By the time I was 2 years old, I had been to the Emergency Room no less than 8 times for breathing troubles. My first visit was at just 6 weeks old. A few months before my third birthday, I would be diagnosed with severe persistent asthma. Today, my asthma is so well-controlled that you would never know that for most of my childhood, I spent days at a time struggling to breathe, and the moments between these flare-ups being terrified that I might start coughing again at any moment.
The good—and bad—thing about asthma is that it doesn't exist in a vacuum. A flare-up occurs as the result of something setting it off; this is called a trigger. Rather than a constant state of being unable to breathe, asthma "kicks in" when something in the environment stresses the body. These could be things your child encounters every day or only once in a while, which is why asthma attacks can seem unpredictable and why the symptoms appear to come and go.
The trick to asthma management, in addition to creating and keeping up with a medical treatment plan, is spotting and controlling the triggers. If you can "treat" the triggers, you can lessen the severity of attacks or prevent them entirely. There are many common, well-known triggers, and some that are completely individual to the child. While you may have to get creative for your child's unique triggers, here are some management guidelines for many of the more common ones.
Trigger: Smoke. Treatment: Ban smoking from your home. Don't let your child go to the homes of people who smoke, even relatives. Avoid burning wood, debris, or leaves near your house, and avoid the use of wood burning stoves and fireplaces whenever possible. When your child is going to be around smoke, like at a barbecue or campfire, have them use their inhaler before the smoke gets going. Keep an eye on wildfire smoke advisories put out by the EPA.
Trigger: Household chemicals. Treatment: Identify which chemicals affect your child's asthma, and replace them with asthma-friendly products. If your child is sensitive to chemicals you cannot avoid using, have them leave the room or house when these chemicals are in use. Always make sure to open windows or increase ventilation to help the chemicals clear quickly.
Trigger: Mold. Treatment: Monitor areas like basements and bathrooms regularly, as mold likes to grow where it is humid. Most mold can be cleaned off with white vinegar or an asthma-safe household cleaner. Consider purchasing a dehumidifier or consulting a professional if mold is a persistent problem in your home.
Trigger: Stress or strong emotions. Treatment: Teach your child self-calming techniques like deep breathing, meditation, or counting to ten. Teach them how to identify when they are getting stressed and when they should employ their relaxation skills.
Trigger: Weather changes/extreme temperatures. Treatment: Limit outdoor time to the most moderate times of the day (morning/evening during summer, and midday during winter). Avoid doing strenuous activity during seasonal transitions until the weather is more stable and the new season has begun. Try to keep the indoor temperature as close to constant as possible.
Trigger: Dust, pollen, and air pollution. Treatment: Consider getting an air filter for your home, or for your child's room. In times of heavy pollution, high pollen count, and dust storms, consider having your child wear a mask. A basic surgical mask can help, though there are plenty of companies that make cute, reusable cloth masks specifically for asthma. Make sure to check the local air quality index (AQI), and always follow published guidelines on outdoor activity during warning days.
Trigger: Illness. Treatment: Use the inhaler preventatively if your doctor says it's appropriate as part of your child's treatment plan. When your child starts getting a cold or other respiratory illness, begin regular use of the inhaler. Make sure your child gets lots of rest, and try having them sleep propped up or reclining instead of lying flat on the bed. This can help keep postnasal drip, sinus congestion, and chest congestion from irritating the airways as badly.
Trigger: Exercise. Treatment: Modify routines, but never avoid physical activity entirely. Exercise is actually one way to help improve lung functioning in asthmatic individuals! Cold weather makes flare-ups more likely, so winter sports should be done with extreme caution. When exercising in the cold, cover the mouth and nose to keep the incoming air as warm as possible. Avoid exercises that involve lots of endurance and sustained speed, like running, basketball, and hockey. In general, warm-weather sports are safest for asthma, as long as they involve only short bursts of speed. Baseball and softball are particularly good. Other warm-weather activities include hiking (low-moderate incline), leisure biking, walking, and horseback riding. Swimming is a year-round option if you use an indoor pool, and the warm, humid environment makes it less likely for an attack to occur.
In general, the rule for asthma triggers is to avoid when at all possible, and minimize exposure when total avoidance isn't an option.
If your child is having unexplained coughing fits (especially if they are worse in the morning or at night), wheezing, shortness of breath, or they complain of something "squeezing" or "sitting on" their chest, speak with a doctor right away. While you wait for your appointment, start working on discovering your child's individual pattern and triggers. Even if it's not asthma, many other conditions like allergies can benefit from trigger management.
Asthma can be a scary diagnosis for both child and parent, but the good news is that we live in a time when asthma is more controllable than ever. In addition to improving medical care, there are dozens of programs out there designed to help asthmatic individuals and the people who care for them. One great resource for Utah parents is the Asthma Home Visiting program, which has a home visitor help identify triggers and set up a management plan. The Utah Asthma Coalition also provides support and resources to individuals with asthma, their family members, educators, and doctors.
You aren't alone in your fight to help your child breathe easier!] For more information about asthma, see the Utah Health Department's Asthma Program, the American Lung Association, and the American Academy of Allergy, Asthma, and Immunology.
Help Me Grow Utah works to connect families to resources like these and many more. We serve families of children from pregnancy through age 8, answering questions about parenting and child development, and helping you find the resources in your community that best meet your family's unique needs. To track your child's development, get answers to questions, or get connected with local resources, contact Help Me Grow today by calling 801-691-5322!