Аsthma in children

Asthma is a chronic disease that causes the airways - the tubes that carry air in and out of your lungs - to become sore and swollen.

Children with asthma may experience wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night.
Many things can cause asthma, including:

  •    Allergens - mold, pollen, animals
  •     Irritants - cigarette smoke, air pollution
  •     Weather - cold air, changes in weather
  •     Exercise
  •     Infections - flu, common cold

When asthma symptoms become worse than usual, it is called an asthma attack.


Approximately 17 million Americans have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them.  Children younger than 18 years of age account for 47.8% of the emergency department visits and 34.6% of the hospitalizations due to asthma exacerbations. The magnitude of the impacts of asthma in children is illustrated by the fact that asthma accounts for more hospitalizations in children than any other chronic illness. Moreover, asthma causes children and adolescents to miss school and causes parents to miss days at work. As might be expected, asthma also accounts for more school absences than any other chronic illness.

Asthma is a disorder caused by inflammation in the airways (called bronchi) that lead to the lungs. This inflammation causes airways to tighten and narrow, which blocks air from flowing freely into the lungs, making it hard to breathe. Symptoms include wheezing, breathlessness, chest tightness, and cough, particularly at night or after exercise/activity. The inflammation may be completely or partially reversed with or without medicines.

The inflammation of the airways makes them very sensitive ("twitchy"), resulting in spasm of the airways that tend to narrow, particularly when the lungs are exposed to an insult such as viral infection, allergens, cold air, exposure to smoke, and exercise. Reduced caliber of the airways results in a reduction in the amount of air going into lungs, making it hard to breathe. Things that trigger asthma differ from person to person. Some common triggers are exercise, allergies, viral infections, and smoke. When a person with asthma is exposed to a trigger, their sensitive airways become inflamed, swell up, and fill with mucus. In addition, the muscles lining the swollen airways tighten and constrict, making them even more narrowed and blocked (obstructed).

So an asthma flare is caused by three important changes in the airways that make breathing more difficult:

  • Inflammation of the airways
  • Excess mucus that results in congestion and mucus "plugs" that get caught in the narrowed airways
  • Narrowed airways or bronchoconstriction (bands of muscle lining the airways tighten up)

Anyone can have asthma, including infants and adolescents. The tendency to develop asthma is often inherited; in other words, asthma can be more common in certain families. Moreover, certain environmental factors, such as viral infections specially infection with respiratory syncytial virus or rhinovirus, may bring the onset of asthma. Recent medical reports suggest that patients with asthma are likely to develop more severe problems due to H1N1 infection. It has also been suggested that there is an association between day-care environment and wheezing. Those who started day care early were twice as likely to develop wheezing in their first year of life as those who did not attend day care. Other environmental factors, such as exposure to smoke, allergens, automobile emissions, and environmental pollutants, have been associated with asthma.

Many children with asthma can breathe normally for weeks or months between flares. When flares do occur, they often seem to happen without warning. Actually, a flare usually develops over time, involving a complicated process of increasing airway obstruction.

Breastfeeding cuts asthma risk

  • Children who are breastfed are less likely to develop asthma, the results of a new study indicate.
  • A team of UK researchers analysed 7,000 school children, aged six to 15. They focused specifically on the positive benefits of breastfeeding in relation to the prevalence of asthma.
  • They found that children who had been breastfed for six months or more had a significantly reduced risk of developing asthma. This was particularly the case among young boys.
  • “Breastfed children showed lower prevalence rates of asthma, rhinitis and eczema, and the effect of breast feeding was more evident in boys than girls. Asthma and wheeze were resolved significantly earlier in breastfed children than those who were not breastfed,” explained Dr Mohammad Shamssain of the University of Sunderland.
  • The study showed that overall, children who were breastfed for four to nine months had a significantly lower risk of asthma, while those breastfed for between seven and nine months had lower instances of persistent wheezing and coughing.
  • “Breast feeding is a cost effective approach to a significant prevention of allergic disease in children. Our research demonstrates that exclusive breastfeeding prevents the development of allergic diseases in children,” Dr Shamssain said.
  • In a second part of the study meanwhile, the researchers discovered that obese children had higher prevalence rates of asthma and respiratory symptoms, such as coughing, breathlessness and exercise-induced wheezing, than non-obese children.
  • “The association between overweight and exercise-induced wheezing is stronger in boys than girls. In boys, the risk of being overweight is associated with exercise-induced wheezing, life-time asthma, and current wheeze. In girls, the risk of being overweight is mainly associated with exercise-induced wheezing,” Dr Shamssain explained.
  • He said that the results demonstrate that obesity ‘is a definite risk factor in asthma among young children’.