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Patient Education

ASTHMA

Asthma is one of the most common chronic (long-term) diseases of the airways. It causes wheezing, breathlessness, chest tightness, and coughing mostly at night or early in the morning. During an asthma flair-up, three things happen that make it harder to breathe:

  1. The muscles around the airways tighten and make the airways smaller.
  2. Cells in the airways make more and thicker mucus than normal.
  3. The airways swell, making them smaller.

asthma

Asthma affects about 25 million people in the United States including 7 million children. That means 1 in 11 children has asthma. Nearly 1 in 2 children miss at least 1 day of school each year because of their asthma. Just about 3 in 5 people with asthma limit their usual activities because of their asthma.

Although there is no cure for asthma, asthma can be managed so you can live a normal, healthy life. Because asthma often changes over time, it’s important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.

 How Can You Tell if You Have Asthma?

Asthma symptoms can differ for each person. Some people may have minor symptoms while others severe symptoms. Symptoms can be infrequent or even in some cases daily.

 Some of the most common symptoms include:

  1. Coughing
  2. Shortness of breath or trouble breathing
  3. Wheezing (a whistling when exhaling)
  4. Chest tightness or pain

We don’t know for sure what causes asthma, but we do know that there are some risk factors associated with the development of asthma.

 Risk factors include:

  1. Having a blood relative (such as a parent or sibling) with asthma
  2. Having another allergic condition (such as atopic dermatitis or allergic rhinitis)
  3. Low birth weight & having a mother who smoked while pregnant
  4. Smoking & exposure to secondhand smoke
  5. Being overweight
  6. Exposure to occupational triggers, exhaust fumes or other types of pollution

However, with proper management of the asthma, such as avoiding triggers, taking prescribed medications, monitoring for warning signs, and knowing what to do during an asthma attack, a child with asthma can conduct a healthy and active lifestyle.

Do children outgrow childhood asthma?

How asthma will affect a child throughout his/her lifetime varies, depending on the child. For some children, asthma improves during the teenage years, while others have symptoms that become more severe over time. About half of the children who have asthma at a young age appear to “outgrow” it, although the asthma symptoms may reappear later in life.

 What can I do to help my child?

Work with your child to make sure your child has the right medicine and is taking it as instructed. Be sure that you understand your child’s medicines, what may trigger his or her asthma symptoms, and how to try and avoid these triggers. Your child should always carry a quick-relief inhaler and spacer, and a copy of his or her personalized asthma action plan.

A quick-relief inhaler is a bronchodilator like Proventil, ProAir, or Ventolin (albuterol) or Xopenex (levalbuterol) thet help open the airway by relaxing the muscles around the airways that get tight during an asthma flair-up.

Make sure your child’s school has a copy of his or her personalized asthma action plan.

Exercise, such as running, may trigger an asthma attack in the majority of children with asthma. However, with proper management of the child’s asthma, a child with asthma can maintain full participation in most sports. Aerobic exercise actually improves airway function by strengthening breathing muscles.

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More information on asthma and proper use of medications:

  • Asthma
  • Asthma and exercise
  • Metered-dose-inhaler (MDI) and spacer use
  • Priming and cleaning MDI and spacer
  • Pulmonary-function-testing

CROUP

Croup is the narrowing of the upper airway from swelling and inflammation following a viral infection. This narrowing makes it hard for young children to breathe. Croup can occur suddenly, often at night. In most cases, it affects children between 6 months and 3 years of age. For older children, the chance of croup is decreased since airways become wider as children grow. What are the signs of croup?

Symptoms may include:

  1. Cough that sounds like a barking seal
  2. A harsh, high pitched sound
  3. Trouble breathing and retractions (“pulling in” of the chest with breathing)
  4. Hoarse voice or cry
  5. Fever
  6. Pale or slightly gray color

What can I do for my child?

Stay calm and reassure your child. Anxiety can make it harder to breathe. Have your child breathe in steam or cool mist. To make a steamy room, take your child into the bathroom and shut the door. Turn on the hot water in the shower or tub. Stay with your child in the room for about 20 minutes. (Keep your child from touching or leaning over the hot water or steam.)

In colder weather, take your child outside, dressed in warm clothes or wrapped in a warm blanket, for about 10 minutes. Breathing in the cold air can help reduce the swelling. Keep talking calmly to reduce anxiety. Encourage your child to drink plenty of clear fluids. You may need to try warm, cold, and room temperature fluids to find out what is most comfortable for your child’s throat.

When should I call my child’s healthcare provider?

Call IMMEDIATELY or call 911 if:

  • Breathing becomes difficult (when your child is not coughing).
  • Your child starts drooling or spitting, or starts having great difficulty swallowing.
  • The warm mist fails to clear up the stridor in 20 minutes.
  • Your child starts acting very sick.

Call within 24 hours if:

  • Stridor occurred and responded to warm mist.
  • A fever lasts more than 3 days.
  • Croup lasts more than 10 days.
  • You have other concerns or questions.

PNEUMONIA

Pneumonia is a lung infection involving the lung alveoli (air sacs) and can be caused by microbes, including bacteria, viruses, or fungi.

Signs and Symptoms

Like many infections, pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. The child also may lose her appetite and seem less energetic than normal. Babies and toddlers may seem pale and limp, and cry more than usual.

Because pneumonia can cause breathing difficulties, you may notice these other, more specific symptoms, too:

  • Cough
  • Fast, labored breathing
  • Increased activity of the breathing muscles below and between the ribs and above the collarbone
  • Flaring (widening) of the nostrils
  • Pain in the chest, particularly with coughing or deep breathing
  • Wheezing
  • Bluish tint to the lips or nails, caused by decreased oxygen in the bloodstream

Although the diagnosis of pneumonia usually can be made on the basis of the signs and symptoms, a chest X-ray sometimes is necessary to make certain and to determine the extent of lung involvement.

What is walking pneumonia?

Walking pneumonia is a mild case of pneumonia. It is often caused by a virus or the Mycoplasma pneumoniae bacteria. When you have walking pneumonia, your symptoms may not be as severe or last as long as someone who has a more serious case of pneumonia. You probably won’t need bed rest or to stay in the hospital when you have walking pneumonia.

Treatment

When pneumonia is caused by a virus, usually there is no specific treatment other than rest and the usual measures for fever control. Cough suppressants containing codeine or dextromethorphan should not be used, because coughing is necessary to clear the excessive secretions caused by the infection. Viral pneumonia usually improves after a few days, although the cough may linger for several weeks. Ordinarily, no medication is necessary.

Because it is often difficult to tell whether the pneumonia is caused by a virus or by a bacteria, your physcian may prescribe an antibiotic. All antibiotics should be taken for the full prescribed course and at the specific dosage recommended. You may be tempted to discontinue them early, but you should not do so. Your child will feel better after just a few days, but some bacteria may remain and the infection might return unless the entire course is completed.

To help prevent pneumonia:

  • Get vaccinated. Vaccines are available to prevent some types of pneumonia and the flu. Talk with your doctor about getting these shots.
  • Make sure children get vaccinated. Doctors recommend a different pneumonia vaccine for children younger than age 2 and for children ages 2 to 5 years who are at particular risk of pneumococcal disease. Children who attend a group child care center should also get the vaccine. Doctors also recommend flu shots for children older than 6 months.
  • Practice good hygiene. To protect yourself against respiratory infections that sometimes lead to pneumonia, wash your hands regularly or use an alcohol-based hand sanitizer.
  • Don’t smoke. Smoking damages your lungs’ natural defenses against respiratory infections.
  • Keep your immune system strong. Get enough sleep, exercise regularly and eat a healthy diet.

Links to more resources

Many resources are available to families. There are newsletters and education materials available through your health care provider or national groups. Support groups and parenting classes are available through your local health care providers. Some groups provide special summer camps for children with asthma. This list is just a few of the places you might find helpful.

*Make sure the list below remains a ‘hyperlink’ where you click each “Icon” or “learn more” and it leads you to the respective websites.

 1 The American Academy of Allergy, Asthma & Immunology is dedicated to the advancement of the knowledge and practice of allergy, asthma and immunology for optimal patient care. Learn more
 2 The American Thoracic Society improves global health by advancing research, patient care, and public health in pulmonary disease, critical illness, and sleep disorders. Founded in 1905 to combat TB, the ATS has grown to tackle asthma, COPD, lung cancer, sepsis, acute respiratory distress, and sleep apnea, among other diseases. Learn more
3 Allergy & Asthma Network is the leading nonprofit organization whose mission is to end the needless death and suffering due to asthma, allergies and related conditions through outreach, education, advocacy and research. Learn more
 4 The Centers for Disease Control and Prevention is the leading national public health institute of the United States. The CDC is a federal agency under the Department of Health and Human Services. Its main goal is to protect public health and safety through the control and prevention of disease, injury, and disability. Learn more
 5 The Cystic Fibrosis Foundation is the world’s leader in the search for a cure for cystic fibrosis. We fund more CF research than any other organization, and nearly every CF drug available today was made possible because of Foundation support. Learn more
 6 The National Institute of Allergy and Infectious Diseases (NIAID) conducts and supports basic and applied research to better understand, treat, and ultimately prevent infectious, immunologic, and allergic diseases. Learn more
 7 The National Heart, Lung, and Blood Institute (NHLBI) provides global leadership for a research, training, and education program to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives. Learn more
 8 The American Lung Association is a voluntary health organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy and research. Learn more
 9 The Asthma and Allergy Foundation of America (AAFA) is a non-profit organization dedicated to finding a cure for and controlling asthmafood allergiesnasal allergies and other allergic diseases. AAFA’s mission is also to educate the public about these diseases. AAFA’s motto is “for life without limits” and AAFA represents the 70 million Americans with asthma and allergies. Learn more
 10 The United States Environmental Protection Agency (EPA) promotes scientific understanding of environmental asthma triggers and ways to manage asthma in community settings through research, education and outreach. Learn more