To live is to breathe. But for the nearly 9 million kids with asthma in the United States, the basic act of breathing can be a difficult, if not life-threatening, experience.
Asthma – a disorder that causes airways to constrict – is the most common chronic disease affecting children. And it’s on the rise, a trend from which the Hoosier state is not immune.
Marion County especially grapples with the condition, boasting a rate of asthma-related emergency department visits that far eclipses the state’s rate overall. What’s more, African-American children are four times more likely to be hospitalized for asthma than their Caucasian peers, data suggest.
Despite the statistics, Dr. Nadia Krupp, director of the Asthma Care Center at Riley Hospital for Children at Indiana University Health, has a positive message for parents. Here, she answers common questions about the disease.
Why do some children develop asthma?
Many factors contribute. No. 1 is having a family history of asthma or allergies. Other major risk factors include being born prematurely, having a mother who smoked while pregnant or having certain respiratory viral infections early in life.
Once a child has developed asthma, he will have his own unique set of “triggers” – things that can cause asthma flare-ups. While these triggers vary from child to child, common examples include: tobacco smoke, mold, dust, pests, perfumes, air pollutants and very cold temperatures. In short, the recipe for asthma is a combination of a child’s genetics and his or her environment.
Can a child’s asthma be cured?
Some children do naturally outgrow asthma over the years, but it can’t be cured.
However, asthma is very treatable. In fact, with proper disease management, the vast majority of kids should be able to do everything healthy children do, such as racing with friends at recess, playing kickball in gym class or joining the soccer team. Exercise is actually very important for kids being treated for asthma, since it can strengthen their respiratory muscles. Activity should only be limited for a child with asthma if a physician has said that is necessary.
Unfortunately, some families struggle to help their children use their medications as prescribed. As many as 60 to 80 percent of kids across the country don’t use their inhalers properly, studies suggest. Some children end up missing more doses of their daily inhalers than their parents realize, and others simply use the inhalers incorrectly.
Another challenge some families face is identifying and eradication triggers at home.
Aside from being potentially life threatening, can asthma cause long-term damage?
Yes. If it’s not well controlled, asthma can actually warp the airways over time, causing permanent lung damage. That’s why it’s so important to help kids keep their asthma in check early on. A common misconception is that asthma only needs to be addressed when an attack is imminent, and that medicine only needs to be taken when the child is sick.
Not so. It’s important to stick with prescribed treatment regimens even on good days and to routinely return for preventive checkups. Shielding kids as much as possible from their asthma triggers is also vital.
What if kids can’t seem to get their asthma under control?
That was one of the primary reasons we launched our high-risk asthma clinic at Riley at IU Health. We recognized there was a certain segment of asthma patients who were having tremendous difficulty managing their disease; kids whose asthma would land them in the hospital more than three times a year, often requiring stays in the pediatric intensive care unit.
Our clinic has been able to help reduce the number of asthma-related hospitalizations these children require by more than 40 percent every year for the last five years. I attribute much of that success to our focus on education, and helping families develop strategies to make sure medicines are taken every day as prescribed – and with the proper technique. Our high-risk asthma patients come to see us, on average, every six to eight weeks, until their asthma is better controlled.
Oral and inhaled medications are used to manage children’s asthma, but what if families need help identifying triggers at home?
They are not alone. The Marion County Health Department and the Asthma Alliance of Indianapolis offer opportunities for families to have their homes evaluated for potential triggers.
Riley at IU Health, in partnership with Indianapolis Emergency Medical Services, has also implemented a new home-visit program, for children who have been hospitalized at Riley for asthma. It’s designed to follow up on children once they go home from the hospital to ensure they are improving, and to help families identify anything that could make kids sick again.
Are kids’ asthma symptoms always obvious?
No. Many people think asthma must be accompanied by wheezing, but that’s not true. Asthma symptoms vary from child to child. While they can include wheezing, watch for frequent coughing as well as shortness of breath.
Healthy children should not cough on a regular basis and they should be able to run, sleep, laugh and cry without becoming breathless. If these symptoms are occurring routinely – say, more than a couple of times a week – it’s time to call your child’s physician.
Families can reach the Riley at IU Health Asthma Care Center by calling (317) 274-7208.
Dr. Nadia Krupp, director of the Asthma Care Center at Riley Hospital for Children at Indiana University Health
