Indiachildren - ASTHMA

ASTHMA

Asthma is a very common disease among children of all age groups. In majority of the affected children, it is mild to moderate in severity and can be managed without difficulty. Many of the children grow out of asthma, some by school age and a few before they become adults. Asthma is an inherited illness, where there is usually a history of asthma, eczema and hay fever in the parents or grandparents.

Causative factors

Children with asthma have air passages which are oversensitive. They react quickly to various irritants, triggering off an asthmatic attack. The known triggers are :

a.	Viral infections (especially common cold).
b.	Sudden changes in temperature, cold weather and strong dry winds.
c.	Strong odour and fumes like fresh paint whitewashing, perfumes and tobacco smoke.
d.	Allergies :
	* Allergies to food like cocoa, eggs, fish or chana dal.
	* Allergies also to house dust, mites, grass pollens of certain flowers.
	* Allergy due to animal fur and feathers.

Symptoms

The pattern and severity of illness varies from patient to patient

a.	Children present as cough which is worse at night.
b.	Moderate difficulty in breathing and the child feels better in a sitting position.
c.	Some children may develop wheeze which sometimes is quite severe and the wheeze sound can be heard at a distance also.

Treatment

Each individual child has to be managed according to the severity and recurrent nature of his condition. Treatment consists of 2 types :

a.	Treatment of acute episodes and persistent symptoms.
b.	Prevention of the attack.

Treatment of the acute episodes

a	Calm the child and be calm yourself as anxiety in the child always worsens the condition.
b.	Various bronchodilators drugs are available, which can be given to the child to open up the nasal passages and ease breathing.
c.	Various inhalers are available, so that the bronchodilator drug can go directly into the lungs. Through the inhaler, the drug reaches the lungs faster, and these are given in a low dosage so that the side effects are comparatively lower.

In children below 6 years who cannot make use of the inhaler, spacer fitted to the aerosal puffer is used. The administration of inhaler medication to infants and very young children is given with the help of a neboliser. The nebuliser is a machine that turns the liquid medicine into a mist by blowing compressed air or oxygen through it. The use of a nebuliser is generally done in the hospital or clinic.

Many parents hesitate to let their children try the inhaler medicine initially thinking that it should be used as the last resort, when other medications fail, or they feel that the child will become addictive to this treatment, and cannot do without it. In fact, the inhaler treatment is very useful and effective tool in the management of asthma even in the initial stages.

Prevention of the attack

The best preventive method is avoiding the triggers which can cause asthma :

a.	Avoid the exposure of the child to cigarette smoke and strong odours like paint, whitewash and strong perfumes.
b.	Children prone to asthma should avoid going to dusty places and even in the house the bedroom furniture should not have carpets, rugs, stuffed toys and calendars which are liable to gather dust and are difficult to keep clean. The mattresses, quilts and blankets should be vaccumed or dusted once a week when the child is not present at home.
c.	Rooms should be kept aired and humidity should be avoided, as moulds tend to grow rapidly in damp and warm places. Air conditioning helps to reduce humidity.
d.	Do not use pillows with feathers or fans.
e.	Avoid taking the child to gardens, the pollens of certain flowers can cause severe allergy, triggering off an attack of asthma.
f.	Avoid giving food that possibly cause allergy to the child e.g. eggs, fish, cocoa products.
g.	Avoid giving aspirin or aspirin containing formulations (anacin) and even ibuprofen to the asthamatic child as it can trigger off an attack.