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This article originally appeared in the November-December 2004 issue
of the Children's Advocate, published by Action Alliance for Children.
Breathing easier
Parents and health educators offer tips for managing children's asthma
By Jessine Foss
Lisa Gill suspected that her children, ages four and two, had asthma
after they were repeatedly hospitalized for breathing problems. "(Doctors)
would say 'It's just a cough,'" recalls Gill. But because she has
asthma herself, she "pushed the issue" and found out, "it
is asthma."
Asthma is a "growing epidemic," says Anne Kelsey Lamb, director
of the Regional Asthma Management and Prevention Initiative. The increase
is greatest for children under five and children of color. Possible reasons
include air pollution, indoor allergens, and increasing obesity, which
is linked to asthma.
Asthma, a chronic disease that causes breathing problems, can be life-threatening.
It "influences all of your life," says Maria Elena Alioto, who
has asthma, has a son with asthma, and works as associate clinical researcher
at UC San Francisco. "Vacations get cancelled, children miss school,
you worry about (paying for) medication. But, she adds, "there are
things you can do."
Learn about possible signs of asthma
Talk with your pediatrician if your child has a persistent cough, wheezes,
or is often out of breath (especially after exercising). Children may
also say their chest feels tight. "Colds can have asthma-like symptoms,
but when the cold gets better, the symptoms go away," adds Alioto.
Talk with your pediatrician
"Don't be afraid to say, 'I think my child has asthma,'" says
Gill. If the doctor prescribes medication, make sure you understand how
it should be taken, what side effects it could have, and how to use asthma
equipment, such as inhalers, peak flow meters (that measure how well a
child is breathing), and nebulizers (for children too young for an inhaler).
Discuss any concerns about the medication or any home remedies you're
using. Kati Baker, whose two children have asthma, adds that parents should
ask about asthma triggers, signs of bad air days, and exercise.
Control asthma with medication
Children with severe asthma often take daily "controller"
medication in addition to "rescue" medication for asthma attacks,
which children with milder asthma also use. Gill says her son rarely has
symptoms since he's been taking controller medication-but he always has
his rescue inhaler with him. "It's hard to get (my two-year-old daughter)
to take her (controller) medicine," she adds. "Some days I want
to say 'let's not deal with it,' but it will be a lot worse if we don't."
Most health insurance (including Medi-Cal and Healthy Families) covers
some asthma medications-and a new law requires them to cover children's
asthma equipment. "It's still a financial burden," says Baker.
"The co-pay for my (son's medications) has gotten up to $100-$150
a month. I'm a single mom, so it's been tough. There have been months
I couldn't afford it and I would ask my pediatrician for (medication)
samples."
Parents may be able to find help with medication, transportation, or
language barriers through their local asthma coalition (see resources)
or public health department.
Manage your child's asthma with an "asthma action plan"
Develop a personal asthma action plan (see resources) with your child
and doctor. These are often based on readings from peak flow meters. When
the reading is in the child's "green zone," says Syliva Amaro,
manager of the Orange County Breath Mobile, the child "can work and
play just fine." Yellow means "Caution, take this medication."
Red is "stop, you need to get to the doctor or emergency room."
Reduce asthma triggers
Notice what triggers your child's symptoms. Common triggers include
allergies to pollen, mold, dust, cats, dogs, and cockroaches, as well
as air pollution, cigarette smoke, and exercise. "Smoke is a huge
issue," says Chris Soden, registered nurse and asthma educator. Experts
recommend that parents quit smoking or smoke outside.
"I vacuum every day," says Baker, "and dust every other
day. I make sure there's no mold. We covered everything (with dust-proof
covers)-pillows, mattress. We have no pets except a lizard."
"It's extra effort," agrees Gill, "but it's worth it.
When they can't sleep, you're up with them. You're missing days of work,
they're missing school."
When a child is having a "bad asthma day," Soden adds, make
sure the child gets enough water and rest. During an asthma attack, keep
the child calm and breathing slowly, adds Mildred Flores, health education
assistant for the Riverside Department of Public Health.
Encourage exercise-in moderation
Sometimes "parents are reluctant to let their child participate
in sports," says Soden, but kids should be active. "We did things
in moderation," says Baker. "My son played soccer and my daughter
did cheering. There were days when they couldn't do it, and that was OK."
To help prevent asthma attacks, kids can use their inhaler 15-20 minutes
before exercising.
Work with schools and child care
Share your asthma action plan with teachers and child care providers
and send medicine to school and child care-a new law allows school children
to carry and use their inhaler. Gill tells child care providers, "when
he has a continuous cough, my son needs his rescue inhaler."
Baker asks teachers to listen to her children "when they say they
aren't feeling well." But she recently had to take her son to the
emergency room after he was told to run a mile on a bad air day. "I
complained," she recalls, and "now they let him sit out when
he's not feeling well." Her son's school now has a program of flag
signals for air quality (see Advocacy).
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Advocacy
Asthma coalitions around the state are working to improve air quality,
housing conditions, and care for children with asthma. For example:
- Schools in Merced and Mariposa counties raise colored flags for
air quality -- on "red" days, schools keep all children
indoors; on "orange" days, children with asthma are offered
indoor activities.
- Community efforts aim to reduce diesel exhaust, including
a recent regulation that limits school bus idling.
- Advocates work for stronger laws to protect tenants' rights
to healthful housing.
For more information, contact Community Action to Fight Asthma, 510-622-4444,
www.calasthma.org
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Resources
- Local asthma coalitions offer free education, equipment, medication,
and referrals. Contact Community Action to Fight Asthma, 510-622-4444,
www.calasthma.org
- Sample asthma action plan in English, Spanish, Chinese, and
Vietnamese at www.calasthma.org/
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