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Asthma in Children

Understanding the Basics of Childhood Asthma

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Updated June 13, 2014

Asthma is a serious and potentially life threatening illness that affects many children. Fortunately, there are many medications that can help control and prevent asthma attacks. However, it can be difficult to understand how all of the different medications are supposed to be used and what you should be doing to help manage your child's asthma.

The symptoms of asthma for most children include coughing, wheezing and difficulty breathing, and they may be brought on or triggered by having a cold, changes in the weather, exercise or exposure to cigarette smoke, pollen, mold, animals, and pollution. If you can learn the things that trigger your child's asthma problems, it can help to avoid them, although finding asthma triggers is often difficult.

Asthma is usually easy to diagnose in a child who is wheezing and having trouble breathing, but it becomes more difficult if the child only has a cough, or cough variant asthma. You should suspect that your child may have asthma if he has a chronic cough that is worse at night or when he is running and playing, even if he never seems to wheeze.

Asthma Treatments

The main treatment when your child is coughing or wheezing and having trouble with his asthma is to use a bronchodilator, such as Albuterol, Proventil, Ventolin or Xopenex (a newer medication). These are also called 'quick relief' or 'reliever' medications. These medications are available for use with a nebulizer, metered dose inhaler, or syrup (rarely used). Younger children may be able to use these asthma inhalers with a spacer or a spacer and mask.

These quick relief medications are usually used on and as needed basis. If you are usually them regularly, on a weekly or daily basis, then your child's asthma is likely being poorly controlled and he would benefit from a preventative medication.

During an asthma attack many children also have to take an oral steroid, such as prednisone, prelone or Orapred, a newer, better tasting form of an oral steroid.

Asthma Prevention

The goal of treating asthma is that your child be symptom free and able to perform his normal activities. Asthma should not usually limit your child's activities, unless he is having an asthma attack at the time.

In addition to avoiding triggers, asthma is prevented by taking a daily preventative medications. These include steroids, such as Flovent, Pulmicort, Qvar, Alvesco, Aerobid, and Azmacort, which are used every day, even when your child is not having any asthma symptoms. These are available as metered dose inhalers and newer dry powder inhalers. Pulmicort is also available in a form (Pulmicort Respules) that can be given with a nebulizer, which is convenient for younger children.

Other preventative medications combine a steroid with a long-acting broncholitator. They are used in children with moderate to severe asthma who aren't controlled with an inhaled steroid and can include Advair HFA, Advair Diskus, Dulera, and Symbicort.

The other main type of preventative medication is the leukotriene modifiers, such as Singulair (available as a chewable tablet for younger children).

If your child is already on a preventative medication and continues to need to use a 'reliever' medication on a regular basis, then your child likely needs to take another preventative medication or a higher dosage of his current medications. For example, if he is already taking Advair 100/50, then he may need to be increased to a higher dose, such as the 250/50 form of Advair, and/or Singulair might be added to his treatment plan.

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