Doctor's Notes on Asthma in Children
Asthma is a chronic disorder caused by inflammation in the airways that causes the airways to tighten and narrow, blocking air from flowing freely into the lungs and making it hard to breathe. The inflammation of the airways makes them very sensitive and an asthma attack can occur when a person is exposed to certain “triggers.” Common asthma triggers include exercise, allergies, viral infections, and smoke. In most children, asthma develops before 5 years of age, and in more than half, asthma develops before 3 years of age.
Symptoms of asthma include
- wheezing,
- breathlessness,
- chest tightness, and
- cough, particularly at night or after exercise or physical activity.
During severe asthma attacks in older children, symptoms may include
- restlessness,
- being out of breath while resting,
- sitting upright,
- speaking just words and not sentences),
- sleepiness, and
- confusion.
Other symptoms of asthma in infants or young children may include
- lung infections (bronchitis) or pneumonia,
- stomach breathing (use of abdominal muscles to breathe), and
- lack of interest in feeding.
What Is the Treatment for Asthma in Children?
Asthma in children is usually treated with two kinds of medications: quick relief and long-term control. Allergy shots (immunotherapy) can also be helpful if a child is found to have asthma due to allergies. Children older than 12 are generally treated with the same medications as adults with asthma.
Quick-relief medications are bronchodilators that expand the airways, and are taken at the first sign of asthma symptoms for immediate relief:
- Short-acting inhaled beta2-agonists (inhalers)
- Anticholinergics
Long-term asthma control medications are taken daily to prevent symptoms and asthma attacks and include:
- Inhaled corticosteroids
- Fluticasone
- Budesonide
- Mometasone
- Antileukotrienes or leukotriene modifiers
- Montelukast sodium
- Zafirlukast
- Zileuton
- Long-acting inhaled beta2-agonists (usually combined with an inhaled corticosteroid)
In severe cases, traditional asthma treatments may be insufficient, and other therapies may be used, such as:
- Biologics
- Mepolizumab
- Omalizumab
- Dupilumab
- Oral corticosteroids
- Immunotherapy is useful when asthma is triggered by an allergy
- Allergy shots
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What Is the Safest Asthma Medication?
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.