Help Kids Breathe Easy

Asthma is the most common chronic illness of childhood, but it needn't define any child's life.

According to the Centers for Disease Control and Prevention, 6.5 percent of U.S. children have asthma, a chronic condition that inflames and narrows the airways in the lung and can make breathing a struggle. A bad asthma attack can be dangerous and also traumatic for parent and child. The Society of Pediatric Psychology reports that poorly managed childhood asthma symptoms can lead to a higher chance of anxiety and depression later in life. That’s all the more reason to handle this childhood illness intelligently, and when BERGEN sought out Tamar Weinberger, M.D., a pediatric allergy and immunology expert at Hackensack Meridian Health, she suggested five ways to do just that:

Find a doctor. The American Institute of Allergy, Asthma & Immunology flags the following symptoms as reasons to seek out a medical specialist for a possible asthma diagnosis:

— a constant cough that is made worse by viral infections, continues while the child is asleep or is triggered by exercise or cold air;

— wheezing or whistling sounds when the child exhales;

— chest tightness;

— unusual fatigue during play; or

— problems sleeping due to a cough.

Early intervention can mean the difference between a bad attack and a controlled one, so don’t hesitate to seek out medical attention if you’re worried. Dr. Weinberger stresses: “Being in touch with a child’s doctors when it’s needed is very important.”

Teach the child. Dr. Weinberger often uses visual aids to explain asthma to her young patients. “I usually show them pictures—that is really helpful for kids,” she says. “I explain that they need to breathe in medicine to help air move in and out more easily so they can run around and play.” She finds that this not only helps kids understand their condition, but also makes the process less scary for them. “Children are really resilient,” she adds. “They are not usually scared unless they’re having severe exacerbations.”

If a child is expressing more fear and anxiety over his or her symptoms, Dr. Weinberger encourages even more explanation. “I always encourage the kids to ask me questions,” she says. “Kids are intuitive and smart, and they pick up on things when their parents are nervous.” For a very anxious child, she recommends seeking out other children with asthma or learning about athletes with asthma. The more children learn, she figures, the less they will worry.

Let practice make perfect. When it comes to taking inhalers and other asthma medication, whether as a preventative measure or in an emergency, practice and preparation are key. “I have families bring their medications to every visit so we can practice and observe how they’re being taken,” says Dr. Weinberger. She also says that YouTube videos that review how medication is used are very useful. She explains: “Frequent follow-up is important, to review and re-review how and when to use medications.” It’s normal, the doctor adds, for a child to need assistance in taking medication.

Keep an open mind. When talking to parents, Dr. Weinberger says, “reassurance is key.” A common source of anxiety for the parents of her patients comes from labeling their child as an “asthmatic,” which feels both limiting and frightening. “I explain that the label is only there to help doctors give them the best medications,” she says. Also, just as they help kids, pictures help adults understand the condition too. The images let them visualize what is going on in their child’s body, which the doctor calls “very helpful.” She also says, “The most important thing to tell them is that the majority of patients who have asthma live healthy, normal lives. They play sports and run. Being aware of their symptoms and how to use medications is the key to success.”

Take a deep breath. Dr. Weinberger stresses that the vast majority of patients with asthma—children or adults—live completely normal lives. The children she treats do not stop acting like children once they are diagnosed, and many of them see no change in their quality of life. “On a normal, day-to-day basis, kids are living their normal lives and feeling totally fine—the parents are the ones reminding them to take their preventative medications when needed,” she says. With those reminders, the correct medications and effective practice, asthma doesn’t need to slow any child down.

THE ASTHMA ACTION PLAN

As pediatric allergy and immunology specialist Tamar Weinberger explains, “Every patient diagnosed with asthma gets an Asthma Action Plan, which is color-coded and reviews their medications.” This is a standard provided by the American Institute of Allergy, Asthma & Immunology; it uses the familiar system of a stoplight—green, yellow and red. The plan tells patients what to expect—and what to do—in each of three categories of symptom activity:

• Green: the “Go Zone”: You’re showing no asthma symptoms. Your breathing is good, you are not coughing or wheezing and sleeping through the night isn’t a problem. In the Go Zone, a patient can work and play as usual. When here, you may take a preventative medication to keep you feeling good.
• Yellow: the “Caution Zone”: Here you are experiencing some symptoms. You may have been exposed to a known asthma trigger, and you’re apt to be coughing. Symptoms may include a mild wheeze, a tight chest or something similar to the first signs of a cold. At this stage, you may be reaching for quick-relief medication such as an inhaler.
• Red: the “Danger Zone”: At this stage, asthma symptoms are getting worse fast. Medication is not working to ease symptoms, and breathing continues to be difficult. You may also be struggling to talk. At this stage, seek help from a doctor right away. If your regular doctor can’t be reached, go directly to an emergency room.