Asthma in babies

My baby is wheezing. Is it asthma?

Though it may be alarming to hear your baby wheezing (a whistling sound), it may not be due to asthma.

As many as 30 per cent of young children have at least one episode of wheezing by the time they are three years old. This is usually when they have a virus or an upper-respiratory tract infection such as a throat infection or a cold. Once the infection has gone, the wheezing problem usually settles. Most babies outgrow these viral-related symptoms by the time they start school.

If your baby wheezes frequently but doesn't have a cold, ask your GP for their opinion.

What are the symptoms of asthma?

A baby's airways are so small that they can make a wheezing sound which isn't true asthma. Wheezing can be quite common in children under the age of three.

Asthma is a long-term (chronic) inflammation of the small breathing tubes (bronchioles) in your baby's lungs. Your doctor will only make a firm diagnosis of asthma when they see a pattern of symptoms emerging over a period of time. Considering your family's medical history will also help with the diagnosis.

Symptoms of asthma are:

• A persistent, dry cough, which is worse late at night, or early in the morning.
• Shortness of breath and tightness in your baby's chest.

It may be difficult to know whether or not your baby has asthma. So your doctor may treat her with asthma medications for a short time. If the symptoms improve as a result, the chances are that your baby has asthma.

What causes asthma?

Asthma in most babies is a reaction to a trigger, often an allergen such as pet saliva, skin or urine, dust mites, or pollen. Airborne irritants such as cigarette smoke and mould spores can also be triggers.

However, a respiratory infection, usually caused by virus such as a cold, may also cause an attack.

As in other types of allergies, the trigger for the attack stimulates antibodies to produce histamine and other allergy chemicals. In asthma, these chemical reactions happen in your baby's lungs. Chemicals released by the antibodies swell the lining of your baby's lungs and tighten the muscles of her airways. Mucus is also produced.

Why may my baby be more likely to develop asthma?

Asthma may be more likely to develop if:

• You or your partner smoke. This makes her nearly four times more likely to wheeze compared with a baby in a smoke-free home.
• You smoked in pregnancy.
• Your baby was born with a low birth weight or was born prematurely, particularly if she was very premature.
• One or both of your baby's parents have asthma, or another allergic condition, such as eczema. This may mean that she develops it earlier than babies who don’t have asthma in the family.
• Your baby has an allergic condition such as eczema, or a food allergy.
• Your baby lives in a home that has damp or mould problems.

I've heard asthma's on the rise. Why?

Asthma has been on the increase over the past few decades, but it has started to level off. Experts aren't sure why, but one possibility is that children's immune systems are less mature than they used to be.

Babies' immune systems were once busy fighting diseases such as rubella and whooping cough. But now that there are fewer infectious diseases to fight off, their immune sytems may be more immature.

This means that your baby's immune system may respond to an allergen a little too zealously, and this may contribute to her asthma. Some experts suggest that early exposure to certain bacteria may help babies to develop effective immune systems that can ward off allergies, including asthma.

Babies living on farms tend to have lower rates of asthma, possibly because they are exposed to a wide range of bacteria.

Can asthma be cured?

Asthma is a long-term (chronic) condition, and there is no known cure. However, many children outgrow their asthma,  or find that it becomes less severe when they get older.

In the meantime, you can help to manage your baby's asthma with medicines, and by reducing her exposure to the trigger for the asthma when you can. Work with your doctor to find the best treatment and method to manage your baby's asthma.

If your baby has asthma, it shouldn't prevent her from taking exercise and leading a healthy, active lifestyle as she grows. Your GP will tailor your baby's treatment so that she can run around and play without triggering her asthma. Exercise will help her to control her asthma and keep her strong.

http://www.babycentre.co.uk/a74/asthma-in-babies#ixzz3brlnLWFf

What is asthma?

Asthma is a chronic inflammatory disease of the lungs and airways — the tubes that bring air into and out of the lungs. If your baby has asthma, these airways are irritated and swollen, and this can affect his ability to breathe.It's important that you work with your baby's healthcare provider to prevent and treat asthma attacks. With the right medications, education, an asthma action plan, and regular medical follow-up, most asthmatic children do just fine.

What happens during an acute asthma attack?

If your baby has an acute asthma attack, the lining of his airways will become even more inflamed and produce more mucus. Then the muscles around his airways will tighten and his breathing tubes will narrow. He may breathe rapidly, cough, or wheeze (make a whistling sound) as his breath is forced through the narrowed airways. You may notice your baby's nostrils flare or the skin around his ribs suck in with each breath.

If left untreated or there's a delay in seeking medical attention, an asthma attack can be deadly. As soon as you notice any symptoms of an attack, promptly give your baby the "quick-reliever" medicine prescribed by his doctor. (If you don't have any emergency medicine, call 911 or take your baby to the closest emergency department.)

Once the medicine opens his breathing tubes, the symptoms should subside. If the symptoms persist or get worse, call 911 or take your baby to the emergency department right away.

What do allergies have to do with asthma?

Exposure to allergens such as dust mites, cockroaches, mold, pollens, or animal dander can trigger or worsen symptoms in some children with asthma. This is referred to as allergic asthma. Seasonal allergies to outdoor pollens (also called hay fever) won't usually be a problem until your child is 4 or 5, because it can take that long for him to be exposed to enough pollens to develop a sensitivity to them. Allergies to dust mites, mold, or animal dander may develop earlier in life, though.

About 75 to 80 percent of children with asthma also have significant allergies. If your child has asthma and you suspect that he has allergies, you may want to take him to an allergist for further evaluation and treatment that may help prevent asthma attacks.

Are there other triggers?

Yes, other possible triggers include cold air, viral infections (such as the common cold), tobacco smoke, and other air pollutants. And once your child's big enough to run, just dashing around could trigger an asthma attack. In fact, if he often coughs and wheezes after a romp on the playground, he may have what's called exercise-induced asthma.

How common is asthma in children?

Asthma is the most common serious chronic childhood disease, and it's the third most frequent cause of hospitalization in children under 15 years of age. Asthma affects 6.5 million children in the United States today. Fifty to 80 percent of children with asthma develop symptoms before they're 5 years old.

How can I tell whether my baby has asthma?

You'll need your doctor's help. Asthma can be difficult to diagnose in children younger than 2, because conditions other than asthma can cause wheezing or wheezing-like sounds. In fact, viral respiratory infections are probably the most common cause of wheezing in babies.

However, if your baby coughs frequently and has allergies or eczema, and your family has a history of asthma and allergies or eczema (especially if you and your partner both have them), there's a good chance that your baby has asthma. His symptoms are likely to be worse at night.

Your child's doctor will examine your baby and take a careful history, including a family health history, to help make a diagnosis.

How do you treat asthma?

If your baby has asthma, you'll want to work with his doctor to develop a strategy for preventing and dealing with asthma attacks. First figure out what triggers the attacks and then do your best to help your child avoid those triggers. Some children have attacks only when they have a cold, for example, while others have attacks after coming into contact with an allergen or an irritant like cigarette smoke.

Stopping an asthma attack
Your doctor will probably prescribe one or more drugs for your baby. Drugs known as quick relievers or rescue inhalers are used to stop an asthma attack. These fast-acting medications relieve the spasms in the airway, making breathing easier. Quick-reliever drugs such as albuterol are administered using either a nebulizer machine or a metered-dose inhaler (MDI).

A nebulizer is an electric or battery-powered machine that turns liquid medicine into a mist that your baby can breathe into his lungs through a mask. Nebulized breathing treatments usually take about ten minutes.

An MDI is a small aerosol can that's inserted into a long tube called a holding chamber or spacer, which has a small mask attached to it. The albuterol is sprayed into the holding chamber and then inhaled by your baby as he breathes through the mask. This type of breathing treatment can be given in less than a minute.

The choice of a nebulizer or a metered-dose inhaler depends mostly on which device is easiest for you and your baby to use. In general, they are equally effective in getting the medicine into your baby's lungs to stop an asthma attack.

Preventing an asthma attack
Drugs known as controllers are used to prevent asthma attacks. These include inhaled steroids, which can help reduce inflammation and swelling and prevent your baby from wheezing. You would give your baby daily inhaled steroid medicine using either an MDI or a nebulizer, depending on the steroid prescribed by his doctor.

If your baby's asthma proves difficult to control, his doctor may refer him to an asthma specialist.

You'll want to make sure that any sitters or daycare providers responsible for your baby's care are familiar with his condition and know how to treat an asthma attack.

What can I do to prevent my child from developing asthma?

There's nothing you can do to fully prevent your child from developing asthma if it's in his genes. And you won't know whether your child will be asthmatic until he shows persistent symptoms, such as wheezing and constant coughing. That said, you may be able to minimize the severity of your child's symptoms or delay the onset of his asthma until he's older (and his lungs are bigger and stronger) if you do the following:

• Limit his exposure to dust mites: Encase your baby's mattress in an impermeable cover, remove carpeting and plush toys from his room, use blinds instead of heavy fabric drapes, and wash his bedding once a week in hot water.
• Keep your baby away from secondhand smoke. Cigarette smoke isn't technically considered an allergen, but it does irritate the lungs.
• Limit his exposure to air pollution. Air pollutants such as ozone can irritate the lungs and cause breathing problems in people with sensitive respiratory tracts. Check your local newspaper or radio for reports on the Air Quality Index, and consider keeping your baby indoors on days when the air quality is poor.
• Avoid using a fireplace or wood stove. Although the warmth and coziness are inviting, the smoke may irritate your child's respiratory system.
• If your child has developed an allergy to your family pet, keep the pet outside if you possibly can. Of course, depending on your pet's disposition and your living situation, this won't always be possible.
• Reduce mold in your home. Install exhaust fans or open the window in the kitchen when cooking and the bathroom when showering, for example. Use an air conditioner or dehumidifier, if necessary, to keep the humidity level between 35 and 50 percent. Repair leaks, which can cause mold growth behind walls and under floors, and clean moldy surfaces using soap and water. Make sure damp or wet clothing or surfaces are dried as soon as possible to prevent mold growth.

Can my child be cured of asthma?

There's no cure for asthma, although some asthmatic babies who wheeze only when they have colds or upper respiratory tract infections outgrow the tendency to wheeze over time. In general, asthma is thought to be a lifelong condition, although the frequency and severity of symptoms may change as your baby grows.

Close medical follow-up and appropriate treatment will enable your child to manage his asthma as he gets older so he can run, swim, and play like other children. Most children with asthma grow up to be healthy adults.

Asthma can be frightening for both you and your child, but remember, you're not alone. You may be surprised to learn how many families are dealing with asthma. Share your concerns about your baby's asthma with other parents in the BabyCenter Community.

http://www.babycenter.com/0_asthma-in-babies_74.bc?showAll=true

Bronchiolitis and RSV

One common condition that mimics asthma in infants is bronchiolitis, which is usually caused by a viral infection, most commonly respiratory syncytial virus (RSV).
The infection affects the tiny airways called bronchioles. The airways swell, making breathing difficult. Infants are often affected because their airways are so small that they become easily blocked.
Symptoms of bronchiolitis include rapid breathing, a cough, wheezing, and fever. Infants who develop bronchiolitis may be more likely to develop asthma later in life. But it's unclear if that's because RSV infection causes asthma or because the child was born with a tendency to wheeze and was therefore more prone to both bronchiolitis and asthma. Studies are being done to clarify the relationship between bronchiolitis and the later development of asthma.
Less common reasons for wheezing in infants include:

• a foreign object or piece of food inhaled into the lungs
• premature birth — preemies who have insufficiently developed airways may wheeze
• cystic fibrosis — this disease can cause wheezing, too, but usually involves additional symptoms, such as delayed growth.

http://kidshealth.org/parent/medical/asthma/wheezing_asthma.html#