Asthma is a disease of the airways, the smaller wind pipes leading to the lungs.  In normal breathing, the airways are wide open, and air moves freely in and out during breathing.  In an asthma attack, the airways tighten up, trapping air in the lower lungs, making it very hard to breathe.  You can often hear a person with asthma breathing loudly, or wheezing, in an effort to force this trapped, stale air out.

Some young children with asthma get better when they are about 4 or 5 years old.  This is probably because their airways grow larger and they can breathe more easily.  Most children do improve as they grow up, but it is important for a doctor to help take care of your child if they have asthma.  Asthma often runs in families, and people with asthma usually suffer from allergies as well.  Many things can make a person have an asthma attack.  These are called asthma triggers, and include such things as:

• Irritants and allergies such as smoke, dust, animal dander, molds, and certain foods.
• Cold, rainy weather fronts, and thunderstorms.
• Running exercise for long, intense periods.
• Emotional upsets or excitement.
• Colds and respiratory infections.

Often the best way for asthma medications to work is by inhaling them directly into the airways.  For milder cases in young children the medicine might be given by mouth.  Older children and adults take puffs of the drug with what is called a metered dose inhaler.  The inhaler may or may not be used with a spacer device (like an Aerochamber) to deliver the medicine in a more natural way.  Children with more severe asthma, or those younger than about 5 or 6 years old who may have trouble learning how to use an inhaler, often use what is called a nebulizer.  This is a machine that mixes the drug with air to form a mist that is then breathed into the lungs.

In the case your child is seen in an emergency by another doctor it is vital that you know the names of the medicines your child is taking, both brand name and generic.  For instance, albuterol is the generic name of the most commonly prescribed medicine for asthma.  You also have to know the two brand names of this drug, Proventil^® and Ventolin^®.  Another different but similar inhaler medicine is pirbuterol, more commonly known by its brand name of Maxair^®.  You may also want to monitor how well your child is breathing with a device that's called a peak flow meter.

Helping your child live with asthma requires a bit of ingenuity on your part.  What steps you take will depend on what triggers your child's asthma.

• One very important rule if your child has asthma is that no one should smoke in your house.  You should not use the fireplace, and the child should try to stay away from outdoor fires and smoke.
• It is best not to keep pets in the house if allergic.  If you must get a new pet, fish are okay.
• You have to try to keep your house as free of dust as possible.  Because carpets and rugs hold a lot of dust, it's usually better to have bare wood floors.
• Your child's mattress should have a plastic cover on it, and the pillow should be made of synthetic fibers, not feathers or down.  Wash the pillow and blankets every month and the sheets every week.
• If mold allergies are a concern, keep the relative humidity in your house at 50% or less.  Air conditioning can help keep the humidity low.

If it becomes necessary for your child to take the asthma medications to school, we'll fill out the order for the school nurse when you bring it to us.  It's usually a good idea to get a refill on your child's inhaler medication three weeks after the first, so that you can have an extra inhaler for the school to use.

If your child has frequent asthma episodes, or requires hospitalization for an asthma attack we will want you to enroll in a formal asthma intervention program.  All of the major health insurance programs have their own programs, and we will help you enroll in these programs if it becomes necessary.

We have other information on this site about inhaler use in both younger children and older kids.