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12 Questions to Ask Your Doctor About Asthma in Children

An asthma diagnosis can be scary and leave parents with many questions regarding the disease and treatment options. If your child is among the 6.3 million children in the United States living with asthma, consider asking your physician the following questions.

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What is asthma?

Asthma is a chronic disease that involves airway inflammation and tight airway muscles around the airway, according to Theresa Guilbert, MD, co-director of the Asthma Center, part of the Division of Pulmonary Medicine, at Cincinnati Children’s Hospital Medical Center in Ohio. Those with asthma always have inflamed airways, but exposure to certain irritants can make the inflammation worse, causing more symptoms, she explains. She says asthma falls on a spectrum and presents differently in different children and at different ages. There is no minimum age to receive an asthma diagnosis; doctors can find asthma in children as young as one year old. Currently, close to 10 percent of children in the United States are living with asthma.

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What are the symptoms of asthma in children?

The hallmark symptoms of asthma are wheezing, shortness of breath, recurrent cough, and chest pain, says Dr. Guilbert. If parents notice these symptoms or their child complains of them, it could be a sign they need to be tested for asthma.

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What questions should I ask at my child’s first asthma-related doctor’s appointment?

While the first visit after an asthma diagnosis can be overwhelming, Tyra Bryant-Stephens, MD, director and founder of the Community Asthma Prevention Program at Children’s Hospital of Philadelphia, says parents should leave the initial doctor’s visit with the answers to several questions about asthma in children. First, parents should know what it looks like when their child is experiencing asthma symptoms. Second, they should leave the appointment knowing how to treat those symptoms. Third, they need to know when children should use prescribed medications and how they should use them. Finally, parents should know when to call the doctor and when to go to the emergency room when their child is experiencing asthma symptoms.

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What triggers or worsens asthma in children?

Respiratory viruses and indoor allergens such as dust, cockroaches, mice, cats, and dogs are common triggers for asthma in children, says Dr. Bryant-Stephens. Mold, cold and dry air, tobacco smoke, and seasonal allergies such as grass or ragweed, can also trigger wheezing and other symptoms. The fall and spring allergy seasons and the viruses associated with fall and winter can worsen asthma as well. Stress, depression, weather changes, and very strong emotions—such as laughing or crying—can also trigger asthma.

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What changes can I make at home to help manage my child’s asthma?

Many children with asthma also have allergies, says Dr. Guilbert, so she suggests that children with allergy symptoms undergo allergy testing to determine what they’re specifically allergic to if anything. “If I know what allergies they have, I can give them very specific advice about what to avoid,” says Dr. Guilbert. In general, you should use dust mite cover on pillows and mattresses, keep a clean kitchen to prevent cockroaches, vacuum regularly, and wash pets consistently.

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What medications are needed to control asthma and how often will my child need them?

Doctors prescribe controller medications, which are inhaled corticosteroids, to be taken daily to control the inflammation in the airways associated with asthma. These work better the more consistently they are used. “In addition, for acute symptoms, we use rescue medicine, which is a form of albuterol. Children can take that whenever they need to, for example, if it seems like they are short of breath,” says Dr. Bryant-Stephens. She also recommends keeping all asthma medications together and monitoring when medications need to be refilled so that the child never is without his or her medicine. Additionally, having a spacer device, a tube that attaches to the inhaler, to help your child inhale the medication correctly is important and something to ask your provider about. (Here’s how to keep fall allergy and asthma flare-ups under control.)

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Do the medications used to treat asthma in children have side effects?

Most children tolerate asthma medications quite well. While side effects are rare and minimal, some can occur. “If children overuse the albuterol, it can cause the heart rate to get a little faster; usually it doesn’t,” says Dr. Bryant-Stephens. “If you use it as instructed, you don’t get into trouble.” The acute side effects of controller medications are very low, but it’s possible that they can affect a child’s growth by about one centimeter or half-inch after being taken for a period of time. If overused, Bryant-Stephens says inhaled corticosteroids can cause some side effects from the adrenal gland being stimulated, although it’s rare. Often doctors often recommend follow-up appointments every three months so they can evaluate the dosage and determine if children need more or less medication. “If your child’s asthma is controlled on the medication that he or she is on, we may be able to lower the dosage and minimize any side effects,” says Dr. Bryant-Stephens.

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What should I tell other caretakers and my child’s school about his or her asthma?

One of the most important things parents can do is educate those interacting with their child—teachers, caretakers, grandparents, coaches—on their child’s symptoms and triggers. Dr. Bryant-Stephens suggest creating an asthma action plan, a written plan for how to manage a particular child’s asthma, and share it with the people who care for him or her.

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Can children outgrow asthma?

“Children who don’t have a family history, don’t have allergies or eczema, and who only have symptoms around colds may outgrow their symptoms with time,” says Dr. Guilbert. However, doctors say that if a strong family history of asthma is present or the child has eczema or allergies, they’re more likely to have persistent asthma for most of their lives.

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Is asthma in children controllable?

How asthma affects a child depends on identifying the triggers and finding the right combination of medications to use. “If we do that, asthma is totally controllable and it’s unlikely that they will have any major problems,” says Dr. Bryant-Stephens. “If we can’t identify the triggers and control them and control the symptoms, then over time there can be a worse outcome.”

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Are asthma symptoms different in young children?

Asthma does present differently in older children and adults than it does in young children. For example, younger children, ages one to seven, with asthma tend to have more problems when they have colds, infections, or are exposed to allergens. Younger children tend to have more asthma attacks than day-to-day symptoms, while adolescents and adults experience more symptoms on a daily basis as lung function declines faster than average in people with asthma, especially in those who smoke cigarettes or are exposed to cigarette smoke. “As you get older and that airway inflammation becomes more set, you may get more consistent symptoms, where you’re always experiencing minor symptoms each week,” says Dr. Guilbert.

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If my child is diagnosed with asthma, is it safe for him or her to play sports?

Absolutely. Dr. Guilbert says exercise helps strengthen lung function and muscles. Doctors sometimes recommend patients use a rescue medication prior to a game or practice to control exercise-induced asthma symptoms that could occur when playing sports. “The idea is to get the asthma under control enough so that they’re able to be as active as they want to be with minimal symptoms,” she says.

Sources
  • Theresa Guilbert, MD, co-director of the Asthma Center, part of the Division of Pulmonary Medicine, at Cincinnati Children's Hospital Medical Center in Ohio
  • Tyra Bryant-Stephens, MD, director and founder of the Community Asthma Prevention Program at Children's Hospital of Philadelphia