HEALTH MATTERS 3/11: Take action to prevent asthma flare-ups in children

By Julie A. Caucino, DO

Does your child complain of not being able to catch their breath when they leave the football or basketball field?

Do they wheeze after playing with the family pet?

Do they constantly cough after being outside in the cold?

These are signs that could indicate that your child is one of the millions of people in the United States who suffer from asthma, a chronic respiratory disease that can make it difficult for children to breathe.

If you suspect your child has asthma, see your pediatrician or allergy and asthma specialist for assessment, treatment, and to create an asthma action plan to prevent and manage flare-ups .

Common in childhood

Asthma is inflammation and narrowing of the airways, often producing excess mucus that makes it difficult to breathe.

Asthma is common in childhood, according to the American Academy of Pediatrics, which estimates that 10% to 15% of elementary school children in the United States have or have had the disease.

Although it is not known why some children develop asthma, studies have identified some predictors of the condition, including:

• Inhalant, food and skin allergies such as eczema.
• Family history of allergies or asthma.
• Prenatal or postnatal exposure to cigarette smoke.
• Live in an area with high air pollution.
• Possible obesity.

Wheezing isn’t the only symptom

Although wheezing is often associated with asthma, you don’t have to be wheezing to have asthma. Other signs and symptoms, which may occur intermittently, may include:

• A persistent cough that gets worse with the cold or lasts longer than normal after cold symptoms have disappeared.
• Cough or shortness of breath causing the child to wake up during sleep or early in the morning.
• Rapid breathing.
• Shortness of breath and/or chest tightness during exercise.
• Not wanting to participate in sports, dancing or other physical activities.
• Younger children may complain that their chests are “sore” or that they feel “funny”.
• The feeling of not being able to breathe deeply.
• Tired.

According to the American Academy of Allergy, Asthma and Immunology, asthma flare-ups are most often triggered by allergens and colds. Common allergens include:

• Dust and mites
• Pollen
• Pet dander
• Molds
• Cockroaches and rodents

Non-allergic triggers such as cold air, second-hand smoke, temperature changes, exercise, and air pollution can also trigger asthma symptoms.

Diagnosis and treatment

When diagnosing asthma, a detailed history is essential. Asthma in children can sometimes be difficult to diagnose, especially at a younger age. Your doctor may ask you to describe the symptoms and when and where they occur.

Do you notice any patterns? For example, do the symptoms reappear after visiting a friend’s house where there is a dog or cat? Do they happen almost every time the child has a cold? Or do they happen after running outside?

Identifying what triggers the symptoms is one of the most important steps towards an accurate diagnosis and treatment plan.

Additionally, allergy testing or, depending on your child’s age, a lung function test may be recommended to manage your child’s asthma.

Asthma treatment involves medication, education, and environmental control. Asthma medications typically focus on long-term management to control the disease and prevent flare-ups, as well as rapid-relief treatment to quickly reduce symptoms when they occur.

Controller medications, most often low-dose inhaled steroids, are usually used daily to stop asthma flare-ups before they happen. The National Institutes of Health’s Asthma Management Guidelines for Children recommend that children who have symptoms more than twice a week or who wake up more than twice a month because of their symptoms use controller medications .

Controller medications may also be recommended at certain times of the year or in certain situations known to trigger your child’s asthma symptoms, such as during spring allergy season or when your child catches a cold.

Quick-relief medications, such as albuterol, are taken for short-term relief and work quickly to open the airways and restore normal breathing.

Asthma Action Plan

If your child is diagnosed with asthma, it’s important to work with your doctor to develop a written asthma action plan to help manage the condition. In general, the plan should include:

• Treatment information, such as what drugs to take and when.
• A list of possible triggers.
• Early symptoms and how to treat them.
• How to initially manage an asthma attack.
• When to call the doctor or go to the emergency room.

The American Academy of Pediatrics and the American Academy of Allergy Asthma and Immunology note that everyone who cares for your child should have a copy of their asthma action plan.

In most cases, you can manage your child’s asthma at home in consultation with your doctor. However, if your child’s symptoms are severe or worsening, or if the medications do not work, seek emergency care immediately.

Although childhood asthma can be a serious condition, by identifying the triggers, seeking treatment, and taking action, you and your child will be able to breathe easier.

To find a physician affiliated with Penn Medicine Princeton Health, call 888-742-7496 or visit

Julie A. Caucino, DO, is board certified in Allergy and Immunology and is on the medical staff at Penn Medicine Princeton Health.

Comments are closed.