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Asthma is a chronic inflammatory disorder of the airways that affects almost 10% of children, making it the most common chronic disease of childhood. Last year, children with asthma missed an estimated 12.8 million school days due to their disease. If not well controlled, asthma may limit a child's activity.

Asthma may be diagnosed at any age, although doctors are frequently reluctant to label very young children with a chronic disease like asthma, as there are many causes of wheezing in infants and toddlers. As children reach school age, symptoms and triggers become more identifiable and predictable, thereby making an asthma diagnosis easier.

 Asthma symptoms include shortness of breath, cough, wheezing, and chest pain or tightness, and may vary from person to person. A variety of situations, such as allergen exposure (e.g., pollen, dust mites, animal dander, house dust, or mold, etc.), infections (colds, upper respiratory illnesses, etc), exercise, changes in the weather, and exposure to airway irritants (e.g., cold air, chemicals, tobacco smoke) can trigger symptoms. Severity of asthma is variable, as well. While some children have occasional mild symptoms, others may have daily severe symptoms.

Since asthma is a chronic disease, many children will need lifelong medications. There are two main types of medications for asthma: controller medications and rescue medications. Controller medications decrease airway inflammation in an ongoing basis and rescue medications quickly and briefly open up the airways. Types of controller medications that you may have heard of are inhaled corticosteroids and leukotriene modifiers. Rescue medications tend to be inhaled, short-acting, beta-agonist drugs, most commonly prescribed as albuterol and levalbuterol in the U.S.

Children with occasional asthma attacks will only need to use rescue medications when they get an attack. On the other hand, children whose ability to participate in their normal daily activities or desired activities are disrupted by their symptoms, those who require frequent use of rescue inhalers, and those with frequent nighttime symptoms will likely benefit from two types of medication: controller medications/inhalers that they use daily to prevent asthma attacks and rescue medications/inhalers that they use to relieve symptoms.  Consistent use of controller medications can prevent many asthma attacks and help children lead normal, physically active lives.

Whether or not your child needs daily medication or occasional medication, all children with asthma should carry a rescue inhaler with them or have one readily available to them at school. It is important that when children develop symptoms, they and their caregivers know how to administer the medication and do so quickly.

Even with the best planning, some children will have asthma attacks that require immediate attention from an emergency physician at the emergency department. The following conditions should prompt a call for emergency help (911 in most areas):

* Symptoms do not improve quickly after the use of rescue inhalers

* The child strains to breathe or cannot complete a sentence without pausing for breath

* The child's lips or fingernails turn blue

Treatment of this kind of asthma emergency is best handled by an emergency physician at a hospital, rather than by parents at home, as medications, oxygen, and any equipment needed are readily available.

In summary, asthma is the most common chronic disease of childhood. With proper planning and care, children with asthma can attend school daily, participate in any activity they choose, and avoid visiting the emergency department altogether.





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