Asthma Health Article

Parental concerns

Parents should take an open and honest approach when explaining asthma to their child. They should explain that asthma does not define or limit the child. The success of the child's treatment plan will depend on parental guidance and support. As a child ages, the responsibility for personal asthma management can be increased. For example, toddlers can mimic treatment on a toy or doll; preschoolers can help parents in peak flow monitoring and discuss symptoms with them; schoolaged children can begin to take medications on their own (while supervised); and adolescents can be nearly independent in following the structured management plan.

Parents should stress the consequences of improper symptom management with their child. The main concern with older children is peer pressure and the desire to fit in; therefore, symptoms may not be reported accurately and medications may not be taken to avoid comments from peers or appearing different. Parents may want to counteract peer pressure by offering a contract that outlines the management plan and lists specific rewards and consequences.

Parents should work with school personnel to foster a supportive environment that so the child's symptoms can be managed properly. A specific action plan can be developed for school by the child's doctor. Parents should inform school personnel about the child's specific allergens and asthma triggers so steps can be taken to help the child avoid them at school. Students who are able to recognize symptoms requiring medication and know how to use their inhaler properly should be permitted to keep the medication with them. For younger children, parents must ensure that school personnel know how to administer the child's medications.

Asthma should not be used as an excuse to avoid exercise. Sometimes children with asthma avoid school activities because they are afraid of being embarrassed if symptoms occur. Parents should encourage athletic or physical activity participation and talk to gym teachers or coaches to ensure they understand the child's symptoms and treatment protocol. They should make sure the child knows what to do if exercise causes symptoms. Swimming is generally well-tolerated by many people with asthma because it is usually performed in a warm, moist environment. Other activities that involve brief, intermittent periods of exertion, such as volleyball, gymnastics, baseball, walking, and wrestling are usually well-tolerated. Cold-weather sports, such as skiing, ice skating, or hockey, may be not be tolerated as well. The child's doctor can provide specific exercise recommendations and guidelines.

See also Allergy shots.

BOOKS

American Medical Association. The American Medical Association Essential Guide for Asthma (Better Health for 2003) Pocket, 2000.

Fanta, Christopher H., et al. The Harvard Medical School Guide to Taking Control of Asthma. New York, NY: Free Press, 2003.

Wolf, Rauol. Essential Pediatric Allergy, Asthma, and Immunology. New York, NY: McGraw-Hill Professional, 2004.

ORGANIZATIONS

Allergy and Asthma Network/Mothers of Asthmatics America, Inc. 2751 Prosperity Ave., Suite 150, Fairfax, VA 22031. (800) 878-4403. Web site: <www.aanma.org.>.

American Academy of Allergy, Asthma and Immunology (AAAAI). 611 E. Wells St., Milwaukee, WI 53202. (800) 822-ASTHMA or (414) 272-6071. Web site: <www.aaaai.org>.

American College of Asthma, Allergy and Immunology (AACI). 85 W. Algonquin Rd., Suite 550, Arlington Hts., IL 60005. (800) 842-7777. Web site: <www.aaci.org.>.

American Lung Association. 1740 Broadway, New York, NY 10019. (800) 586-4872. Web site: <www.lungusa.org.>.

Asthma and Allergy Foundation of America. 1233 20th Street, NW, Suite 402, Washington, DC 20036. (800) 727-8462 or (202) 466-7643. Web site: <www.aafa.org>.

National Asthma Education Program. National Heart, Lung and Blood Institute Information Center. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 592-8573. Web site: <www.nhlbi.nih.gov/about/naepp/>.

National Institute of Allergy and Infectious Diseases. NIAID Office of Communications and Public Liaison, Building 31, Room 7A-50, 31 Center Dr., MSC 2520, Bethesda, MD 20892-2520. Web site: <www.niaid.nih.gov>.

David A. Cramer, M.D. Angela M. Costello