Alexia, a 7-year-old girl, has experienced increased sneezing with a stuffy nose, cough, and wheezing at night for more than 3 years, particularly worse in the spring and fall.

Asthma is one of the most common chronic inflammatory airway diseases of childhood.  Approximately 75 to 80 percent of children with asthma develop symptoms prior to age 5.  Childhood asthma is a disorder with genetic predisposition and a strong allergic component.  Allergic disorders often occur within families, including closely linked conditions such as allergic rhinitis and atopic dermatitis.  Inhalant allergens, viral respiratory infections, irritants, exercise, and cold air commonly trigger asthma.  Inflamed airway passages become over-reactive, thus producing increased mucus, mucosal swelling, and muscle contraction.  These changes produce airway obstruction, chest tightness, coughing, shortness of breath and wheezing; the characteristic symptoms of adult asthma are not the most common symptoms of childhood asthma. Wheezing episodes might not be noted in children until after 18 to 24 months of age. Any child who has frequent coughing, particularly at night or after exercise, should be evaluated for asthma.

Childhood asthma is frequently triggered by airborne allergens.  Eighty percent of children with asthma have significant allergies.  The allergens involved are commonly indoor inhalants (dust mites, molds, pets, or insects, especially roaches) or outdoor inhalants (grasses, trees and weeds). Food allergens are much less frequently the cause of asthma.  Viral respiratory infections, including Influenza, frequently trigger episodes.  It is important for children with asthma to get vaccinated for the flu each year.  Asthma can also be triggered by bacterial infections stemming from either the sinus or ear.

Exercise or running also can trigger symptoms of asthma in children.  Bronchodilator medications used before exercise can prevent most of these episodes.  Swimming seems to be the least asthma-provoking form of exercise.  Cold air, too, can trigger asthmatic attacks.  Precautions may be necessary to avoid inhalation of cold air in winter, including the use of a special ski mask or heavy scarf, worn loosely over the nose and mouth.

Most people are not allergic to cigarette smoke, but cigarette smoke is highly irritating and can trigger an asthmatic attack.  Secondhand smoke can also cause serious harm to children.  Cigarette smoking should be avoided in the home of any child with asthma.  Children frequently suffer from severe anxiety as a result of difficulty of breathing during an asthma attack.  When this happens, the parent should remain calm, encourage the child to relax and breathe easily, and give appropriate medications.  Although there is currently no cure for asthma, the majority of childhood asthma episodes are reversible and controllable.  Through early diagnosis, reducing asthma triggers, and properly employing medications, including allergy shots, your child should be able to sleep, learn, play, and enjoy a wonderful childhood.

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