How parents can help kids avoid asthma attacks and control symptoms

Tanya Martinez-Fernandez, M.D.
Pediatrics

Children with asthma often describe the symptoms as “feeling like a fish out of water,” gasping for air but never quite getting enough.

More than 6 million kids in the U.S. suffer from asthma, making it the most common pediatric chronic illness. In Texas, nearly 8% of children have childhood asthma – that’s more than 541,000 kids, and rates in the Metroplex are higher at 9-10%.

Asthma is a chronic disease that causes inflammation in the lungs, resulting in wheezing, coughing, and difficulty breathing. It’s a serious condition that can be life-threatening if not properly managed. Over 50% of children with asthma have attacks, and up to 20% visit the emergency department at least once a year for respiratory care.

Pediatric asthma can have different causes and symptoms depending on your child’s age. Whereas wheezing in children under 5 is often caused by lower airway infections, it can signify asthma or allergies in older kids.

Nationally, a well-documented annual increase in asthma attacks and ER visits is seen in September, when changes in weather and the start of the school year expose kids to a “perfect storm” of more viral illness and allergic, climate, and environmental triggers.

While there is no cure for asthma, it can be controlled.

UT Southwestern and Children’s Health have North Texas’s only academic-affiliated severe asthma program for children from birth to 18. Our pediatric pulmonology and allergy physicians, as well as our advanced practice providers, have in-depth knowledge of evaluating and treating children with asthma and allergies.

Working with parents, we help kids avoid triggers, maintain a healthy body weight, stay active and manage their asthma throughout their childhood.

Risk factors and symptoms

Black children in the U.S. are three times as likely to have asthma compared to white peers. Native American and Puerto Rican children also are at increased risk compared to white children.

Socioeconomic challenges are a major risk factor for developing asthma, including limited access to medical care, less flexibility for time off work for healthcare appointments, and living conditions that negatively impact respiratory health, such as vape or smoke exposure, environmental irritants, and exposure to mold or cockroaches. Additional risk factors include:

• Allergies
• Family history of asthma
• Frequent upper respiratory infections
• Low birthweight
• Obesity

Every child is different and so are their symptoms. Common signs of asthma include:

• Frequent coughing unrelated to a cold, especially during physical activity or excitement
• Low energy or trouble keeping up with other kids on the playground
• Complaints of “chest hurting” when breathing in and out

• Wheezing
• Feeling of tightness in chest
• Labored breathing
• Shortness of breath
• Waking up at night with breathing symptoms

Asthma symptoms can come on and become dangerous quickly. If your child has severe wheezing, coughing, trouble talking, has fast breathing, blue lips or fingernails, or loses consciousness, call 911 immediately or get to the closest emergency room. Severe symptoms may not respond to a rescue inhaler and can be life-threatening.

What parents can do to reduce asthma attacks

Children often outgrow their asthma as they age. Until then, reducing risk is the best way to prevent serious attacks. Here are some of the best ways to do that:

• Avoid triggers. Steer clear of irritants that make asthma symptoms worse. Common triggers include environmental allergies, animal dander, mold, or strong smells including cooking spices or cleaning products.
• Avoid smoke and vape exposure. Secondhand smoke and vape chemicals are the most common irritants for people with asthma. Both can lead to permanent lung damage.
• Control dust and mold in the home, especially your child’s bedroom. Cover their mattress and pillows with protective dust-mite-proof covers. Wash blankets and stuffed animals in hot water once per week. Vacuum frequently and remove carpeting and rugs in bedroom if possible.
• Allergy treatment and testing. Not all kids with allergies have asthma, but allergies are common in those with asthma and can trigger attacks. Talk with a pediatrician about safe allergy remedies. If there’s no improvement, a pediatric allergist can pinpoint your child’s allergies and provide a treatment plan, which might include testing and immunotherapy.
• Have a written asthma action plan. Your child’s provider can discuss instructions on how to best manage your child’s asthma and provide a written plan to follow.
• Take your controller medications regularly. Inhaled corticosteroids and other control medicines can prevent asthma attacks. Continue to give them as recommended even when your child is doing well and not ill.
• Carry your child’s rescue medications. Rescue inhalers or nebulizers such as albuterol can give quick relief of symptoms. Have them readily on hand and carry along with spacer and/or nebulizer.
• Recognize the warning signs of attacks. Know what to do in an emergency, and help your child learn to describe how they are feeling.
• Inform teachers, friends, and family. Make sure everyone in your child’s circle is aware of their condition, signs to look for, how to manage their medication, and knows when to call 911.

Keeping a healthy body weight can reduce your child’s asthma risk. There is a documented link between childhood asthma and obesity, with research showing that the risk of asthma increases by 20% in children who are overweight. A sedentary lifestyle is one of the biggest causes of obesity in children and teens, which can make breathing worse. In fact, our asthma program provides physical therapy to help facilitate exercise in a controlled environment.

Most kids with asthma can safely participate in sports and exercise. However, the fear of triggering an asthma attack can lead to anxiety, causing kids to sit out and parents to restrict activity. Talk with your provider to come up with a plan that allows your child to be active.

Limiting exercise now can cause more obesity-related health problems down the road, including high blood pressure and type 2 diabetes. Make sure your child takes medications as prescribed and warms up before exercise to reduce the risk of an exercise-induced asthma attack.

As a parent, you are your child’s best advocate. Talk with school and state officials about issues that are affecting your area, including air quality and issues with unsafe or unhygienic living environments. The state of Texas requires schools to allow kids with asthma to carry and self-administer asthma medications. It also requires local school districts to create asthma medication policies and provide resources and guidelines.

If your child is struggling with asthma or allergy symptoms, talk with a pediatric pulmonologist or allergist about allergy and lung function testing. We see young patients in Dallas and Frisco, in person and via telehealth – our goal is to help your child feel like an active kid again, instead of a fish out of water.

To talk with a specialist about your child’s asthma, call 214-645-8300 or request an appointment online.