Childhood asthma

Last updated on: 20 April 2022 | Released on: 24 December 2020

Q1
What are the side effects of inhaled steroids?
A1
Unlike oral steroids, inhaled steroids are delivered directly to the bronchial tubes. This is why they exert sufficient effects even in small doses. Even when taking a long-term control medication every day, there is no need to worry about major side effects as long as the inhaler is being used correctly.
However, residues of the inhaled steroids in the mouth can lead to throat discomfort, hoarseness, or oral thrush (a yeast infection in the mouth) although such events are rare in children. To prevent these problems, gargle every after use of inhalers. If the patient is too young to gargle, you can have him/her drink water or eat food after using the inhaler.
Recent studies have shown that inhaled steroids may have a small effect on height growth, depending on the type and quantity of the steroid used. However, the widespread use of inhaled steroids have dramatically improved asthma control. They have helped reduce deaths and hospitalization from asthma, and the frequency of attacks. They have allowed patients to lead unrestricted lives (family life, school, etc.).
If your doctor has prescribed inhaled steroids, then he or she has considered both of its benefits and side effects. Consult your doctor if you have any questions or concerns. Do not reduce or stop steroid use without your doctor’s approval.
Q2
What does childhood asthma have to do with other allergies such as food allergies or atopic dermatitis?
A2
In many cases, childhood asthma tends to develop in children with a predisposition to allergies. Therefore, children with asthma have a high probability of developing other allergic diseases, such as food allergies, atopic dermatitis, and/or hay fever.
Children who are predisposed to allergies also tend to experience an “Allergic March,” in which they go through a series of allergic symptoms as they grow. These include food allergies and atopic dermatitis in infancy, and asthma and allergic rhinitis in early childhood.
Q3
The asthma attacks have stopped. Can I stop the use of regularly taken medication?
A3
When a person has asthma, their airway is constantly inflamed, even when there are no subjective symptoms. This is like a fire that has been extinguished but is still smoking. If you stop the treatment now, the flames may reignite and begin to burn again. This is why it is important to use long-term control medications (such as inhaled steroids) to keep “bronchial inflammation” under control. Make sure you follow your doctor’s instructions on how to use these medications.
Q4
Is infant asthma different from childhood asthma?
A4
Infants are medically defined as babies under the age of 1 (i.e. 0-year-olds). However, “infant asthma” is an exception, as it refers to asthma in children under 2 years old (i.e. 0 and 1 year old). It is distinguished from childhood asthma, which is for children of older ages. This is because children under 2 years of age have narrow airways, and even a mild cold can lead to wheezing and mild breathing difficulties in this age group. Therefore, a diagnosis of asthma must be made carefully.
Q5
My parent(s) suffered from childhood asthma. Is the child of an asthmatic parent more likely to develop asthma?
A5
It is believed that allergies are hereditary. However, allergic diseases, such as bronchial asthma, atopic dermatitis, and food allergies, are greatly affected by environmental factors (infection, dust mites, dust, pets, diet, etc.). Therefore, just because a parent has asthma does not mean their child will develop asthma. We recommend that you practice environmental control measures (no smoking, controlling dust mites, etc.) to prevent asthma from developing.
Q6
Does a child with childhood asthma need to have restrictions placed on physical activity?
A6
Children with asthma do not need to avoid exercise. Of course, exercise must be restricted if their asthma is unstable, but keeping the asthma under control will enable the child to exercise without fear.
However, in some cases, even a person with well-controlled asthma may develop asthmatic symptoms when they exercise.
This is called “exercise-induced asthma.” If an asthma attack occurs during exercise, discontinue the activity, rest in a comfortable position, and use a bronchodilator or other medications. If symptoms get better, the patient can begin exercising again. However, if the symptoms persist or if there is intense breathing difficulty, consult a physician. Repeated bouts of exercise-induced asthma may mean the asthma is not well controlled. We recommend you talk to your doctor.
Q7
It is hard to stick to the inhaler treatment regimen. Do you have any tips to make it easier?
A7
You are not alone. Many people find it difficult to adhere to asthma treatment programs such as inhalants. One reason is that they have unclear or no understanding of what the treatment means and why it is necessary. It is important to help each child understand his/her medical condition appropriately based on the generation and learn the need to take the medicine.
This understanding should then be supported by making the medicine a part of the child’s daily routine. Some ideas might be to use the inhaler at a set time every day, or associating it with a strongly ingrained habit (breakfast, dinner, morning face-washing, tooth brushing, etc.). You might also consider taking some creative steps to make sure the child doesn’t forget (such as by placing the inhaler in a highly noticeable location), or to make the inhaler a fun event (by putting a mark or sticker on a calendar, for example). Boost your child’s sense of self-efficacy such as by praising him/her for using the inhaler well. Also, please keep in mind that family’s support and cooperation are major contributors for child to successfully keep treatment.
The patient should not be criticized for being unable to comply with the treatment program. If you experience difficulty, talk to your doctor, nurse, or pharmacist.
Q8
What should I do if an acute asthma attack occurs at home?
A8
First, determine the severity of the attack (severe, moderate, or mild). Then, follow the doctor’s instructions according to the severity of the attack. Drug treatment mainly consists of bronchodilators. Consult with your doctor to have a plan ready in case of an attack. These might include which medicine to use, when to see the doctor, and which healthcare facility available during weekends, holidays, and night.
Q9
My child is now in high school and would like to switch to internal medicine from pediatrics. Please advise us on when to make this transition and what should be considered.
A9
Just because someone has started high school or college does not necessarily mean they have to switch to internal medicine, although depending on medical institutions. Find out how your child feels about this matter, and talk with your doctor to decide what to do. If you do switch doctors, make sure you get a referral, test data, and other information from your doctor so that treatment can be continued seamlessly. If your child encounters difficulties with the new doctor, consult with the original doctor.