Understanding asthma: What can I do for my child?

In the United States, more than 5 million children and 19 million adults struggle with asthma. In fact, asthma is the most common chronic condition in children. If you or your child has an asthma diagnosis, it’s important to take steps to manage symptoms.

Asthma signs and symptoms

Most commonly, the first sign of asthma is a chronic cough. Some children may cough only at night. Others may cough primarily when running around the playground or playing sports.

Wheezing is also a common first sign, although the cough may be a more noticeable symptom. Babies who have significant bronchiolitis (a common lung infection) may be more likely to develop asthma as they get older.

Understanding asthma triggers

Asthma triggers may vary from person to person. Serena Tu, MD, pediatrician with Adventist Health, explains that the most common triggers are environmental. For example, children may experience an increase in asthma symptoms after exposure to:

• Dust
• Mold
• Pet dander
• Pollen
• Pollution
• Secondhand smoke

Catching a cold or another virus can also exacerbate asthma symptoms. “When families come to my office, one of the first things we do is talk through their history and known triggers,” Dr. Tu explains. “For example, a parent may say that their child’s symptoms always worsen after they play in the grass.” Your child’s pediatrician may order an allergy blood test to make an accurate diagnosis. From there, healthcare providers may prescribe medications, educate parents and answer additional questions.

How often should my child use an inhaler?

Perhaps the most well-known asthma treatment is an inhaler. As Dr. Tu notes, it’s important to understand that there are two types of inhalers. The first type contains a controller medication (an inhaled steroid) designed to decrease sensitivity to your triggers. The second type contains a rescue medication. It’s designed for use only when someone with asthma is actively wheezing. It works quickly but also wears off quickly.

Your child’s pediatrician will provide instructions about how often you should be using each type of inhaler. Some children may need to use the controller inhaler daily, while others may use it only as needed, such as when they have a cold. In general, you may need to follow up with your child’s healthcare provider if your child is using the rescue medication more than:

• Two times per month at night.
• Two times per week during the day.

Using the rescue inhaler too often could be a sign that your child’s daily medication isn’t working effectively to control asthma symptoms.

When should I go to the emergency room?

When your child is prescribed a rescue inhaler, the pediatrician will educate you about warning signs and when to go to the emergency department. “If your child is actively wheezing, start using the inhaler or nebulizer every three to four hours,” Dr. Tu explains. “If you have to use the inhaler more than twice or more than every four hours, that’s a sign to go to the emergency room.”

Dr. Tu also notes that you should take your child to the emergency department if they show signs of true respiratory stress, such as:

• Wheezing so hard that they can’t get through speaking a full sentence.
• Using their tummy or neck muscles to breathe.
• Changing color in their skin, such as a pale or bluish complexion.
• Grunting or nose flaring while trying to breathe.

Although locations such as urgent care centers may offer some help, these places do not have all the equipment needed to treat emergency respiratory distress. If you child shows any of these signs, call 911 or take them immediately to the nearest emergency department.

What else should I know about inhalers?

Dr. Tu points out that many patients—both children and adults—who have asthma don’t use their inhaler properly. “We recommend that everyone use a spacer, no matter how old they are,” Dr. Tu says. A spacer is a cannister that holds the inhaler. It aerosolizes the medication so that you can breathe it in over several breaths, instead of in one quick breath. “Often, if you’re not inhaling when you press the button on your inhaler, you’re just swallowing medication and it doesn’t go to your lungs,” Dr. Tu explains.

For more information about childhood or adult asthma, find a provider near you.