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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Asthma

Asthma is the most common chronic lung disease among children that causes difficult breathing. Most children who develop asthma have had their first attack by the time they are 4 or 5. Asthma is characterised by rapid, laboured breathing, indrawing of the chest on inhalation and generally wheezing on exhalation. In young children, the first signs of asthma often include a recurring cough that accompanies a cold or after exercise, or a cough that occurs primarily at night. If treated correctly, most asthma sufferers can lead a completely normal life, but if left untreated, it may slow your child’s growth, cause permanent damage to the airways and it can be potentially fatal (Bupa, 2010; Collins, 2003; Leary, 1990).

 

What is an asthma attack?

During an asthma attack, the airways of the lungs – the trachea, bronchi and bronchioles – narrow in response to the offending allergen. This occurs because the lining of these airways becomes irritated and inflamed, the muscles contract, further obstructing the passage of air, and extra mucus is produced. As a result, it is more difficult for the air to flow in and out of the lungs, the chest muscles have to work harder to get air through these narrowed airways, and breathing becomes more rapid. On exhalation, the airways become even narrower, the obstruction of air even greater, and a musical sound, like a wind instrument, called wheezing, is often produced. To compensate for these breathing difficulties, your child may exhibit indrawing of the chest on inhalation, coughing to dislodge mucus, and wheezing on exhalation (Bupa, 2010; Colins, 2003; Leary, 1990).

 

Symptoms

Symptoms may vary from mild, moderate to severe and include:

·         wheezing

·         coughing

·         shortness of breath

·         tightness in the chest

·         difficult or noisy breathing

·         drowsiness

·         difficulty speaking

·         blue lips, tongue or fingernails

·         difficulty sleeping

·         refusal to eat or drink (Bupa, 2010; Collins, 2003)

 

Causes

Asthmatic children often have other allergies, such as allergic rhinitis or atopic eczema. There may also be a family history of asthma or other allergic conditions. Individual asthma attacks are commonly triggered by:

·         viral infections, such as a cold or the flu

·         irritants – dust, cigarette smoke or fumes

·         chemicals

·         allergies to animals, dust mites, certain foods or pollen

·         certain medications

·         exercise, especially in cold, dry air

·         emotions – stress, anxiety, or laughing or crying very hard (Bupa, 2010; Collins,  2003)

 

Diagnosis of asthma

If you think your child has asthma, consult your doctor within 24 hours. If her symptoms are severe, call an ambulance or take her to the nearest emergency room. Your doctor will ask about your child’s symptoms, if there has been any possible exposure to allergens and if there could be any factors causing your child any anxiety. After performing a physical examination, one or more of the following tests will be used to confirm the diagnosis:

·         Peak flow measurement – this test measures the capacity to exhale air.

·         Chest X-rays to check for any associated infections.

·         Spirometry, which also checks lung functioning, by measuring the speed of the air flow and how much air is flowing.

·         Allergy testing to help find out whether your child is allergic to certain substances.

 

In children under the age of 5, a diagnosis may be made on the basis of whether or not your child responds to allergy treatment (Bupa, 2010; Collins, 2003).

 

Treatment of asthma

Asthma treatment is aimed at helping your child manage her symptoms and will be specifically designed to meet her individual needs:

 

Inhalers

Inhalers containing gas or dry powder propel the correct dosage of medication into your child’s airways, when she presses the top down and inhales. There are two types of inhaler medications that are used for asthma (Bupa, 2010).

·              Relievers, commonly known as bronchodilators, are used when asthma symptoms occur      and contain medication such as salbutamol (e.g. Ventolin). They work quickly by relaxing muscle spasms in the lower respiratory tract, opening the airways to make airflow easier, and are extremely effective for ‘breaking’ an asthma attack and easing symptoms such as wheezing (Bupa, 2010).

·              Preventors are designed to reduce inflammation of the airways and prevent histamine      release. Preventors should be taken on a daily basis, even if your child does not have      symptoms. They usually contain a steroid medication, such as fluticasone (e.g. Flixotide) (Bupa, 2010; Leary, 1990).

Your child may also be prescribed a long-acting reliever that is combined with a steroid medication, such as symbicort (e.g. Seritide) (Bupa, 2010; Leary, 1990).

 

Spacers

Spacers are long tubes that can be clipped on to the inhaler to help your child use it correctly. She can then breathe in and out of a mouthpiece at the end of the tube. Spacers are particularly effective and helpful for children, even those as young as 3. In the case of babies or very young children, a face mask can be attached. Spacers are designed to allow you to activate the inhaler and they then hold the drug before it is inhaled. They also reduce the risk of your child getting a sore throat from steroid inhalers (Bupa, 2010; Collins, 2003).

 

Nebulisers

Nebulisers have a pump that disperses a fine mist into a face mask. They are particularly effective in delivering the medication to exactly where it is needed and may be useful when treating infants with asthma. Nebulisers are important if your child has severe asthma and requires emergency treatment at home or in hospital (Bupa, 2010; Collins, 2003).

 

Other medication

Some children may require oral corticosteroids periodically if they suffer from severe allergies and asthma (Collins, 2003).

 

Prevention

Although an asthma attack cannot be prevented, you can help your child in the following ways:

·                In children over the age of 6, a peak flow meter can be used to monitor their asthma and may provide warning of an impending attack.

·                Since asthma may change, develop or subside over time; keep a daily record of your child’s symptoms and peak flow meter readings. This will help your doctor make adaptations to your child’s treatment in accordance with her needs.

·                Always keep a bronchodilator readily available in case of an attack of asthma.

·                To reduce the severity of your child’s asthma symptoms, remove or reduce her exposure to known allergens.

·                Help your child deal with stressful situations and be supportive and empathetic if she is feeling anxious.

·                Reduce exercise-induced asthma attacks by giving your child her asthma medication half an hour before the planned activity (Collins, 2003).