Children's Health

Treatment of Asthma

The Five Parts to an Asthma Treatment Plan continued...

In some cases, the doctor may recommend immunotherapy (allergy shots) when control measures and medications are not effective. Speak with your child's doctor about these options.

Step 2 - Anticipating and preventing asthma flares

Patients with asthma have chronic inflammation of their airways. Inflamed airways are twitchy and tend to narrow (constrict) whenever they are exposed to any trigger (such as infection or an allergen). Some children with asthma may have increased inflammation in the lungs and airways everyday without knowing it. Their breathing may sound normal and wheeze-free when their airways are actually narrowing and becoming inflamed, making them prone to a flare. To better assess a child's breathing and determine risk for an asthma attack (or flare), breathing tests may be helpful. Breathing tests measure the volume and speed of air as it is exhaled from the lungs. Asthma specialists make several measurements with a spirometer, a computerized machine that takes detailed measurements of breathing ability.

At home, a peak flow meter (a hand-held tool that measures breathing ability) can be used to measure airflow. When peak flow readings drop, airway inflammation may be increasing. The peak flow meter can detect even subtle airway inflammation and obstruction, even when your child feels fine. In some cases, it can detect drops in peak flow readings 2-3 days before a flare occurs, providing plenty of time to treat and prevent it.

Another way to know when a flare is brewing is to look for early warning signs. These signs are little changes in a child that signal medication adjustments may be needed (as directed in a child's individual asthma management plan) to prevent a flare. Early warning signs may indicate a flare hours or even a day before the appearance of obvious flare symptoms (such as wheezing and coughing). Children can develop changes in appearance, mood, or breathing, or they may say they "feel funny" in some way. Early warning signs are not always definite proof that a flare is coming, but they are signals to plan ahead, just in case. It can take some time to learn to recognize these little changes, but over time, recognizing them becomes easier.

Parents with very young children who can't talk or use a peak flow meter often find early warning signs very helpful in predicting and preventing attacks. And early warning signs can be helpful for older children and even teenagers because they can learn to sense little changes in themselves. If they are old enough, they can adjust medication by themselves according to the asthma management plan, and if not, they can ask for help.

Step 3 - Taking medications as prescribed

Developing an effective medication plan to control a child's asthma can take a little time and trial and error. Different medications work more or less effectively for different kinds of asthma, and some medication combinations work well for some children but not for others.