For children with exercise-induced asthma, a mild case of spring fever could turn into a full-blown asthma attack if they do too much too soon when the Spring weather warms.
“If your child experiences chest pain, cough, wheezing and other asthma symptoms, the first stop should be your child’s primary care provider,” said Lisa A. Jones RN, BSN, AE-C, an Asthma and EZ Breathing Program Coordinator at Akron Children’s Hospital. “Depending on the symptoms present, your child may be referred to an allergist-immunologist or pulmonologist for further examination.”
Like other forms of asthma, prevention is also key to keeping your child healthy. There are several steps parents can take to ease their child’s symptoms.
1. Know and avoid typical triggers such as:
- Cold, dry or polluted air
- High pollen counts
- Chlorine in swimming pools
- Chemicals used with ice rink resurfacing equipment
- Respiratory infections or other lung diseases
- Activities requiring long periods of deep breathing, like swimming, soccer or long-distance running.
2. Inhalers with short-acting beta agonists (SABAs) such as Albuterol and Levalbuterol can be used 15-20 minutes before exercise – per doctor’s orders – to open up airways. Daily use of a SABA is not recommended since your child may develop a tolerance to it.
3. If the pre-exercise inhaler is not effectively managing the symptoms, the doctor may prescribe a long-term control medication to complement the pre-exercise medication. Usually taken daily, these medications include:
- Inhaled corticosteroids – These work by suppressing inflammation in the airways. It may be 2-4 weeks before your child realizes the full benefit of these medications. Drug/brand names include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex) and beclomethasone (Qvar).
- Combination inhalers – These drugs relax airways and reduce inflammation with the dual action of a corticosteroid and long-acting beta agonist (LABA). Combination inhalers include fluticasone and salmeterol (Advair), budesonide, formoterol (Symbicort), mometasone and formoterol (Dulera).
- Leukotriene modifiers – Taken orally, these medications block inflammation. The most common is Singulair, which should be taken daily. Potential side effects include behavior and mood changes and suicidal thoughts. Talk to your doctor if your child experiences these signs or symptoms.
- Antihistamines – Taken orally, these may be helpful if your child has pollen allergies and is exercising outdoors.
4. Write down how many puffs your child takes weekly, how often he needs a pre-exercise inhaler for prevention and how often he uses an inhaler to treat symptoms. If your child needs to use an inhaler more than a few times a week for symptoms, the doctor may adjust his long-term control medication.
5. Work with the doctor to develop an action plan in case your child has symptoms at school. The plan should provide step-by-step instructions for teachers, nurses and coaches, including what treatments your child needs, when treatments should be administered and how to ease symptoms.
6. Other steps your child can take to minimize symptoms include:
- Warming up for at least 10 minutes before exercise.
- Breathing through the nose to warm and humidify air before it enters the lungs.
- Wearing a face mask or scarf when exercising in cold, dry weather.
- Exercising consistently to stay in shape and to strengthen respiratory health.
- If allergies are a problem, avoiding triggers like high pollen counts.
- Limiting strenuous exercise if she has a cold or other respiratory infection.
7. Seek emergency medical treatment if your child has:
- Wheezing or shortness of breath that’s rapidly worsening
- No improvement after using a prescription inhaler
For more information on managing your child’s asthma, visit the American Academy of Allergy, Asthma and Immunology (AAAAI).