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  Helping a kid with asthma be a kid

Asthma is the most common serious chronic disease of childhood, affecting nearly 9 million children in the United States. Characterized by coughing, chest tightness, shortness of breath and wheezing, asthma is the cause of almost three million physician visits and 200,000 hospitalizations each year.

Just because your child has asthma doesn’t mean they have to suffer with asthma. Children with asthma can lead relatively normal lives, just like their non-asthmatic friends. Diligent monitoring and adherence to a management plan can make all the difference. This includes taking regular peak flow meter readings, maintaining the prescribed medication schedule and monitoring symptoms. In addition, there are environmental control measures that can be extremely useful in controlling triggers that worsen asthma symptoms.

Controlling asthma at home
It is impossible for your child to completely avoid all of the things that trigger their asthma, but taking steps to reduce your child’s exposure to their triggers can help reduce their symptoms. Following are some of the major indoor triggers for asthma and suggestions for reducing exposure:

Tobacco smoke, wood smoke
  • Parents and caregivers should stop smoking.
  • Do not allow smoking around the child or in the child’s home.
  • Eliminate the use of wood stoves and fireplaces.

Dust Mites
  • Encase the child’s pillow, mattress and box springs in plastic or allergen-proof covers.
  • Bedding should be washed weekly in hot water (130ºF) and dried in a hot drier.
  • Ideally, remove carpets from the child’s bedroom, and carpets in other rooms that are laid on cement.
  • Avoid sleeping or lying on upholstered furniture.
  • Minimize stuffed toys in the child’s bedroom and wash them weekly in hot water.
  • Reduce indoor humidity to less than 50% through the use of a dehumidifier or a window air conditioner.

Animal Dander (saliva, dead skin and urine from furred animals)
  • Ideally, remove the pet from the home also any products made from feathers.
  • If removal of the pet is not possible then:
    • Keep the pet out of the child’s bedroom and the door closed.
    • Keep the pet off of upholstered furniture and carpets.
    • Use a filter on air ducts in child’s room.
  • Consider getting a pet such as a turtle, hermit crab, fish, snake or other animals without fur or feathers.

Cockroaches
  • Do not leave food or garbage exposed.
  • Reduce indoor humidity to less than 50%.
  • Fix leaky faucets and pipes.
  • Use boric acid traps (avoid using poison around very young children).

Indoor Molds
  • Reduce indoor humidity to less than 50%.
  • Fix leaky faucets and pipes.
  • Avoid vaporizers.

Controlling asthma at school
Since school is the child’s home away from home, it is one of the most important environments to safeguard. The child’s parents should work closely with school personnel to help them understand asthma, its impact and how to meet the needs of children with asthma.

You should work with your child’s allergist to develop an "Asthma Management Plan" for personnel at your child’s school that includes the early warning signs of an asthma episode, what medications the student uses and how they are taken, how to help the child minimize their exposure to triggers and when to contact the child’s physician or emergency room.

School personnel should also know how to use devices to deliver asthma medications and how to use a peak flow meter. Ideally parents and school officials will meet at the beginning of each school year to make them aware of the child’s asthma and to review the Asthma Management Plan. Parents should emphasize that students with asthma should be treated "normally" like other children and be allowed to take their medications as required without making it "a big deal."

Some of the asthma triggers your child may encounter at school include dust mites, chalk dust, animal dander, saliva and urine, strong odors (perfumes, paints, chemicals). You should make school personnel aware of your child’s asthma triggers so they can help your child avoid them at school. Some suggestions for avoiding triggers at school include:

  • Encourage teachers to use dry-erase boards or "dustless" chalk in their classrooms.
  • Suggest that class pets not have fur or feathers such as a turtle, hermit crab, fish, or snake.
  • Ask staff to avoid using strong smelling soaps, deodorants, perfumes and colognes.

Asthma medications in school
Children with asthma often experience a sudden onset of symptoms from a variety of causes. In most cases, symptoms can be alleviated with inhaled medications. According to the AAAAI position statement "The Use of Inhaled Medications in School by Students with Asthma," students able to recognize symptoms requiring medication and know how to use their inhaler properly should be permitted to keep their physician-prescribed inhaled medications with them.

School policies that require inhalers to be kept in a school official’s office often interfere in the medical needs of the student and may seriously delay treatment. School officials should discuss their concerns about the use of inhaled medications with parents or physicians.

Developing peer support systems
Children experience rapid physical and emotional changes as they grow up, particularly during adolescence. These changes can be confusing, and having asthma can add to this conflict. Parents can help their children by letting them know that many children, with and without asthma, are going through these changes.

As children mature, there is increased involvement in peer relationships. Friends provide security to children as they start to exert their independence from their parents or caretakers. Children provide support to each other in clubs and groups.

For those with asthma, support groups provide a means by which they can learn more about their condition and share their thoughts and feelings with peers in similar situations. Close friendships and peer relationships help children develop internal standards and judgments about themselves: who they are, what they like and what their future goals are.

As they mature, children develop the ability to use these experiences with peer relationships and apply their social skills to master their environment, shape their future and to have a healthy dose of self-esteem, which helps them to appropriately care for their asthma.

This article was written and medically reviewed: March 31, 2000

Information for this educational article was derived from the document:
Pediatric Asthma: Promoting Best Practice Guide for Managing Asthma in Children

Known as the Pediatric Asthma Guide for short, it represents the collective work of many people and many organizations. It is the only document for treating childhood asthma that is endorsed by the American Academy of Allergy, Asthma and Immunology, the American Academy of Pediatrics, and the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung, and Blood Institute. The Guide is based on guidelines developed by the NAEPP. This pediatric initiative adapted those guidelines into an easily-referenced, user-friendly, pediatric-focused document for medical professionals.

The Guide is but one part of a larger initiative committed to ensuring that a broad spectrum of health care providers learn about, understand and implement clinical and best practice information for diagnosing and managing children with asthma.

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