Asthmatic Baby

Asthma is a recurrent condition, affecting the airways in the lungs. It is characterised by coughing, wheezing (whistling sound in the chest), and difficulty in breathing.

What causes asthma in children?

Asthma is an allergic condition that tends to occur in families. That is, it is hereditary. Several members of one family may have asthma or other allergic conditions.

An acute asthmatic attack may be triggered by flu, house dust mite, pollen, etc. House dust mite are tiny micro-organisms, commonly found in blankets and dust. They trigger attacks at night, when the patient is asleep and breathes in the mite droppings on the bedding. That is why most asthmatic children wake up wheezing or coughing. House dust mite are also found in hidden or high places in the house. The house dust mite do not elicit any body reactions in the majority of people.

When an asthmatic attack occurs, three key changes take place in the patient’s lungs. These being; very thick and sticky mucous is formed in the air tubes, hence clogging the air circulation system; the air tubes swell; and the air tube muscles tighten. The overall result is that the air passage becomes narrower, making breathing difficult.

How can one detect an asthmatic baby?

Asthma is mainly diagnosed through clinical examination. An instrument used to detect asthma is called a peak flow meter. This is a portable, hand-held equipment which measures air flow from a person’s lungs. The patient is required to blow into the device in one full and fast blast. Based on the blast, the meter shows a reading of the patient’s ability to push air out of the lungs.

A peak flow meter can be useful in daily management of asthma, since it indicates the severity of the attack- and therefore the adjustment necessary to the type and amount of medication.

There are two ranges of peak flow meters; a low range for small children- and a standard range for older children, teenagers and adults. In general, children as young as three years can be trained to use a peak flow meter, with assistance from an adult. However, most doctors recommend the device only for moderate to severe asthma. Mild asthma can be diagnosed and treated without the device, as daily management of the condition is not necessary.

A child with asthma will be found to have wheezing on several occasions. A positive family history of asthma also aids in arriving at a diagnosis.

It is important to note that asthmatic attacks can occur both suddenly, or over a period of time. It is some times possible for an observant parent to tell that a child is developing symptoms of an attack.

What first aid should be given to an asthmatic child before being taken to the hospital?

There are medicines to help open up the airways in the lungs called bronchodilators. These are available as inhalers, syrups or tablets and caregivers should keep at least one of these at home or in school. In case of an asthmatic attack at home or in school, the child should be given the medicine as they prepare to go to hospital. The inhaler is the best at such times.

Can asthma be prevented?

Asthma as a condition is difficult to prevent as it is mostly inherited. Asthmatic attacks can however be reduced by avoiding substances that trigger them.

House dust mite can be reduced by airing the bedding frequently, using duvets instead of blankets, avoiding carpets in the patients’ bedrooms and cleaning the bedroom frequently.

There is also a flu vaccine that is recommended for asthmatic children to reduce the flu attacks. The vaccine is given once a year.

Can asthma be treated?

Yes. There are medicines that are used to treat or prevent acute asthmatic attacks. Bronchodilators are medicines that help to open up the narrowed airways in the lungs. The most common medicines used in this are in a group called salbutamol (common name Ventolin). This is dispensed as an inhaler, syrup or tablet. The medicines can also be delivered to the lungs, with the use of a machine called a nebuliser, in the hospital.

The second group of medicines are steroid based. They are used to prevent acute attacks- as well as stop the attacks. They are available as inhalers, tablets or injections. Patients who get frequent attacks are put on long-term steroids.

What are the side effects of the treatment?

Common side effects of salbutamol include palpitation (heart beating faster such that it can be felt by the patient), shaking of the hands, and abdominal pains.

Long-term use of steroids may cause raised blood sugar, hypertension, reduced immunity to infection and thinning of the skin. This can lead to cracking and bleeding.

Treatment may also give rise to undesirable features like; obesity in the trunk (unusual deposits of fat behind the neck and in the abdomen), excess hair, facial rashes, excess red blood cells and weakness, moon face, lines in the abdomen, etc.

If a mother is asthmatic can she infect her baby through breastfeeding or while in the womb?

Asthma is not infectious; it is genetically inherited hence a mother will not infect her baby through breast milk. Sometimes a parent does not have asthma but one of the grandparents does, and so the child inherits asthma this way, through the genetic tree.

What care should be given to an asthmatic child?

Asthmatic children can and should lead normal lives, just like any other children. However, they should avoid environments that trigger asthmatic attacks- such as dusty environments.

Can children with asthma infect their siblings?

Asthma is not infectious, however, because of common genetic makeup and sharing of the same environment, children may present with asthma at the same time.

Should an asthmatic child be immunised?

Yes, they should have the normal childhood immunisation. In addition they should get their yearly dose of flu vaccine. There is no vaccine that is known to trigger asthmatic attacks.

BLN: PG 06/51-52

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