Pediatric Asthma Lifestyle Management

Asthma, like all chronic conditions of childhood, affects not only the child but the entire family. For children with mild asthma, the impact on the family may be minimal — but with more severe disease, parents may have issues in several areas.

Age Appropriate Self-Management

As children get older, they are able to take more responsibility for their daily activities, including management of their disease. As your child takes on more responsibility, it should be appropriate for the age and abilities. It may be difficult to find the right balance of support and responsibility at times.

A preschooler’s tasks often include learning to cooperate with inhaled medications and the adult takes the leading role in asthma management. A school age child is learning to take more responsibility with the adult still taking the leading role. The adolescent can gradually assume more responsibility and the adult will move into more of a guidance role. It is important for the adult to routinely monitor medication technique and supplies. Family meetings can help identify how the daily medications and activities and the asthma action plan are going.

School

A variety of issues may arise in connection with school. Fortunately, there are steps you can take to address these issues.

Arrange a School Conference Before the School Year Begins

This conference should include your child’s teachers, physical education teachers, school nurse and teacher aides. It is important for them to have an understanding of your child’s asthma. You can give a brief asthma education lesson — discussing what can make asthma worse in the school environment, your child’s daily treatment including exercise pre-treatment if needed, techniques to inhale medication, asthma symptoms, peak flow zones and the school Asthma Action Plan.

Provide a Written Asthma Action Plan

This school asthma action plan should include what makes your child’s asthma worse, long-term control medication, especially those taken at school, asthma symptoms, peak flow zones, quick-relief medications to be taken for peak flows in the yellow and red zone or asthma symptoms, and emergency telephone numbers. Immediate access to quick-relief medication is important. When approved by the doctor, parent and school personnel, it is helpful if the child with asthma can carry the quick-relief medication for immediate access. Ask your child’s doctor to work with you and the school if further arrangements are needed. A written asthma action plan is always useful.

Communicate Regularly With School Staff

Talk with your child and the school staff regularly to assure your child’s asthma action plan is working.

Some children have difficulty keeping up with their school work because of missed school days. When asthma is severe enough to require hospitalization, school days may be missed. However, it is usually not necessary to miss school because of mild asthma symptoms, which can be handled at school. Monitoring your child’s asthma symptoms and peak flows at home and at school can be very helpful.

These steps will help address school issues related to your child and asthma so your child can have a positive and enjoyable school experience.

Discipline

Parents are sometimes hesitant to punish children with asthma for fear punishment will cause an attack.  While it is true that children who are upset by restrictions (or any frustrating situation) may develop asthma symptoms, the harm done by letting a child always have his or her own way because of asthma is much greater, even if some asthma symptoms occur with discipline. Follow your child’s action plan if asthma symptoms occur. Also, if there are other children in the family, they may resent what they see as special treatment.

Counseling

Asthma is not a psychosomatic illness. However, as a result of prolonged asthma, behavior problems can arise. When a child has self-destructive behavior — such as using asthma to avoid school or manipulate the family, or deliberately missing medication to cause an episode — a referral to a psychologist or psychiatrist may be helpful.

Asthma, like any chronic illness, may sometimes magnify other family problems. Family stresses which may be tolerable when the child is healthy may become major problems when the child is ill. Sometimes a cycle is set up in which asthma and other family problems aggravate each other. Individual counseling for your child may not be sufficient, and family counseling may be recommended.

Diet

Children with asthma have the same nutritional requirements as other children. Aside from avoiding specific foods that you know cause symptoms, no special kind of diet has been shown to be beneficial for asthma. Extra vitamins, over and above normal daily requirements, typically are not needed. Some children need extra calcium and vitamin D because of long-term steroid (pills or syrups) therapy.

Remember, your child should be able to:

• Participate in activities, including physical activity without asthma symptoms,

• Sleep through the night without asthma symptoms,

• Have normal or near normal lung function,

• Have few, if any, emergency room visits and hospitalizations,

• Have few, if any, side effects from the medications taken and

• Feel good about his or her asthma care.