The air we breathe is full of dust, pollen, mold spores and pollutants. Most children are unaffected by these intruders, but for those with asthma and allergies, simple contaminants can make life miserable.
Asthma and allergies are the result of exposure to allergens that create inflammation in the nose and lungs. Both conditions often start in childhood and continue throughout life. Although allergies can trigger asthma and asthma is often associated with allergies, they are actually two different things.
“In simple terms, asthma is a chronic condition originating in the lungs; whereas allergies describe reactions that originate in the immune system and can affect many organs, including the lungs,” says John Prpich, MD, a pediatric pulmonologist at St. Joseph’s Children’s Hospital.
A recent report by the Centers for Disease Control and Prevention indicates that more than seven million U.S. children have asthma, making it one of the most common chronic diseases in kids. The condition causes the airways in the lungs to become inflamed, making it hard to breathe. Symptoms of an asthma attack include coughing, shortness of breath, wheezing and tightness or pain in the chest.
“If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs,” Dr. Prpich notes.
While many different substances and circumstances can trigger an asthma attack, including exercise, cold air, viral infections and tobacco smoke, for the majority of asthma sufferers, the cause is linked to exposure to a host of allergens. In fact, approximately 80 percent of children with asthma also have allergic rhinitis, better known as seasonal allergies.
According to Dr. Prpich, seasonal allergies occur when airborne irritants kick your immune system into high gear, triggering a release of histamines, a chemical messenger that causes sneezing, runny nose, itchy throat and watery eyes.
Symptoms of seasonal allergies include repeated or chronic cold-like symptoms — such as nasal stuffiness, a dry cough, headaches and fatigue — that last more than a week or two, or develop at about the same time every year.
“Nationwide, close to 40 percent of children suffer from seasonal allergies,” Dr. Prpich says. “It’s important to note that even though we say allergies are seasonal, they typically occur year-round.”
While neither condition can be cured, with proper care both asthma and allergies can usually be kept under control.
One of the most important treatments for asthma is to control the underlying inflammation of the airways. This can be done with medications or by avoiding environmental factors that cause or aggravate airway inflammation.
“Medications used to control asthma include inhaled beta-agonists to stop attacks, and inhaled steroids, long-acting beta-agonists and leukotriene modifiers to prevent attacks from occurring at all,” Dr. Prpich says. “Which medication is prescribed is based on a number of factors, including the child’s age and the severity and frequency of asthma attacks.”
Dr. Prpich suggests that parents work with their child’s doctor on a written asthma action plan. It should include information on the child’s symptoms, medications, rescue inhaler or nebulizer treatments, physical activity limits and instructions on what to do and whom to call if medication doesn’t help an attack.
“Not taking basic steps, like having a fast-acting rescue medication available at school in case of an asthma attack, can be dangerous,” he says. “And anyone who’s responsible for your child, including teachers, coaches and scout leaders, should have a copy of your child’s asthma action plan.”
Dr. Prpich also recommends that parents track symptoms that worsen, and notes that nighttime coughing or waking can warn of uncontrolled asthma or a looming attack.
“Parents shouldn’t be satisfied until their child’s asthma is controlled,” says Dr. Prpich. “We expect children with asthma to be as active as any other children in school, and with just a few exceptions, this is a reasonable goal for parents to shoot for.”
For mild seasonal allergy symptoms, saline nose drops or a nasal wash can help remove mucus from the nose or flush pollen or other irritants out of the nasal passages. Antihistamines work well for treating allergies in children, and are often recommended when symptoms occur less frequently and don’t last for long.
Other medications prescribed for seasonal allergies include nasal corticosteroids sprays, which treat and prevent inflammation, itching and congestion in the nasal passages, and decongestants, which help relieve sinus congestion and discomfort.
According to Dr. Prpich, allergy shots — or immunotherapy — may be necessary if symptoms are severe and fail to respond to other treatments. Immunotherapy involves regular injections of trace amount of allergens over a period of several years.
For both asthma and allergies, experts agree that the best treatment is to take steps to reduce your child’s exposure to well-known irritants.
Outdoor exposure to pollution, pollen and damp or cool weather is often blamed for allergy or asthma problems, but Dr. Prpich notes that indoor exposure to irritants is more important. “Kids spend more time indoors, which means more exposure to the big offenders — dust, tobacco smoke, chemicals and pet dander.”
Most people who think they’re allergic to dust are not. It’s far more likely they’re allergic to dust mites. Dr. Prpich recommends that parents:
Smoke - Tobacco smoke can trigger an asthma attack and aggravate allergies. “Kids with asthma and allergies should never be exposed to tobacco smoke in their home, in a car or wherever they spend a lot of time,” Dr. Prpich suggests.
Chemicals - Cologne and perfume can trigger a problem. The same is true for strong household cleaning products and scented candles. If it has a powerful odor, it might be a trigger.
Pets - While cats cause a higher degree of problems for asthma and allergy sufferers, dogs can be the source of the trigger too. Be sure to keep pets off furniture, out of the child’s bedroom and regularly bathe animals.