Managing Asthma

The Learning Process

The good news is that for most kids with asthma, it can be well controlled — sometimes so well that flare-ups are rare. 

For many families, the learning process is the hardest part of controlling asthma. Between diagnosis and good control, there's a lot to learn and a lot to do.

Don't be surprised or discouraged if your child has flare-ups while learning to control asthma. Asthma control can take a little time and energy to master, but is worth the effort!

How long it takes to get asthma under control depends on a child's age, the severity of symptoms, how often flare-ups occur, and how willing and able the family is to follow a doctor's prescribed treatment plan.

All kids need a doctor-prescribed asthma action plan to control symptoms and flare-ups.

Identifying and Controlling Asthma Triggers

Triggers — things that can irritate airways and lead to an asthma flare-up — can vary from season to season and as kids get older. Common triggers include:

• allergens, including microscopic dust mites present in house dust, carpets and pillows; animal dander and saliva; pollens and grasses; molds; foods; medications; and cockroaches.
• viral infections, including the common cold and the flu.
• irritants, including smoke, air fresheners, aerosols, paint fumes, hair spray, and perfumes
• exercise
• breathing in cold air
• weather changes

Identifying triggers and symptoms can take time and good detective work. But once patterns are discovered, some of the triggers can be avoided through environmental control measures.

Anticipating and Preventing Flare-Ups

Many kids with asthma have increasing inflammation in their airways from everyday trigger exposure — but they just can't feel it. Their breathing may sound normal and wheeze-free when their airways are actually narrowing and becoming inflamed, making them prone to a flare-up.

Since just listening to a child's breathing (or asking how the breathing feels) can't give an accurate sense of what's happening inside, a better way to measure breathing is needed. Breathing tests measure the volume and speed of air as it is expelled from the lungs.

Asthma specialists make several measurements with a spirometer, a computerized machine that takes detailed measurements of breathing ability.

Anticipating Flare-Ups at Home

At home, a peak flow meter — a handheld tool that measures breathing ability — can be used. When peak flow readings drop, it's a sign of increasing airway inflammation. The peak flow meter can detect even subtle airway inflammation and obstruction — even when a child feels fine. In some cases, it can detect drops in peak flow readings 2 to 3 days before a flare-up occurs, providing plenty of time to treat and prevent it.

During the first stages of treatment, the doctor usually will have a child take a series of peak flow readings for a period of time. The readings help to establish a child's baseline PEFR, or peak expiratory flow rate — a personal best during a time with few symptoms. After establishing a baseline, readings should be taken at least once a day so they can be compared with the baseline.