammation of the muscles around the airways and increased mucus in the lungs. As the airways narrow, less air flows into the lungs. The result is the onset of unpleasant symptoms, such as wheezing, coughing, chest tightness and shortness of breath.
Asthma affects an estimated 9 million Americans under age 18, more than 1.3 million of whom are less than 5 years old, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). The disorder leads to nearly 15 million missed school days each year.
More and more children are diagnosed annually. Experts attribute the increase to several factors, including our superclean lives. Fewer of our children are now exposed to microbes that might stimulate the immune system and protect them from allergies and asthma later in life.
Experts also blame the upswing on pollution and the buildup of greenhouse gases, which increases the production of pollen, a top allergy trigger. Thankfully, dying from childhood asthma is increasingly rare, but "all patients with asthma still need to be closely monitored," says Devang R. Doshi, M.D., director of the division of pediatric allergy and immunology at William Beaumont Hospital in Royal Oak, MI.
In nonallergic asthma, a child's airway inflammation can be caused by these culprits:
- Viral infectionsRhinovirus, respiratory syncytial virus (RSV) and other respiratory infections can predispose a child to asthma or trigger an attack.
- Cigarette smokeSecondhand smoke might cause up to 26,000 new cases of childhood asthma each year.
- Household irritantsPaint fumes, aerosol sprays and perfumes are triggers for some kids.
- Other factorsExercise-induced asthma is triggered by physical activity, especially in the cold. Chilly air, weather changes and heightened emotions can contribute to breathing difficulties. "If asthma is not well-controlled, even laughing too hard or getting upset can lead to bronchial constriction and symptoms," says Asriani M. Chiu, M.D., assistant professor of pediatrics/allergy at the Medical College of Wisconsin in Milwaukee.
Up to 80 percent of kids with asthma have allergic asthma, according to the Asthma and Allergy Foundation of America (AAFA). In addition to the possibility of being triggered by the irritants mentioned above, their asthma attacks may be spurred by common allergens such as:
- Pollens from grasses, trees and weedsThese seasonal menaces affect allergy sufferers in the spring, summer and fall, causing asthma symptoms in vulnerable children.
- CockroachesInsect feces and saliva can cause problems.
- Dust mitesKids may react to these microscopic creatures that eat dead skin flakes and nest in mattresses, pillows, upholstered furniture, carpets, clothing and stuffed animals.
- AnimalsChildren may be allergic to pets' saliva, urine and skin flakes. "Any type of furred animal, and even horses and cows, can cause an asthma attack," says Maeve O'Connor, M.D., a pediatric allergist at the Carolina Asthma & Allergy Center in Charlotte, NC.
- MoldsWherever there is moisture, molds produce spores that become airborne and can be inhaled.
- FoodsAllergies to foods such as eggs, cow's milk, soy, nuts, wheat and peanuts can trigger an asthma attack.