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You brought your child to the hospital with the symptoms like wheezing, cough, difficulty in breathing and tightness of chest. Moreover, these symptoms were recurrent and frequent, more during night and precipitated after exposure to certain triggers such as exposure to cold, pets or after exercise and heightened emotions including laughter. There are many conditions which cause some of these symptoms in children. The diagnosis of asthma in your child was made by your doctor after putting together all the symptoms, thorough clinical examination and sometimes assisted by certain test reports.
Asthma is caused by swelling in the airways. When an asthma attack occurs, the muscles around the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.
Asthma is the leading cause of hospital stays and school absences. Asthma and allergies often occur together. The allergic response plays a strong role in childhood asthma.
Common asthma triggers include:
Animals (hair or dander)
Aspirin and other medicines
Cold air, such as changes in weather (most often cold weather)
Chemicals in the air or in food
Viral infections, such as the common cold.
Fig.1. Illustrations of changes in airways during asthma attacks
Doctors along with you had made an asthma action plan for your child which outlined how to:
Avoid asthma triggers
Measure peak flow
Children with asthma need a lot of support at school.
Give the school staff your asthma action plan so they know how to take care of your child's asthma.
Find out how to let your child take his or her medicine during school hours.
Having asthma does not mean your child cannot exercise. Coaches, gym teachers, and your child should know how to recognize and treat asthma symptoms caused by exercise. Please ask your doctor on topics of what physical activities your child can engage in school.
There are two basic kinds of medicine used to treat asthma.
Long-term control drugs are taken every day to prevent asthma symptoms.
Quick relief, or rescue asthma drugs work fast to control asthma symptoms.
Doctors prescribed the medications to relieve your child's asthma symptoms immediately and to prevent future asthma attacks.
Fig.2. An inhaler for quick relief from asthma symptoms
wheezing (there may be a whistling sound when your child breathes)
coughing, particularly at night and early morning
attacks triggered by exercise, exposure to allergens and other triggers . Symptoms vary between children and they may have one or more of these symptoms.Be aware of any signs of worsening asthma in your child. These may include:
your child becoming more wheezy, having a tight chest or breathless
the reliever inhaler not helping as much as usual
Signs of a severe asthma attack include:
the reliever inhaler does not help symptoms at all
the symptoms (wheezing, coughing, tight chest) will be severe and constant
breathing very fast and too breathless to complete a sentence in one breath or too breathless to talk or feed
a racing pulse
feeling agitated or restless
lips or finger nails may turn blue
Call the doctor immediately if your child's asthma symptoms become severe.
Self-care instructions: Do's and Don'ts:
Make sure you know the asthma symptoms to watch out for in your child.
You should know how to take your child's peak flow reading and what it means.
Know your child's personal best number.
Know your child's peak flow reading that tells you their asthma is getting worse.
Know your child's peak flow reading that shows you need to call their doctor.Keep the phone number of your child's doctor with you.
Triggers may make asthma symptoms worse. Know which triggers make your child's asthma worse and what to do when this happens.
Smells from chemicals and cleaners
Grass and weeds
Rooms that are damp and have house dust mites and moulds
Know how to prevent or treat asthma that comes on when your child is active. These things might trigger your child's asthma:
Cold or dry air
Smoky or polluted air
Grass that has just been mowed
Starting and stopping an activity too fast. Try to make sure your child warms up before being very active and cools down after.
Heightened emotions including laughter.
Understand your child's asthma medicines and how they should be taken.
Being active is great for your child's health and well being. Sometimes, however, the physical exertion of exercising or playing sport can trigger an episode of asthma. This is called exercise-induced asthma(EIA). Child with asthma should be able to participate in almost any sport or exercise. Scuba diving is the only sport not recommended. Most individuals with EIA can exercise to their full potential if their symptoms are managed properly.
If your child feels the symptoms of asthma while exercising, ask to:
Stop the activity.
Follow the asthma action plan.
Wait four minutes.
Only return to exercise or activity if the symptoms go away.
Use the reliever, if the symptoms don't go away, or if they return during exercise. Do not return to any exercise or activity for the rest of the day and see the doctor.
It is important for both the child and the parent to assess, understand and refrain from getting exposed to the triggers for asthma. Common asthma triggers can be cold or allergens such as - smoke, pets, dust, cigarette smoke, anxiety, pollen, cockroach debris etc.
Proper drug administration is crucial for good recovery.Talk and discuss with your allergist or doctor to understand how medications work and what is best for your child. Educate your child and make him aptly able to handle and treat himself during an asthma attack.
Air allergens can either trigger or aggravate asthma symptoms. If the outside air is polluted, use a mask. Within the house, you can improve the air quality by using an air humidifier. Clean and replace the room AC filters as recommended by the manufacturer. Keep your house dust free and clean.
Keep a check on your childs weight as weight gain can aggravate the asthma symptoms and may also lead to other complications.
Heartburn or acid reflux can worsen the asthma symptoms.Talk to your doctor to learn more of how to control it either through diet or medications.
Yoga, breathing techniques (like pranayama), acupuncture can help manage asthma symptoms.
Healthy food habits are important to be cultivated early. Eating nutritious and good food also helps boost the immune system and manage asthma. Generally, all food items can be classified into six major groups as shown in the Food Pyramid.
Immediate Diet Plan
1. Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables in your daily diet.
2. Add plenty of Whole Grains such as whole wheat flour, brown rice, whole beans etc. to the diet.
3. Choose foods high in Good Fat such as olive oil, peanut oil, fatty fish, walnuts, flaxseeds. If you do not eat fish, talk to your doctor about taking fish supplements. These good fats help improve the immune system and manage asthma.
4. Include foods rich in Calcium, as this is an important nutrient for development of bones. Milk, yoghurt cheese, green cabbage, mustard greens, black eyed peas are some examples of calcium rich foods.
5. Rich sources of Magnesium, Vitamin A, Vitamin E and Vitamin C should be included in the diet to boost the immune system.
1. Say NO to all Sugary beverages and foods. Do not add any extra sugar to beverages like tea coffee etc.
2. Refined ingredients like white rice, white flour, maida should be completely omitted from diets. .
3. Avoid combination of sugary and refined foods like cakes, pies, ice creams as they do the most harm.
4. Avoid Unhealthy Fats such as Cholesterol, Saturated and Trans Fat. Limit from egg yolks, cream, butter, ghee, coconut, deep fried items, whole milk, dalda, vanspati.
5. Slash down any intake of carbonated and sugary beverages like cola, soda, juices etc.
6. Avoid fried, spicy or acidic foods as they tend to increase heartburn.
7. Refrain from packaged food like instant soups, noodles, chips etc.
Sample Diet Plan
Below is a sample Diet Plan for a child suffering from asthma. Make sure to check the correct portion/serving sizes for each food item.
For cooking, try to use either Olive oil or peanut oil. Try not to serve cold dishes or beverages as low temperatures can trigger asthma. Water should be offered with every meal or snack.
- 1 Cup (250ml)Mixed fruit (banana, strawberry, mango) milkshake OR Badam milk
- 1-2 Moong Dal Dosa (click on Recipe) OR 2 Whole wheat toast sandwich (stuffed with bell peppers, carrots and peas) OR 1 Cup Whole wheat vermicelli vegetable Upma - 1 med Apple OR 1/2 Cup of Pomegranate seeds
Early Morning Snacks
- 2 dried apricots and 1 whole walnut OR 2 dried figs and 2 almonds (unsalted) OR 2 Whole wheat crackers - 1 Cup Coconut water (discard the malai")
- 1-2Whole wheat or Multigrain phulka OR Methi Paranthas - 1/2 Cup Palak Dal OR Rajma
- 1/2 Cup Cauliflower sabzi OR Okra sabzi
- Fresh salad (cucumber, tomato, radish, carrot slices)
- 1/2 Cup Yoghurt
Mid Afternoon Snack
- 1/2 Cup of Mixed sprouts OR 1/2 Cup Popcorn OR A few cubes of Dhokla
- A few dates
- 1Cup whole wheat pasta with homemade tomato sauce OR 1 Cup of Brown rice Khichadi with 1 medium bowl of Raita made with low fat yoghurt
- Fresh salad (cucumber, tomato, radish, carrot slices)
- 1 Cup of Guwar (cluster beans) curry OR 1 Cup of cabbage curry - 1/2 Cup Palak paneer OR Matar paneer
- 1Cup Yogurt
Late Night Snack
- 1/2 Cup cubed Watermelon OR Muskmelon
- 1/2 Cup Low fat milk