Asthma

Asthma

Asthma is the most common chronic disease of childhood, affecting almost 10% of U.S. children. Although asthma can occur in people of any age, most children with asthma begin showing symptoms by age 5. Asthma is a chronic (long-term) illness in which the airways become inflamed or narrowed. While this narrowing is usually temporary, it causes shortness of breath, difficulty breathing, and other symptoms. If asthma becomes severe, a child may need emergency treatment to restore normal breathing.

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The Lungs and Asthma

When a child breathes in, air travels from his nose and / or mouth through the trachea (or "windpipe"). From there, it enters a series of smaller tubes in the lung called bronchi and bronchioles. The bronchi and bronchioles are the part of the lung most affected by asthma.

The symptoms of asthma can be triggered by cold air, exercise, allergens, tobacco smoke, environmental irritants, and some types of viral infections. When the airways come into contact with one of these triggers, the tissue inside the bronchi and bronchioles becomes inflamed and the muscles on the outside of the airways tighten up. Then mucus is released into the bronchioles, which also become swollen. As the breathing passages continue to narrow, breathing becomes difficult.

Although everyone's airways constrict somewhat in response to these triggers, in a person with asthma, the airways are hyper-reactive (in other words, they overreact to things that would just be minor irritants in people without asthma). In mild cases of asthma, the symptoms may subside on their own, but most children with asthma need medication to control or prevent the episodes. The need for medication is based on how often asthma attacks occur and how severe they are. With the treatments available today, most children with asthma can do almost everything that children without the disease can do. 

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What Are the Symptoms of Asthma?

Wheezing:  high-pitched, whistling sound while breathing
Chronic cough:  especially at night and after exercise or exposure to cold air
Shortness of breath:  especially during exercise (All children get out of breath when they're running and jumping, but most resume normal breathing very quickly afterward.)
Tightness in the chest:  if you notice any of the above symptoms, ask your child whether he or she feels a tight, uncomfortable feeling in the chest.

If you are concerned your child or teen may have asthma, please call our Patient Care Line at 303-699-6200 to make an appointment for an asthma evaluation.

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What to Do in an Asthma Attack

Call 911 Now If:

  • Child has severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath).
  • Child has passed out or has bluish lips / tongue.
  • Wheezing started suddenly after medicine, an allergic food or bee sting.

For more information, see Pediatric Web Asthma Attack article.

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Common Asthma Triggers

There are a number of things which can cause an asthma attack or make asthma worse. Some of the most common asthma triggers are:

Allergens:  Many people with asthma have allergies, which are a major cause of asthma symptoms. Common allergens include house dust mites, animal dander, mold, pollen and cockroaches. Tips to reduce asthma symptoms due to allergies include:

  • Reduce exposure to dust mites by covering your child's mattress and pillows with allergy proof covers and wash bedding in hot water every 1 - 2 weeks. It is important to keep stuffed toys out of the bedroom and vacuum and dust regularly. Removing carpeting in the bedrooms is also helpful.
  • Reduce exposure to pollen by using an air conditioner and leaving doors and windows closed during high pollen times.
  • It is best not to have furry pets in the home if children are allergic to them. If this is not possible, keep pets out of your child's bedroom and consider using a HEPA filter. Be sure to bath pets regularly to minimize dander.
  • Treat cockroach infestation by exterminating, setting roach traps, repairing holes in walls or other entry points, and keep food and garbage well contained.
  • Prevent household mold by using exhaust fans in the bathrooms and kitchen and adding a dehumidifier in your home. Clean existing mold contamination with detergent and water. Walls, ceilings and floors contaminated with mold due to leaks, flooding or excessive humidity may have to be replaced.


Infections:  Viral and bacterial infections such as the common cold and sinusitis make asthma symptoms worse. Be sure to get your family vaccinated against the flu each year, practice good hand washing, and stay away from those who are ill.

Smoking & Environmental Irritants:  Air pollution, strong odors or fumes (including perfumes and other fragrances and cleaning supplies), and tobacco smoke are common irritants that often aggravate asthma. The providers at Advanced Pediatrics strongly recommend that families avoid exposing children (particularly those with asthma) to second hand tobacco smoke. Research shows that exposure to second hand tobacco smoke causes increased visits to the doctor and emergency room, disturbed sleep, and activity limitations due to wheezing. For tips on how to quit smoking, see the following links below:

Avoid other environmental irritants by checking air quality reports and keeping your child indoors when air quality is poor. Use unscented cleaning products and toiletries and avoid using mothballs, room deodorizers or scented candles.

Cold Air:  Exposure to cold, dry air may aggravate asthma symptoms.

Exercise:  Many patients with asthma develop wheezing, coughing and a tight feeling in their chest when exercising. This is called exercise-induced bronchoconstriction (EIB). Talk with your child's provider if he or she experiences exercise induced asthma symptoms.

Stress:  Emotional anxiety and stress may increase asthma symptoms and trigger an attack. Proper rest, diet and exercise are important for overall health and can help in managing asthma.

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Asthma Care at Advanced Pediatrics

The providers at Advanced Pediatrics are committed to providing the most advanced care available for children with asthma. As such, our clinical committee regularly reviews the latest advancements in asthma care. In addition, our providers and staff attend in-service meetings with community allergy and asthma specialists and review recommendations for improving patient training in using asthma medications. Our asthma program includes a thorough evaluation, development of an asthma action plan, regular follow-up appointments, and ongoing management of medications.

The goals of our Asthma Care Program are to help patients to:

  • Maintain normal lung function and activity levels
  • Prevent chronic symptoms
  • Use medication appropriately, minimizing use of "rescue" medications
  • Recognize and develop strategies to avoid triggers
  • Reduce acute attacks which require sick visits, trips to the emergency room, and hospitalizations

The Asthma Care Program at Advanced Pediatrics consists of the following components:

  • Annual well care appointment
  • Asthma check-ups every 3 to 6 months
  • Participation in the Asthma Registry
  • Annual flu vaccine
  • Nurse advice

Asthma check-ups are scheduled to evaluate how well asthma is being controlled, adjust medications, change medication technique, and provide education. They are scheduled every 3 - 6 months depending on the severity / history of asthma symptoms. These check-ups are in addition to the annual well care visit. If your child is under the care of a specialist for his or her asthma, the three to six month check-up visits are not required, but please have the specialist send regular reports to our office.

Advanced Pediatrics uses "spirometry" to measure lung function at all asthma check-ups, as well as some acute / sick visits. Please bring all medications -- including rescue inhaler and spacer device -- to all asthma appointments. In addition, please download, print and complete the appropriate Asthma Follow-Up Packet (see parent handouts) prior to every asthma visit, and bring it to your visit.

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Asthma Registry

Advanced Pediatrics participates in the Colorado Pediatric Collaborative Asthma Registry, which is designed to track, monitor, and improve the health of asthma patients. Patients in the data base are classified as having intermittent or persistent asthma. The asthma registry was developed to:  1. Allow for optimal treatment plans and better parent / patient education; 2. Help asthma patients maintain activity and maximal pulmonary function; and 3. Reduce acute visits and trips to the emergency department.  In addition, the Asthma Registry tracks whether asthma patients have received their annual flu vaccine, which is very important to improving the health of asthmatic children.

If you have a child that has been diagnosed with asthma or wheezing, ask your provider whether your child has been included in the registry. If your child has not had an asthma visit in the last three to six months, please call our Patient Care Line at 303-699-6200 to schedule one as soon as possible.

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Prescription Refills

When your child is diagnosed with asthma, the development of an asthma action plan, regular follow-up appointments and ongoing management of medications are important aspects of care. At Advanced Pediatrics we have specific prescription refill guidelines we follow to ensure your child gets the proper care.

  • When prescribed medications are not managing your child's symptoms, please call our Nurse Line (303-699-6200, Option 2) to discuss your child's symptoms and the need for an appointment for further evaluation.
  • Refill requests for your child's medications may be made online through our MyChart patient portal or called in to our central prescription refill line at 720-870-0244. Your medication refill request will be filled based on your child's last asthma check-up and well-care visit. If your child is due for a well-care or asthma check-up visit, you will be asked to schedule that appointment.

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Recommended Resources

Parent Handouts
Recommended Reading
Helpful Websites

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