1. What is asthma?

Asthma is an ongoing condition that interferes with your chil's breathing. Children with asthma almost always have some degree of inflammation in their lungs, even if there are no symptoms. As a result, their lungs are especially sensitive and easily irritated. When irritated by a trigger, their airways swell up and become filled with mucus. This blocks the flow of oxygen to their lungs and makes it hard for them to breathe. At the same time, the muscles around their airways constrict and grow tighter. When this happens, their breathing passages narrow; this also makes it hard to breathe and creates a variety of asthma symptoms. It is, therefore, important to take a preventive (also known as controller) medicine regularly to keep this inflammation down in the first place.

2. What kinds of asthma symptoms should I look out for in my child?

Children’s asthma symptoms are like children themselves: sometimes loud, sometimes quiet. Your child's "loud" symptoms are the more obvious ones you see and hear during an attack—wheezing, coughing, shortness of breath, and tightness in the chest.

"Quiet" symptoms are just as important to watch for. They include anxiety, unusual paleness or sweating, restlessness during sleep, and tiredness.

3. What asthma triggers should I help my child avoid?

Your child’s lungs are especially sensitive and are easily irritated by things in the air. Some common triggers,¹ which include both irritants and allergens, are

• Tree/grass/weed pollens
• Molds
• Dust and dust mites
• Foods or food additives
• Animals
• Indoor pests such as cockroaches
• Strong odors/perfumes
• Cooking fumes
• Aerosol sprays
• Cigarette smoke
• Wood/fireplace smoke
• Weather changes/cold air
• Colds or viral infections
• Exercise
• Prolonged crying or laughing
• Reflux disease/heartburn
• Medications

There are also times of year when your child may be more susceptible to viral triggers like cold and flu germs. During those times of the year, it may take a little more effort on your part to help keep your child’s asthma under control.

4. What is the difference between rescue medicine and preventive/controller medicine?

If your child has asthma or asthma-related breathing problems, you may be familiar with rescue (sometimes called “quick relief”) medicines, like albuterol or oral steroids, which are used to provide fast relief from sudden asthma symptoms that accompany attacks. But, rescue medicines are not meant to be used every day.

Controller (sometimes called “preventive” or “maintenance”) medicines, when used as prescribed, help prevent asthma symptoms and attacks on an ongoing basis. Some work to keep the underlying inflammation caused by asthma from getting worse. It’s important to remember, though, that because controller medicines aren’t rescue medicines, they should not be used to treat sudden symptoms.

5. What are inhaled corticosteroids?

Inhaled corticosteroids are anti-inflammatory medicines that work on the underlying cause of asthma symptoms—inflammation in the lungs. They are similar to natural corticosteroid hormones produced by the body’s adrenal glands. Corticosteroids work in several ways: they reduce swelling and irritation in the airways, make the cells in the airways less sensitive to asthma triggers, and decrease mucus.

The National Institute of Health (NIH) has developed guidelines to help physicians manage asthma. These guidelines may be considered together with other information by your child's doctor to determine individual patient treatment needs. For patients who need a controller medication for persistent asthma, the NIH guidelines recommend inhaled corticosteroids as the preferred therapy.

6. Will my child experience any long-term effects from taking inhaled corticosteroids every day?

Inhaled corticosteroids may cause a small reduction in how quickly your child’s height increases. However, poorly controlled asthma itself may pose a risk of delayed growth. The effect on final adult height is not known. And, several studies have shown that there was no statistically significant impact on growth in children who received long-term inhaled corticosteroids for the treatment of persistent asthma.^2,3,4

Once your child's asthma stabilizes and remains consistently controlled, your child's health care provider will make sure he or she receives the lowest possible dose of inhaled corticosteroid to help minimize the risk of side effects. Your child's health care provider will also regularly check your child's growth and weigh the risk of growth reduction with the benefits of taking a daily preventive asthma medication.

Corticosteroids are NOT the same as anabolic steroids. Many people are unaware that there are several types of steroids. Anabolic steroids have been misused by athletes to build muscles and improve performance. Corticosteroids work very differently and should not be confused with anabolic steroids. Talk to your child's health care provider if you have any questions regarding the different kinds of steroids.

7. What is a nebulizer?

A nebulizer is a machine that turns certain medicines into a fine mist that your child simply breathes in through a facemask or mouthpiece. It delivers the medicine straight to your child’s lungs where it’s needed the most.

8. How do I care for my child's jet nebulizer?

Regular care of the nebulizer system is very important. To maintain the proper operation of your child's nebulizer system, it is recommended that you clean and store it according to the manufacturer's instructions. It is important to note that different nebulizer systems may require different cleaning procedures.

If the manufacturer specifies that certain nebulizer parts (nebulizer cup, face mask, or mouthpiece) are dishwasher safe, place them in a dishwasher-safe basket (such as a baby bottle washing basket) and put the basket on the top rack of the dishwasher. You may also wash them by hand.

If you are hand washing, wash the nebulizer parts (nebulizer cup, face mask, or mouthpiece) with warm water and dishwashing soap. Rinse the parts using warm water and then shake the extra water out. After hand washing, place the parts on a clean cloth or paper towel to air dry or hand dry with a lint-free cloth.

Note: Not all nebulizer parts are dishwasher safe.

9. When should I call the doctor?

Call your child’s doctor if…

• You think your child may have asthma or is experiencing an asthma flare
• Your child experiences daytime or nighttime symptoms such as coughing, wheezing, shortness of breath, or chest tightness more than twice a week
• Your child uses rescue medicine more than two times a week
• Your child awakens from sleep because of asthma

10. Is asthma hereditary?

In some cases, yes. Children with a family history of asthma have been known to have a greater chance of getting it. But your child can develop asthma even if there is no one else in the family who has asthma.

11. What causes asthma?

The causes of asthma are not known, and there’s no accurate way to predict who will get asthma. Children with a family history seem to be more prone to getting asthma, particularly those who are allergic to something in their home environment (such as pets, dust mites, molds). Other environmental factors such as air pollution, indoor pests, dust, tobacco smoke or toxic chemicals may provoke asthma as well. The underlying problem of asthma is swelling (inflammation) of the airways. A swollen airway is more susceptible to environmental triggers and viral respiratory infections

12. What is the best way to cure asthma?

There is no known cure for asthma; however, there are ways you can help prevent your child’s asthma symptoms. First, it's important to be aware of his or her symptoms and triggers and to take steps to avoid triggers when at all possible. There are also controller medicines that help to prevent inflammation in your child's lungs from getting worse when he or she comes in contact with a trigger.

13. My child has asthma and she wants a dog. Should I get one for her or will it make her asthma worse?

It's a known fact that dog dander can trigger asthma symptoms and if your child has allergies, she may be more prone to this type of trigger. You may want to consider holding off for now just to be on the safe side. However, if you do choose to get a dog, there are things you can do to reduce the impact of pet dander. You might want to consider purchasing a short-haired dog, as they tend to shed less. Be sure to keep the dog off furniture, out of your car and out of your child’s bedroom. Remove carpeting to minimize trapping dog hair and dander. Wash the dog frequently and make sure to vacuum and dust the areas of the house where the dog is permitted on a daily basis. Consider purchasing room HEPA filters for the rooms where the dog is most of the time.

14. My child has asthma and she wants a cat. Should I get one for her or will it make her asthma worse?

It's a known fact that cat allergens can trigger asthma symptoms, and if your child has allergies, she may be more prone to this type of trigger. Cats carry allergens in their saliva and urine. When they clean or lick themselves, their saliva dries on their hair and ultimately transfers to the air. If you do choose to get a cat, make sure to keep it out of your child’s room. Also remember to keep litter boxes out of bedrooms and bathrooms that your child uses.

15. My 4-year-old child was diagnosed with moderate asthma. He tends to get out of breath quite easily when he’s playing with his friends. Should I be concerned? Should he be using his inhaler?

It's important to remember that kids don’t normally get out of breath when they are active. Shortness of breath is an asthma symptom and if it comes on suddenly, your son may need a rescue medicine for quick relief. However, if this is a common symptom that your child experiences frequently when he’s active, you may need to do more to help prevent his asthma symptoms. Schedule some time to talk to his doctor about your concerns and ask if your son may benefit from a controller medicine.

Controller (sometimes called “preventive” or “maintenance”) medicines, when used as prescribed, prevent asthma symptoms and attacks on an ongoing basis. Some medicines work by preventing the underlying inflammation from getting worse and causing asthma symptoms or attacks. It’s important to remember, though, that because they aren’t rescue medicines, controller medicines should not be used to treat sudden symptoms.