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Things to do to effectively manage asthma in children and adolescents

Did you know that asthma is the most common reason for school absenteeism and hospitalization among children and adolescents?

If left undiagnosed and undertreated during childhood, asthma may lead to severe psychosocial disturbances in the family.

What is asthma?

Asthma is ongoing (chronic) inflammation of the airways in the lungs. This inflammation makes the airways vulnerable to episodes of difficult breathing (asthma attacks). Common triggers of attacks include allergies, cold exposure, viral infection and exercise.

Asthma in older children can interfere with sleep, school, sports, and social activities. The emotional, social and developmental changes associated with adolescence may sometimes complicate disease management.

For most kids with asthma flare-ups are common and that is when usually the disease gets diagnosed. Teaching your kids about asthma, what triggers to avoid and when to take the medication is paramount.

Common signs and symptoms of asthma:

• Cough

• Wheezing, a high-pitched, whistle-like sound when exhaling

• Trouble breathing or shortness of breath

• A tight, uncomfortable feeling in the chest

The severity and patterns of symptoms may sometimes vary:

• Worsening of symptoms at night

• Short periods of coughing and wheezing between periods of time with no symptoms

• Frequent or chronic symptoms with episodes of worse wheezing and coughing

• Seasonal changes based on prevalent infections or allergy triggers

Asthma symptoms may be triggered or worsened by certain events too:

• Colds or other respiratory infections

• Exposure to allergy-causing agents (allergens), such as dust, pet dander or pollen

• Activity or exercise

• Exposure to cigarette smoke or other airborne irritants

• Strong emotional reactions, such as crying or laughing

• Menstruation

• Changes or extremes in weather

Managing asthma in kids and adolescents

The most important element in asthma management for kids and adolescents is adherence to the treatment plan, regular monitoring, adjusting in the plan as needed and self-care.

For children, they must be taught to independently take their medication in times of need and be extremely alert on triggers and symptoms. For adolescents, sometimes management becomes challenging as they are in an age where they seek greater autonomy, are evolving socially and emotionally, and experience changes in their relationships with friends and family.

The task of managing a chronic medical condition or taking medication in front of peers may cause embarrassment or self-consciousness. Moreover, adolescents with asthma may be at greater risk of depression and anxiety, and these psychological factors may result in poorer asthma management.

Things to do for effective asthma management:

• Identify triggers (skin prick test, blood tests and clinical history as advised by your doctor)

• Assess symptoms of depression or anxiety

• Assess risk-taking behaviors

• Assess proper technique in using medications

• Talking with your child about his or her understanding of the disease and the impact of the medication

• Talking with your child about how he or she feels about taking medication, especially in front of people

Lifestyle changes- frequent changing of linen, avoiding furry soft toys and avoiding fast food

Creating an action plan is most important

It is important to work with your doctor and your child to create an action plan that outlines self-monitoring and care. Your child can learn to minimize symptoms by following the action plan to monitor and adjust treatment, when necessary.

You should share the plan with other family members, friends, teachers, coaches and school administrators to ensure effective management. A thorough plan includes the following:

• Your child’s name and age

• Physician and emergency contact information

• Instructions on triggers

• The type, dose, and timing of long-term medications

• The type and dose of rescue medication and how to take them

• A list of common asthma triggers for your child and tips for avoiding them

• A system for rating normal breathing and moderate symptoms and severe symptoms

• Instructions for when to seek emergency care

 

At the end, make sure your child gets a yearly flu vaccine.  The flu vaccine is recommended for all kids, especially those with asthma to avoid flare-ups and development of more serious illness.

 

Authored by Dr Shivaresmi Unnithan, Consultant, Pulmonology, Fortis Hospital Anandapur, Kolkata

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