Dr Vijay Kumar

Childen Allergy and Asthma Conditions

Many diseases can affect a child’s body. While some of them develop as formative disorders while the child is still in the mother’s womb, the others can be acquired at early or later stages in life. One such problem which presents itself very commonly and early in children is a disease of the lung, called Asthma. The advancement in medical science has made us understand the disease better.

Allergy is when the immune system mistakes a harmless substance such as pollen, as dangerous and triggers an attacking response against it. Allergic responses triggered by various inhaled substances can result in an asthma attack.

Allergy and Asthma constitute common childhood concerns that are frequently the reason for missed school or hospitalization. Early detection and treatment can prevent debility in children.

Dr. Vijay Kumar holds a Diploma in Allergy and Asthma from the prestigious, CMC Vellore institute and has expertise in treating Allergy and Asthma, including performing skin prick tests.

Asthma

What is asthma?

Asthma in children, just like in adults, is a reversible disease of the airways that causes cough, breathlessness, and wheeze.

What happens during asthma?

Airways are tubes that carry air in and out of the lungs. In asthma, the airways become inflamed and narrowed.  In addition, the inflammation causes excess production of mucous. These changes can happen due to several triggers. These triggers produce asthma symptoms only in individuals with a genetic tendency to have the disease. Asthma can interfere with the day-to-day activities of the child. Though this isn’t a different disease than asthma in adults, children face unique challenges. Asthma is a leading cause of emergency department visits, hospitalizations, and missed school days in children. Fortunately, in most of the patients, the above changes could be reversed with appropriate treatment.

What causes asthma in children?

Many factors can be responsible for the development of asthma in children. Some risk factors are as mentioned below:

➡️ Allergy to a specific irritant such as pollen or dust mites
➡️ Family history of allergies, or asthma
➡️ Frequent respiratory infections
➡️ Exposure of child to smoke before or after birth
➡️ Low birth weight of the child
➡️ Living in an area with high air pollution
➡️ Obesity
➡️ Some types of airway infection at a very young age

How to know if my child may be suffering from asthma?

Signs and symptoms of asthma in children include:

➡️ Frequent coughing during the day while the child is playing or laughing. The cough is typically worse at night time and early morning. At times coughing may be the only symptom.
➡️ Less energy during play
➡️ Rapid breathing
➡️ Child complaining of pain or tightness in the chest (may report it as a funny feeling in the chest)
➡️ Wheezing (a fine whistling sound when the child breaths out air from the lungs)
➡️ Shortness of breath
➡️ Delayed recovery from a respiratory tract infection
➡️ Some children may have excess sputum production

It may however be difficult to tell whether such symptoms are caused by asthma or any other infectious respiratory disease. The symptoms of asthma may vary from child to child.

What are the common triggers of asthma?

Asthma triggers could be divided into allergic and non-allergic factors. The common allergic triggers include house dust mites, pollen, and animal allergens. The common non-allergic triggers include viruses (common colds, flu), exercise, cold air, weather changes, and air pollution (including cigarette smoke).

When to visit a doctor?

In case of noticing any of the symptoms mentioned above or in case of repeated episodes of bronchitis, one should visit a doctor. Early treatment helps control symptoms and possibly prevent asthma attacks.

If diagnosed with asthma, your doctor will create an asthma action plan for your child which can help the child and/or the caregiver monitor it.

What can I expect when I visit the doctor?

Your doctor will first confirm whether your child has asthma or not. To confirm your doctor will:

➡️ Take a detailed medical history- Your doctor will ask you in detail about the symptoms of the child and the details about your family history. You may also be required to detail out on allergies or in the child in the family if any.
➡️ Perform a physical examination of the child- The doctor will examine in detail and listen to the sounds of the lungs and the heart.
➡️ Employ diagnostic tests- A chest X-ray and pulmonary function test using a spirometer may be performed to check lung function in older children above 5 years.

Once your doctor confirms the diagnosis of asthma, they will make an asthma action plan for your child, which will help you understand managing it for your child.  Medications given to your child can include those used for the treatment of asthma attacks (relievers) and those used to prevent the attacks (preventers). These can be given as pills or inhalers and are to be taken only on the advice of your doctor.

Additionally, your doctor can also help you in identifying the specific allergens for your child by employing some simple tests. Identification of allergens can help in better control of asthma attacks in the child.

What to do if your child suffers an asthma attack?

In case your child suffers an asthma attack:

➡️ Give them their reliever medicine as prescribed by the doctor at the time of diagnosis.
➡️ Wait for 15 minutes after giving medicine. The symptoms may subside and your child may resume doing their normal activity. If the symptoms persist follow the next step as suggested by your doctor as a part of the Asthma Action Plan.
➡️ If the symptoms do not improve or if you do not know what to do, visit your doctor.

When should I seek emergency treatment?

In either case, whether your child has been diagnosed with asthma or not, seek emergency care if your child shows the symptoms as mentioned below:

➡️ If you see your child’s chest and sides pulling inward as he/she struggles to breath
➡️ Your child has increased heartbeat, sweating, and pain in the chest
➡️ Your child has to stop mid-sentence to catch his/her breath
➡️ Your child has widened nostrils when breathing

Asthma attacks can start with coughing and go on to develop wheezing and laboured breathing.

How can I prevent asthma attacks in my child?

Once diagnosed the best way to prevent asthma attacks in your child is to avoid asthma triggers. Below are some points you can follow to help your child with asthma:

➡️ Help your child avoid the allergens or irritants which can trigger asthma symptoms.
➡️ Do not allow smoking around your child- Tobacco smoke is not only a risk factor for the development of asthma but also, triggers and worsens the symptoms of asthma
➡️ Encourage physical activity- As long as the symptoms of asthma are controlled, good physical activity can help keeps the lungs healthy
➡️ Make sure to visit your doctor when necessary and regularly- Since the symptoms of asthma change over a period of time, such visits will help the doctor make necessary treatment adjustments.
➡️ Help your child maintain a healthy weight- Being overweight can worsen your child’s symptoms of asthma.

Can asthma be cured completely?

Unfortunately, asthma cannot be cured completely and its symptoms continue into adulthood. But with the right treatment, you can keep the symptoms of your child to the minimum which can prevent damage to their growing lungs.

ALLERGY

What is allergy?

Allergy is an abnormal immune reaction to specific things  known as allergens that are typically harmless to most people. Allergy causes symptoms that can range from mild to possibly life-threatening. Common allergens include some foods, dust, plant pollen, and medicines.

What happens during allergy?

➡️ The child is exposed to a specific substance that his/her body doesn’t recognize as safe
➡️ The body’s immune system overreacts to fight the substance
➡️ To protect the body, the immune system makes antibodies called immunoglobulin E (IgE) in excess
➡️ Chemicals such as histamine are released in the body to defend against the invader substance
➡️ The release of chemicals causes allergic reactions, which can range from mild to severe
➡️ Future exposure to the allergen produces similar reactions

Types of Allergies

Allergies can be:

Airborne

These include allergies due to airborne substances:

➡️ Dust mites
➡️ Pollen
➡️ Pet hair
➡️ Molds

Food allergies

Some foods may cause allergies such as:

➡️ Cow’s milk
➡️ Eggs
➡️ Shellfish
➡️ Nuts
➡️ Soy
➡️ Wheat, etc.

Other common allergies include insect allergies, some medicines, and some chemicals.

When should you visit a doctor?

If your child has cold-like symptoms lasting longer than a week or two or develops a cold at the same time every year, talk to your doctor, who might diagnose an allergy.

In case your child develops any rashes or itchiness commonly after being exposed to a food or substance, or you don’t know why then let your doctor know about it.

To know the cause of allergy your doctor will perform a skin test for various substances and help you identify the allergen for your child which can then help you prevent exposure to it.

Dr. Vijay conducts regular allergy and asthma clinics where skin tests are performed. He is practicing at Vijayawada.