Asthma Touches All Parents

According to the American Lung Association, 5.6 million schoolchildren in 2007 were reported to have asthma. This translates to an average of three kids in a classroom of 30 – a stunning number. So chances are that even if your child does not have asthma, you know someone who does.


Q: In my daughter’s preschool, there is a child who has asthma. What, if anything, should I be prepared to tell my daughter?

A: Preschoolers are incredibly curious and observant, so talking to your child about her classmate is a good idea. Asthma is a chronic inflammatory disease of the lung’s air passages that can make breathing difficult. There is no cure and it will not go away, but there are very good treatments to control it. 


Reassure your child that the parents and teachers know what to do if her friend has trouble breathing. Remind her that she should always tell a grownup if any friend, asthmatic or not, seems to be feeling sick or not acting normally. You may also want to reassure your daughter that just because her friend has asthma doesn’t mean she will get it. Asthma is not contagious. 


Q: My asthmatic son is starting kindergarten next year and I’m very nervous about entrusting his care to the school. 

A: Make sure that the teachers and school administrators understand that every case of asthma has unique characteristics. Even though they may have had asthmatic students before, this alone will not fully prepare them for caring for your child. 


Ask for a conference with your son’s teacher before he starts kindergarten. It is important that you have an action plan put together by you and your doctor that will tell the school staff what to do and who to call in the event of an asthma episode.


Tell the teacher as much as you can about your child’s individual asthma triggers and how well controlled his asthma is. It is important that the school and the teacher are familiar with asthma inhalers and the proper technique for using them. 

Ask about available resources, including whether there is a school nurse on site and during class trips. Make sure you understand how physical activity is handled. If needed, should your child take his asthma medication before physical activities? 


Schools now require a signed permission slip before a child can take a prescription medication in school. Make sure you have the proper permission slips filled out and signed by your child’s doctor. 


It is natural to be concerned about entrusting your child’s care to someone else. However, with proper medical care as well as good planning and communication between parents, doctors and educators, most children with asthma can participate fully in school activities. 


Q: How can I reduce the risk of my child having an asthma episode?

A: When a person has asthma, his or her airways are always swollen and sensitive, even when he or she feels just fine. When something irritates the swollen and sensitive airways, the tissue becomes even more inflamed and the airways start to narrow. As they narrow, breathing becomes more difficult and the person suffers an asthma episode. 


To reduce the risk, you need to break this chain of events. One way is to manage the inflammation with drugs. These work slowly over days and weeks, so closely follow the asthma care plan recommended by your doctor.


Upper respiratory diseases can also worsen asthma symptoms, so teach your child the importance of frequent hand washing and good hygiene during cough, cold and flu season. And of course, get flu shots when they are available.  


Finally, do what you can to control environmental irritants that worsen airway inflammation. Approximately 60 percent of asthma cases are caused by allergies to dust mites, mold, pollen and animal dander. I recommend tackling these allergens first. Take simple steps such as: 


• Getting an allergy casing for your child’s pillow(s)


• Washing all bedding, especially blankets and comforters that would normally be washed less frequently than sheets


• Keeping stuffed animals off the bed as they can harbor dust mites


• Changing into bed clothing right before bed


• Keeping the bedroom quiet for one hour before your child’s bedtime to avoid stirring up allergens


Q: My child was recently diagnosed with asthma and I am concerned about the effect of taking steroid medications to control her asthma. Doesn’t long-term use of steroids harm growth?

A: Corticosteroids in pill and liquid form are usually used for acute asthma attacks. With continued use, these can impact growth. However, the long-term treatment of choice for asthma is inhaled corticosteroids that work slowly over time. Scientists have studied large groups of children taking inhaled corticosteroids for asthma and found that the side effect risk is very low.


Steven Rubinstein, M.D., a board-certified specialist in Allergy and Immunology at the Palo Alto Medical Foundation (PAMF) Mountain View Center, provided this month’s medical responses. Advice is not intended to take the place of an exam or diagnosis by a physician.

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