Asthma at Children and Newborns
Not all children show the same symptoms. Asthma symptoms can vary even at the same child – it all depends on age. The following signs and symptoms may occur:
- frequent cough, especially during physical activity (during games), at night or while laughing or crying;
- chronic cough (which may be the only symptom);
- loss of desire to play active games;
- rapid breathing (periodically);
- complaints of compression or pain in the chest;
- whistling sound during inhalation or exhalation, called wheezing;
- strong chest movements, caused be dyspnea. These movements are called retraction;
- dyspnea, wheezing, air insufficiency;
- feeling constriction in the neck and chest;
- weakness or fatigue.
Although these symptoms are characteristic of asthma, but doctor, before making diagnosis and prescribing asthma treatment, should examine a child for other diseases that can also cause respiratory failure. Almost at half of infants and children, who manifest such symptoms as dyspnea or cough (even if these symptoms respond to treatment, used for asthma) asthma is not detected till up to 6 years. That is why many pediatricians, describing child’s condition, use such terms as «reactive airway disease» or bronchitis (not sticking «asthmatic» label to a child).
How Often does Asthma Appear at Children?
Asthma is the main cause of chronic diseases at children. According to Asthma Inhalers Online statistics, it affects about 10 – 12% of children worldwide, and for unknown reasons, this figure continues to grow. Asthma can develop at any age (even at very elderly people), but at children the first symptoms may appear only after 5 years.
Here are the main risk factors that influence asthma development at children:
- allergic rhinitis (hay fever) or eczema (allergic skin rash);
- hereditary predisposition to asthma;
- frequent respiratory infections;
- small weight at birth;
- mothers, smoking during pregnancy and frequent presence of the child next to smokers;
- growing up in a family with low income.
Why is Asthma at Children Percentage Increasing?
Why more and more children become ill with asthma is not known. Some experts suggest that children spend too little time in the fresh air, and are often found in areas of severe pollution, are passive smokers. Others believe that children now get less sick with traditional childhood diseases, so that they do not acquire strong enough immunity against bacteria and viruses.
How Is Asthma at Children Diagnosed?
Diagnosis is usually made on the basis of disease history, symptoms and physical examination of the child. Remember that very often the case is that before a child is examined by doctor, asthma symptoms may disappear. Therefore, parents play an important role. They help doctor to understand signs and symptoms that occur at their child.
Medical history and symptoms description: physician should be aware of any existing or previous illnesses associated with breathing difficulties. In addition, doctor may ask questions about family history of asthma, allergies, painful skin condition, called eczema, and other pulmonary diseases. It is important to correctly and as fully as possible describe child’s symptoms (cough, wheezing, pain or feeling of pressure in the chest), and especially when and how often these symptoms occur.
Physical examination: during physical examination, doctor listens to child’s heart and lungs, as well as check nose or eyes for allergic reaction.
Tests: very often X-rays examination is used, and also children over 6 years old undergo simple pulmonary function examination – spirometry. Spirometer measures lung capacity and how quickly the air is exhaled.
Asthma at Children: Symptoms and Treatment
Unfortunately, in our time asthma at children is a quite common disease. This is connected to worsening ecological situation, in particular to pollution of air, we breathe.
The main asthma cause is hypersensitivity to irritation. Asthma appearance at a child may be related to environmental factors, and to hereditary predisposition. Asthma attacks can be triggered by:
- allergens: dust, pets hair and saliva, mites, mold, house plants pollen, food;
- bacterial and viral infections: colds, bronchitis, sinusitis, influenza;
- stimuli from environment: cigarette smoke, perfumes, sprays, exhaust gases;
- medications: especially nonsteroidal anti-inflammatory drugs or aspirin;
- stress, fear, anxiety;
- intense physical activity.
Asthma Symptoms at Children
Signs of asthma at children may be different, as they depend on disease severity. Here are the main symptoms list by Asthma Inhalers Online, starting with least hazardous to health:
- slight difficulties with breathing;
- tightness in the chest;
- asthma attacks.
If child’s breathing is difficult or is accompanied by whistles, it is necessary to immediately consult a doctor so that he appoints examination and according to its results prescribes appropriate treatment. When diagnosis «bronchial asthma» has been made, and a baby regularly uses asthma inhaler, it is necessary to keep track of how often he has to use it. If there is a need to use inhaler more often than prescribed by doctor, you should consult your pediatrician for advice.
Usually asthma symptoms at children persist for 24 – 48 hours. Otherwise, emergency medical care is necessary, and maybe hospitalization. If a baby has difficulties with speaking and asthma attack begins, it is necessary to urgently call an ambulance.
Childhood Asthma Treatment
For bronchial asthma treatment at children several groups of medicines are used, which are divided into basic and symptomatic. Basic drugs action is aimed at suppressing allergic inflammation in bronchi. These drugs do not have fast action, they are intended for long-term treatment. By suppressing inflammation in bronchi, basic drugs lead to attacks of breathlessness severity and frequency decrease. And at the end of treatment there may be observed complete cessation of seizures. Since inflammatory process in bronchi is chronic, to obtain positive treatment effect long-term use of drugs is required. The first results of asthma treatment will be seen not less than 2 – 3 weeks after medication therapy beginning. Most often hormonal glucocorticoids are prescribed.
To date, for asthma treatment at children inhaled steroids are prescribed, as they are drugs of not systemic, but local action. Therefore, they have fewer side effects that negatively affect child’s health. For these drugs application nebulizers-sprays or metered-dose inhalers are used. Inhaled glucocorticoids affect bronchial tree reactivity level, which reduces possibility of organism inadequate reaction to external stimuli.
As practice shows, constant use of inhaled glucocorticoids allows to relieve asthma course, and, possibly, to minimize need for means to relieve asthma attacks.
Symptomatic medications are used for quick bronchospasm relief, their action is aimed at bronchial patency restoration. This group of medications includes bronchodilators and bronchial spasmolytics. Symptomatic drugs are used only when they are needed.
Asthma attacks prevention at children can be primary and secondary. Primary prevention task – to prevent asthma occurrence, and secondary – to prevent complications development and asthma attacks occurrence at patients. Here are primary asthma attacks prevention measures at children:
- improving the environment as much as possible, for example, take a child for the summer to the country or sea;
- frequent cleaning of the room, a child lives in;
- removing rugs, soft toys from the child’s room;
- personal hygiene;
- no pets, if there are, it is necessary to pay attention to their cleanliness;
- hypoallergenic household items;
- using food with minimal amount of food additives and on the market taking only «seasonable» fruits and vegetables;
- no perfume, air fresheners, spray deodorants in child’s presence;
- no smoking in child’s presence;
- no self-medication: giving child medicines only if they are prescribed by doctor.
Let’s list secondary asthma attacks prevention measures at children:
- immediate treatment of respiratory system diseases, especially obstructions;
- no smoking in child’s presence;
- ventilating and wet cleaning the room the child’s lives in every day;
- removing all objects that can accumulate dust from the child’s room;
- avoiding communicating with pets as much as possible, oddly enough, but aquariums are also not recommended, since feed for fish has asthmatic activity;
- breathing exercises;
- excluding products with high allergenicity from child’s diet;
- visiting salt rooms if possible.
Asthma Frequency and Nature
Asthmatic condition is relatively rare at young children and more frequent in the age of 8 – 12 years. In anamnesis of many children with asthma, there are indications of allergic diseases presence in the family (migraines, urticaria fever, asthma, vasomotor rhinitis, obesity, urate diathesis). Sometimes cause of asthma at a child is a particular diathesis. Often, asthma symptoms alternate with skin manifestations. Currently, asthma can be regarded as an allergic condition of the body, occurring on the background of hypersensitivity to various sensitizing substances (allergens) because of altered central nervous system reactivity. Allergens, causing asthma, can be first of all food substances (mostly proteins), inhaled substances (pollen, wool, silk and so on) and other chemical substances or bacteria. Allergic condition itself is based on functional autonomic nervous system disorders (increased vagus nerve excitability), causing abnormal excitability and spasm of bronchial tubes, and mucus hypersecretion. Alternating asthma course is based on complex reflex nature of repeating in certain stereotype seizures. Expiratory dyspnea at bronchial asthma is caused primarily by increased activity of respiratory center expiratory function in presence of bronchial spasm and increased expiratory muscle activity.
The leading element in asthma genesis should be considered cerebral cortex processes disorder with subsequent disturbances in subcortical areas, regulating bronchial muscles activity. The basis of cortex functions violation is excitation and inhibition collision, which causes breakdown of all bronchial vegetative apparatus.
Skin tests with allergens at children with asthma often gives positive reaction to egg white, milk, animal hair extract and so on. In addition to asthma of allergic origin, there is symptomatic asthma associated with diseases of nasopharynx, tuberculosis of bronchial glands. There’s also the so-called psychogenic asthma.
Asthma clinical picture at older age is the same as at adults, but at children productive form dominates. At early childhood asthma picture is somehow distinctive. After catarrhal symptoms, and sometimes even at complete health severe dyspnea can develop with tension of all auxiliary inspiratory muscles, with severe lips and limbs cyanosis, general sudden anxiety, replaced by helplessness and lethargy. At older ages, attacks occur more easily and are usually accompanied by dry whistling and buzzing wheezing and extended exhalation. Viscous sputum can contain deflated epithelium, eosinophils, sometimes Charcot-Leuden crystalls, Curschmann’s spirals. Eosinophilia are present in blood. The attack lasts for a few hours, sometimes a few days.
Often, instead of typical asthma attack, there is a picture of an asthmatic bronchitis lasting for 10 – 14 days with periods of improvement and exacerbations.
Asthma prognosis is serious, because asthma can periodically repeat, lasting for indefinite period of time. Sometimes asthma, which began at early age (up to 5 years), can completely disappear with onset of puberty.
Asthma attack treatment is to ensure fresh air intake, use of hot foot baths, mustard plasters on chest. Of great importance are psychogenic factor, calmness, confidence in successful result, switching attention. It is often possible to stop asthma attack with appointment of adrenaline (1. 1000 0.5 – 0.75 subcutaneously), antiasthmocrine or astmolisine (in the same doses). In case of bronchial tubes swelling appointment of atropine subcutaneously helps. In mild cases, Asthmatolum vapors, saltpeter paper inhalation helps. In severe cases it is necessary to resort to luminal (0.02), urethane (0.5), chloral hydrate.
Outside attacks calcium chloride solution 5% and iodine preparations in large doses are useful.
Reflex asthma requires removal of adenoids, nasopharynx, enlarged tracheobronchial glands treatment. If possible, remove from contact with child all sources of allergens (animal hair, feather pillows, etc.). Sometimes relocation to a new environment benefits the child.
It is advisable to try to desensitize body by administering diphenylhydramine (0.02 – 0.05), peptone or neobenzinolum injections (2%) by 0.1 – 0.2 every 2 – 3 days for 2 – 3 weeks. Sometimes effect of oral administration of small doses of peptone, sulfur, novoprotein, a course of treatment with penicillin, aloe extract.