Allergies and Asthma

The summer is a great time to bring your child to see their provider to discuss environmental allergies and asthma. This visit helps assure you have a good preventative plan in time for the school year. Most people’s allergies worsen in the fall, winter, and spring, so summer is a great time to plan for these seasons. Schedule your appointment today!  On our blog today we are answering common questions about allergies and asthma.


Asthma


What is asthma? How is it diagnosed?

Asthma is a chronic disease of the lungs, in which the airways become sensitive to allergens.                

When the airway is exposed to these irritants, 3 things happen:

  1. The lining of the airways become swollen
  2. The muscles around the airways tighten
  3. Excess mucus is produced

This causes a tight airway and can make breathing very difficult. While asthma is a chronic illness, with proper management and treatment, asthma can be well controlled and children with asthma have no activity restrictions.

It is important to bring your child to their doctor if they have any difficulty breathing. If it is severe or they are turning blue around their mouth, it is important to call 911 immediately.

Asthma is diagnosed by a provider after several different episodes of wheezing. Just because your child wheezes once or twice intermittently or requires a nebulizer when they are young and sick does not mean they have asthma.  Talk to your child’s pediatrician if you have concerns about whether your child could have asthma. Asthma, allergies, and eczema often go together and often run in families.


What are the symptoms of asthma?


How is asthma treated?

Asthma treatment is very individualized and depends on your child and the severity of the asthma. In general there are two types of medications commonly used. The first is a quick acting ‘rescue’ inhaler; the most common medication in this type is albuterol. Albuterol is a bronchodilator, meaning it helps dilate the airway and lungs to help bring more air in.  This is a very effective medication. The second type of medication is a long term ‘controller’ medication. Some children may need this medication daily to help prevent the inflammation/swelling in the lungs; this is often an inhaled steroid and helps prevent asthma attacks. Both of these medications are very important in asthma management and work very differently.  It is important to work closely with your provider and ensure you understand what medications your child is taking and what they are being used for.

In addition to medications, it is important to eliminate/avoid asthma triggers. Triggers vary from person to person but can include: environmental allergens (pollens, trees, grasses, molds, dust, animal dander),  chemicals (smoke), weather changes (cold air), and illnesses.. Talk to your child’s provider about your child’s asthma triggers and work together to avoid these as much as possible. If your child has exercise-induced asthma, talk to your provider about what to do before exercise to prevent an asthma attack; often this is using your fast acting inhaler prior to exercise. We do not want children missing out on any activities due to asthma.


What is an asthma action plan and why is it important?

An asthma action plan is developed with you, your child, and your doctor. It is a short checklist of things to do if asthma symptoms worsen. It can help you see the signs of worsening asthma and know what treatment to start to alleviate symptoms; it is a very useful tool.  Many schools require children with asthma have an asthma action plan on file with their school nurse. As your child gets older it is important to involve them in the care of their asthma, especially since they will not always be with their parents.


Why should my child have an asthma check up?  How often should this be done?

An asthma check up is a great time to talk with your child’s provider or asthma specialist about your current concerns, about how their current medication regimen, and also help plan for the upcoming seasons. Many children do not need all their medication year round, and this is a great time to discuss this with your provider.  At Pediatric Associates, we are also able to do a spirometry test (on children 5-6 years and older), to test how their lungs are functioning. This gives us a great baseline for comparison when they have an asthma exacerbation or are sick.

This is also a great time to go over all the medications your child is taking, ensure they have enough refills, and make sure your child is using all medications as prescribed. Using an inhaler is not as simple as taking a pill, and there is a technique to ensure the medication is entering the lungs. Children (and adults) of all ages should use a spacer to ensure the medication reaches the lungs and is not just sprayed in the back of the throat, where it will not optimally help with symptoms.


This link from Children’s National Hospital in Washington DC has some great information about asthma for those who would like to read more: https://childrensnational.org/choose-childrens/conditions-and-treatments/airway-lungs/asthma


Environmental Allergies


What are seasonal allergies?

Seasonal allergies occur when something in the environment triggers an immune response in the body. The body has an exaggerated response in trying to get rid of the allergen by causing a runny nose, watery eyes, etc. It is not known what causes some children to be allergic to certain things, but we do know there is a genetic component to allergies. Therefore, if someone in the family has allergies, it is possible that the child will too; though, this does not mean that everyone in the family will be allergic to the same things.


How do I know what my child is allergic to?

There are several ways to determine the things to which your child is allergic. The first, and easiest approach, is observation.  If your child consistently has worsening symptoms in the month of March, you can look up an allergen report for your area at that time to help determine the cause.  

There are also two types of allergy testing. There is a blood draw that can test for levels of allergy response in the blood.  The second is an allergy skin test, which involves putting the small amount of each allergen on the back and monitoring the reaction.  Please talk to your child’s pediatrician if you have concerns and want to learn the best way to have testing done.


Is there any treatment I can do at home? Are there over the counter (OTC) treatments?

There are many over the counter medications that can be used for allergy treatment. Nasal saline is safe for children of all ages and can be very effective at helping to clean allergens out of the nose.

Over the counter (OTC) medications can also be used. Discuss these with your provider to ensure you are providing your child with the proper dosages. Claritin, Zyrtec, and Allegra are all commonly used.  Flonase and Nasonex are nasal steroid sprays that can also be used in older children. If avoiding allergens is possible, it is also recommended. There are also many ways to decrease the allergens in your home. Click this link from the Mayo clinic for more information. https://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy/art-20049365


Will my child outgrow allergies? Is there a treatment?

As children grow their reactions to certain allergens may change and some children may no longer have symptoms, or have much more mild symptoms. They also may have worsening symptoms or may be allergic to different things as they grow.

If your child has severe allergies that are not able to be managed well with traditional treatments, your pediatrician may recommend you see an allergist. The allergist is able to take your child’s allergy test results and make sublingual drops or shots to slowly expose your child to these allergens over time which can be very effective over several years of treatment.


References:

https://acaai.org/asthma/who-has-asthma/children

https://childrensnational.org/choose-childrens/conditions-and-treatments/airway-lungs/asthma

https://www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Seasonal-Allergies-in-Children.aspx

https://kidshealth.org/en/parents/allergy.html

https://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy/art-20049365


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