Your Source for Comprehensive Asthma Care

According to the Centers for Disease Control and Prevention, 9 million children in America are diagnosed with asthma, a chronic or acute inflammatory condition of the airways that can make breathing difficult. However, many children with asthma have not been diagnosed.

Asthma is the most common chronic disease in children and is becoming increasingly prevalent, although physicians are still working to determine why. If your child experiences frequent coughing at night, wheezing with respiratory infections or trouble with exercise he or she may suffer from chronic asthma.

“Children with asthma have swelling in their airwaves and increased mucus production. Asthma attacks often occur with illness or when the airways become inflamed and swollen after exposure to certain environmental triggers,” said Monica Federico, MD, Director of the Asthma Management Program at The Children’s Hospital. “Allergies, upper respiratory infections, weather changes or airborne irritants such as cigarette smoke and aerosol sprays could cause an acute or allergy induced asthma attack.”

Examining the Condition in Your Child

Children who show signs of asthma should be seen by their healthcare provider. The initial treatment is an inhaled beta agonist such as albuterol. If a child improves with albuterol and there is no reason to suspect another chronic lung disease, he or she most likely has asthma. Asthma can be classified into the following categories:

• Intermittent asthma is the least severe type, with symptoms occurring fewer than two days a week of fewer than two night per month.
• Mild persistent asthma occurs when symptoms appear more than twice per week or two nights per month, but not every day.
• Moderate persistent asthma is characterized by symptoms occurring daily or more than one night per week.

If a child has persistent asthma, a physician may recommend inhaled or oral medication or a combination of both so the child can continue living a normal life. When a child has well-controlled asthma, they have infrequent symptoms and no exercise limitations.

Diagnosing the Condition

Pediatric specialists at Children’s can help make the diagnosis of asthma using lung function and other testing. Patients already diagnosed with asthma can be referred to the asthma clinic at Children’s Hospital. High-risk asthma patients or patients who have difficult to control asthma can also be referred to our asthma clinic. High-risk asthma is defined as two or more emergency room visits or one or more hospitalizations for asthma in the last 12 months.

The clinic provides patients with extensive asthma education and diagnostic testing such a spirometry. Spirometry is a breathing test to measure obstruction in airflow to the lungs — to determine the child’s level of lung function. Skin testing can be performed to determine possible triggers for patients with allergy-induced asthma, and exercise testing can help physicians develop plans for children with exercise-induced asthma to help them stay active.

Improving Treatment Methods for Patients in the Hospital for Asthma

The pediatric asthma specialists at Children’s not only provide asthma treatment, but they also educate other physicians in the area and set standards for asthma care. In 2002, Gwen Kerby, MD, Director of the Asthma Management Program at Children’s, developed the Asthma Pathway or clinical care guideline — an approach including national guidelines that enable physicians to provide standardized care for patients hospitalized with asthma. The protocol is now being used in other U.S. hospitals to help ensure these patients receive treatment according to the national guidelines for care.

“The asthma clinical care guideline is one example of how Children’s is staying at the forefront of research to ensure patients receive the most advanced care,” Dr. Federico said. “It also incorporates education and appropriate follow-up measures so parents can help their children manage the condition in the future.”

For more information about The Children’s Hospital Asthma Management Program, visit www.thechildrenshospital.org and click on “Conditions We Treat” followed by “Asthma, Breathing & Lung.”