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Asthma Basics
Take a long, deep breath — right now. Inhale slowly, until your lungs can't hold anymore . . . now let the air out gradually . . . ahhh. Breathing feels so natural that it's easy to take for granted, isn't it?
Normally, the air you breathe travels effortlessly through your nose and mouth, down the trachea (also called the "windpipe"), through the bronchial tubes into the lungs, and finally to tiny clusters of air sacs, called alveoli. Here, oxygen is exchanged for carbon dioxide in your blood.
Now try something different: run in place for 3 minutes. Then place a straw in your mouth, close your lips around it, and try to breathe in and out — but only through the straw. Not so easy anymore, is it? Now, narrow the straw by pinching it in the middle. Even more difficult to breathe?
That's what it feels like when someone tries to breathe during an 
More than 20 million people have asthma in the United States. In fact, it's the No. 1 reason for kids chronically missing school. And asthma flare-ups are the most common cause of pediatric emergency room visits due to a chronic illness.
Some kids have only mild, occasional symptoms or only show symptoms after exercising. Others have severe asthma that, left untreated, can dramatically limit how active they are and cause changes in lung function.
But thanks to new medications and treatment strategies, kids with asthma no longer need to sit on the sidelines, and parents no longer need to worry incessantly about their child's well being.
With patient education and the right asthma management plan, families can learn to control symptoms and asthma flare-ups more independently, allowing kids and parents to do just about anything they want.
About Asthma Flare-Ups
Asthma is a chronic lung disease that causes airways to become inflamed, leading to symptoms such as coughing, wheezing, and shortness of breath. Anyone can have asthma, including infants and adolescents. The tendency to develop asthma is often inherited.
Many kids with asthma can breathe normally for weeks or months between flare-ups. When flare-ups do occur, they often seem to happen without warning. Actually, an asthma flare-up usually develops over time, involving a complicated process of increasing triggers.
When exposed to these triggers, the muscles surrounding the airways tend to tighten, which makes the already clogged airways even narrower. Things that trigger flare-ups differ from person to person. Some common triggers are exercise, allergies, viral infections, and
lung function tests.
During this process, parents must provide the doctor with detailed information, such as:
- symptoms: how severe they are, when and where they occur, how frequently they occur, how long they last, and how they go away
- allergies: the child's and the family's allergy history
- illnesses: how often the child gets colds, how severe they are, and how long they last
- triggers: exposure to spirometer, a machine that analyzes airflow through the airways. A spirometer can also be used to see if the child's breathing problems can be helped with medication, a primary characteristic of asthma.
The doctor may take a spirometer reading, give the child an inhaled medication that opens the airways, and then take another reading to see if breathing improves with medication. If medication reverses airway narrowing significantly, as indicated by improved airflow, then there's a strong possibility that the child has asthma.
If your child is diagnosed with asthma, it's important to learn how to peak flow meter — a hand-held tool that measures breathing ability — can be used at home. When peak flow readings drop, it's a sign of increasing airway inflammation.
More Information
Exercise-Induced Asthma
Kids who have rescue medication to all games and activities, and the school nurse, coaches, scout leaders, and teachers must be informed of a child's asthma, especially so kids who need to can take medication at school as needed.
Allergy-Triggered Asthma
Not every child with asthma has allergy-triggered asthma, but an estimated 75% to 85% of people with asthma have some type of allergy. Even if the primary triggers are colds and Environmental control measures for the home can help reduce exposure to allergens. When avoidance isn't possible, antihistamine medications may be prescribed to block the release of histamine in the body.
Nasal steroids may be given to block allergic inflammation in the nose. In some cases, an allergist can prescribe
- Mild intermittent asthma
A child who has brief episodes of wheezing, coughing, or shortness of breath occurring no more than twice a week is said to have mild intermittent asthma. Symptoms between flare-ups are rare, with the exception of one or two instances per month of mild symptoms at night.
- Mild persistent asthma
Kids with episodes of wheezing, coughing, or shortness of breath that occur more than twice a week but less than once a day are said to have mild persistent asthma. Symptoms usually occur at least twice a month at night and flare-ups may affect normal physical activity.
- Moderate persistent asthma
Kids with moderate persistent asthma have daily symptoms and require daily medication. Nighttime symptoms occur more than once a week. Flare-ups occur more than twice a week, last for several days, and usually affect normal physical activity.
- Severe persistent asthma
Kids with severe persistent asthma have symptoms continuously. They tend to have frequent flare-ups that may require emergency treatment and even hospitalization. Many children with severe persistent asthma have frequent symptoms at night and can handle only limited physical activity.
Every child needs to follow a custom asthma management plan (known as an Elana Pearl Ben-Joseph, MD
Date reviewed: May 2007