Education on Childhood Asthma: Causes, Symptoms, and Treatment

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Asthma is a serious yet common respiratory condition that affects more than 26 million Americans, including more than 4.6 million children, according to the CDC. Since spring weather causes an increase in symptoms due to the presence of allergens and pollution, asthma treatment—especially in children—is a case of vigilance and a customized approach.

Pediatric pulmonologist and director of the Pediatric Asthma Center at NewYork-Presbyterian Queens Dr. Kalliope Tsirilakis provides tips on identifying, treating, and managing asthma in an effective manner.

What Is Asthma and How Does It Affect the Body?

Asthma is a chronic disease in which inflammation of the lungs and airways occurs, making it difficult to breathe. This inflammation exists even when a child seems to be free from symptoms, described as persistent asthma. When the inflammation is exacerbated due to exposure to irritants like pollen, pollution, or viruses, the asthma attack happens.

It's like having a rash inside your lungs,'" says Dr. Tsirilakis.

Common Asthma Triggers in Children

Knowing what provokes asthma is the best way to prevent flare-ups. Typical asthma triggers are:

• Pollen, dust, and mold
• Viral infections (particularly in young children)
• Air pollution
• Indoor allergens such as cockroaches, mice, and pet dander
• Chemical irritants (for example, house cleaners)

Who Is Most at Risk for Asthma?

Kids—especially city kids where pollution is high—are more at risk. In the city of New York alone, more than 1 in 10 children under the age of 12 have asthma, with the highest concentration along the crowded Cross Bronx Expressway.

Yes, genetics play a role in asthma, but there is no single gene that does. More than 30 genes have been linked to risk of asthma. But the condition usually emerges due to a combination of genetic predisposition and environmental exposure.

How Is Asthma Diagnosed?

Despite the fact that there is no single test for diagnosing asthma with certainty, doctors employ:

• Clinical evaluation (ongoing observations of symptoms)
• Spirometry testing (lung function measurement)
• Testing for allergy (to identify environmental triggers)

Diagnosis is more precise in older children but even 3-year-old children can benefit from testing.

Do Children Outgrow Asthma?

Symptoms of asthma may change over time. Some become better with increasing age, and some may have worsening symptoms to develop, especially around puberty or after changes in the environment like moving.

Successful Asthma Treatments for Children

Although there is no cure for asthma, it is easily managed with:

Inhaled Steroids

Initial treatment to reduce lung inflammation with few side effects.

Combination Inhaler

Have a long-acting bronchodilator (LABA) to have patent airways for 12–24 hours.

Rescue Inhalers

Relief medications like albuterol to alleviate acute symptoms.

Biologic Therapies

New and promising, biologics use monoclonal antibodies to reduce allergic inflammation and are effective in moderate to severe asthma.

How to Know If It's Asthma or It's Just a Respiratory Virus

It's usual for kids to wheeze when they have a viral infection like bronchiolitis, but if wheezing or coughing continues even after the virus has passed, it might be asthma.

"If your child has to use an inhaler repeatedly after a cold, it's time to talk to a specialist," advises Dr. Tsirilakis.

Home Tips to Control Asthma Triggers

• Cover pillows and mattresses with dust mite covers
• Make the house cockroach- and mouse-free
• Use gentle chemical cleaning products, if any are necessary
• Address mold and moisture issues right away
• Encourage handwashing to prevent infection

Also, create an Asthma Action Plan with your doctor. Store medication and the plan in a clear plastic bag for easy access at school, daycare, or playdates.

The Future of Asthma Care: Biologic Treatments

Biologics are reshaping the treatment of asthma by targeting directly the allergic culprits that trigger the inflammatory process. Administered intramuscularly or subcutaneously every few weeks, biologics hold out the hope of long-term control and, in some instances, reversal of some of the lung changes caused by asthma.

Closing Thoughts

Asthma does not need to define a child's life. With accurate diagnosis, management, and treatment of triggers, asthma children can enjoy full, healthy lives.

"I tell all of my patients—there are Olympic competitors who have asthma," Dr. Tsirilakis states. "It won't hold you back at all."