What Is Universal & Unique for Pediatric Asthma?

Asthma affects an estimated 5 million children in the United States alone, making it the most common serious chronic childhood illness. For those who suffer from asthma, and for caregivers of children with asthma, it is critically important to know that symptoms and treatment vary from child to child and that pediatric asthma symptoms are not the same as adult asthma symptoms.

Symptoms

• Kids can’t communicate as well as adults, so caregivers rely on observable symptoms to gauge the severity of the asthma attack and to guide a treatment plan. Kids’ symptoms may vary dramatically from one child to the next. For example, one child may have a nighttime cough, and another child may exhibit rapid or noisy breathing. Some children complain of chest congestion, and others have obvious shortness of breath. Smaller children may exhibit flaring nostrils or sucked-in ribs. Nighttime cough, even without other symptoms, is a typical indicator of pediatric asthma. On the other hand, asthma symptoms most people think of, such as wheezing, may or may not be present.

Symptom Onset

• Asthma is characterized by inflammation in the airways. The inflammation makes the airways smaller, making it more difficult to get adequate oxygen into the lungs. Because children have small airways, even slight inflammation in a child with asthma can create an asthma attack. Pediatric asthma can come on very slowly and be persistent, but it can also come on very rapidly and reach a danger level very quickly. This means that it is very important to know the signs and symptoms of pediatric asthma and react promptly with appropriate treatment.

Diagnosis

• In children, symptoms that indicate asthma may also indicate other conditions. Diagnosis for all children, therefore, includes a holistic evaluation that includes a full patient and family history. The patient history drives the rest of the evaluation and eventually the diagnosis. For example, if a child has a dog or a cat in the home, the doctor may recommend allergy testing because allergens are a primary asthma trigger. If the child is young, the doctor may recommend limited allergy testing versus a full panel of allergy tests.

Management

• In all cases, education about asthma and an understanding of your child’s asthma are crucial to appropriate treatment. Beyond that, asthma management is unique for each child. Every child should have an asthma action plan that outlines appropriate treatment. The action plan helps identify your specific child’s escalation of symptoms and corresponding treatment. Asthma action plans are not universally applicable.

Medications

• Most doctors follow a fairly universal protocol for treating pediatric asthma that includes daily controller medications and quick-relief medications used in an increasing stepwise fashion to match symptoms. However, many formulations of these medications are available. A medication that works well with one child may not have any impact at all in another. Every child’s asthma action plan and corresponding treatment medications are unique to that child.