Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children. 3.5 million Blacks had asthma, and have the highest asthma prevalence of any racial/ethnic group (36 percent higher than that for Whites).
• In 2007, African Americans were three times more likely to die from asthma related causes than the White population.
• From 2003-2005, African American children had a death rate 7 times that of non-Hispanic White children.
• Black children have a 260% higher emergency department visit rate, a 250% higher hospitalization rate, and a 500% higher death rate from asthma, as compared with White children.
• Children in poor families are more likely to ever have been diagnosed with asthma.
• While all of the causes of asthma remain unclear, children exposed to secondhand tobacco smoke exposure are at increased risk for acute lower respiratory tract infections, such as asthma, and children living below or near the poverty level are more likely to have high blood cotinine levels, a breakdown product of nicotine, than children living in higher income families.
The exact cause of asthma isn’t known. Researchers think some genetic and environmental factors interact to cause asthma, most often early in life.
These factors include:
• An inherited tendency to develop allergies, called atopy (AT-o-pee)
• Parents who have asthma
• Certain respiratory infections during childhood
• Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing
If asthma or atopy runs in your family, exposure to irritants (for example, tobacco smoke) may make your airways more reactive to substances in the air.
Some factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma.
Common signs and symptoms of asthma include:
• Coughing. Coughing from asthma often is worse at night or early in the morning, making it hard to sleep.
• Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
• Chest tightness. This may feel like something is squeezing or sitting on your chest.
• Shortness of breath. Some people who have asthma say they can’t catch their breath or they feel out of breath. You may feel like you can’t get air out of your lungs.
Exams and Tests
Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose.
Sometimes it’s hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions.
Also, many young children who wheeze when they get colds or respiratory infections don’t go on to have asthma after they’re 6 years old.
A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds.
A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:
• One or both parents have asthma
• The child has signs of allergies, including the allergic skin condition eczema
• The child has allergic reactions to pollens or other airborne allergens
• The child wheezes even when he or she doesn’t have a cold or other infection
The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it’s hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children’s medical histories, signs and symptoms, and physical exams to make a diagnosis.
Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds.
To control asthma, partner with your doctor to manage your asthma or your child’s asthma. Children aged 10 or older—and younger children who are able—also should take an active role in their asthma care.
Taking an active role to control your asthma involves:
• Working with your doctor to treat other conditions that can interfere with asthma management.
• Avoiding things that worsen your asthma (asthma triggers). However, one trigger you should not avoid is physical activity. Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
• Working with your doctor and other health care providers to create and follow an asthma action plan.
There are two basic kinds of medication for the treatment of asthma:
• Long-term control medications
• Quick relief or “rescue” medications
Long-term control medications are taken every day to prevent asthma symptoms, even when your child does not have symptoms. Some children may need more than one long-term control medication.
Using an Inhaler
A number of your child’s asthma medicines can be taken using an inhaler.
• Children who use an inhaler should also use a “spacer” device, which helps them to get the medicine into the lung properly.
• If your child uses the inhaler wrong way, less medicine gets into the lungs. Have your health care provider show you how to correctly use an inhaler.
• Younger children can use a nebulizer to take their medicine rather than an inhaler. A nebulizer turns asthma medicine into a mist that you breathe in.
The complications of asthma can be severe.
• Persistent cough
• Lack of sleep due to nighttime symptoms
• Decreased ability to exercise and take part in other activities
• Missed school
• Missed work for parents
• Emergency room visits and hospital stays
• Trouble breathing that requires breathing assistance (ventilator)
• Permanent changes in the function of the lungs
When to Contact a Medical Professional
Call your health care provider if you think that a child has new symptoms of asthma. If your child has been diagnosed with asthma, call the doctor:
• After an emergency room visit
• When peak flow numbers have been getting lower
• When symptoms are more frequent and more severe and your child is following the asthma action plan
If your child is having trouble breathing or having an asthma attack, seek medical attention immediately.
Emergency symptoms include:
• Difficulty breathing
• Bluish color to the lips and face
• Severe anxiety due to shortness of breath
• Rapid pulse
• Decreased level of alertness, such as severe drowsiness or confusion
Currently, asthma can’t be prevented. However, you can take steps to control the disease and prevent its symptoms.
• Learn about your asthma and how to control it.
• Follow your written asthma action plan. Use medicines as your doctor prescribes.
• Identify and try to avoid things that make your asthma worse (asthma triggers). However, one trigger you should not avoid is physical activity.
Physical activity is an important part of a healthy lifestyle. Talk with your doctor about medicines that can help you stay active.
• Keep track of your asthma symptoms and level of control.
• Get regular checkups for your asthma.
Don’t let asthma knock the wind out of you. Asthma is a lung disorder characterized by sudden fits of wheezing, coughing, or shortness of breath. According to research or other evidence, the following self-care steps may be helpful:
What You Need To Know:
- Clean it up
To avoid triggering asthma attacks, control household and workplace irritants such as dust, mold, smoke, chemicals, and animal dander, and dietary triggers like certain food additives
- Keep a healthy body weight
Shed extra pounds to improve breathing and decrease the need for medications
- Check out certain antioxidants
30 mg a day of lycopene or 64 mg a day of natural beta-carotene can help prevent exercise-related asthma attacks
- Try proven herbal remedies
Supplements containing boswellia extract (900 mg a day), ivy leaf extract (50 drops a day), or tylophora leaf (200 to 400 mg a day) may improve breathing symptoms; children should be given one-half of these amounts or less, depending on body weight
- Watch the salt
Avoid aggravating symptoms by limiting use of table salt and salty fast foods, and by reading labels to find low sodium groceries
- See an allergist
Find a specialist to help you build tolerance to allergens
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full asthma article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.