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About 10 percent of children in the United States have asthma. Asthma is the third leading cause of hospital admission for children and accounts for more than 13 million missed days of school each year! But what is asthma? Is it something your child might be at risk for?

Asthma is a condition where the airways that allow children to breathe become inflamed, narrowed and blocked. Imagine your child’s airways as an upside down tree: a large hollow trunk feeds air to increasingly tiny branches so that oxygen can reach the lungs and be taken up into the blood. In asthma, inflammation leads to airway swelling and mucus, both of which can block the airways. This makes it difficult for the child to breathe.

Symptoms may include wheezing, shortness of breath (at rest or with exercise), and coughing. In a serious asthma attack, children may breathe quickly and their skin may tug around their ribs and neck (“retractions”). This can be a medical emergency with immediate intervention required. Often, symptoms are worse at night and with exercise.

Triggers for asthma may include secondhand smoke, allergens, air pollution, viral infections like the common cold, weather changes, exercise, and any sort of aerosol such as perfumes or air fresheners. In children, there is a strong link between asthma and allergic conditions such as eczema and allergic rhinitis.

Evaluation for asthma often includes lung function tests to measure lung capacity in children old enough to do it. More specialized testing may be needed in some cases to check for other contributing factors such as allergies, gastric reflux, sinus disease, abnormal airway anatomy, and/or sleep apnea. In some instances, other conditions may mimic symptoms of asthma. For example, in infants younger than 2 years of age, gastric reflux can cause wheezing that mimic asthma, and proper diagnosis is critical for adequate treatment.

Treatment for asthma often requires at least two medications: an inhaler to use only when symptoms are present (a “rescue” or “reliever” inhaler) and at least one medication used every day to treat airway inflammation and help prevent attacks from happening (a “controller” inhaler). If your child has been prescribed a controller medication, it is very important that it be used exactly as prescribed as missed doses can result in poor asthma control. In children, almost all inhalers should be used with a special plastic tube attached (a “spacer” or “holding chamber”). This device makes it much easier for children to use their inhaler correctly and make sure the proper amount of medicine gets into the lungs where it is needed.

With proper treatment, children with asthma can do everything their friends can! They can play sports, excel at school, and lead a normal life. Close follow-up and monitoring of lung function, however, are key to ensuring a child’s asthma remains under good control. As a child grows, medications may need to be adjusted. Our goal is always to have patients on the lowest dose of medication needed to maintain control of their symptoms.

UofL Physicians has a team of pediatric pulmonologists dedicated to the care of children and infants with asthma and other respiratory conditions. To learn more about UofL Physicians – Pediatric Pulmonology click here.

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Article by:

Scott Bickel, M.D.

Dr. Scott Bickel is a pediatric pulmonogist with UofL Physicians. He is also an assistant professor in Pediatrics in the Division of Pediatric Pulmonology. Dr. Bickel grew up in Louisville where he attended Trinity High School. After completing his undergraduate studies in computer science at Ohio State, he came home to the University of Louisville where he completed medical school, pediatric residency and his pediatric pulmonology fellowship training. He has helped author multiple peer reviewed publications and presented over a dozen abstracts at national and international meetings. He is a member of the American Academy of Pediatrics, American College of Chest Physicians and American Thoracic Society. Dr. Bickel serves on Norton Children’s Hospitals’s asthma task force. Dr. Bickel is married to his lovely wife Katherine, and they are the proud parents of two sweet and spunky girls, ages two and four.

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