Asthma epidemic among kids may be slowing

This is one in an occasional series about children’s health issues. We know that many of our readers are grandparents keenly interested in the health and well-being of grandchildren. We hope this series will provide readers useful health information you can share with your family.

For the last few decades, asthma has been a children’s health issue of epidemic proportions, but this may be changing. According to a recent government analysis, the number of kids with the condition has leveled off when viewed overall. While that’s good news, it’s not the whole story; asthma is still on the rise for certain segments of the population, including kids who live in the South.

Asthma diagnoses doubled in the 1980s and 1990s; this may have been a result, at least in part, of better asthma-awareness by doctors.

“The definition of asthma has always been somewhat elusive. In earlier decades, kids who had asthma may have been diagnosed with some other kind of respiratory illness,” said Hermes Velasquez, M.D., who is affiliated with the Indian River Medical Center and is board certified in Sleep Medicine, Pulmonary Medicine and Critical Care.

Asthma is a common lung condition in kids and teens; sufferers have inflamed bronchial tubes that produce thick mucus. Their airways are also overly-sensitive to things like exercise, dust, and cigarette smoke. These problems cause breathing problems, with symptoms such as coughing, wheezing and shortness of breath. The tendency to develop asthma often runs in families.

For the recent study, a questionnaire about their children’s health was sent to a nationally representative sample of parents. The resulting analysis included records from over 150,000 children and was published in the January edition of Pediatrics magazine. The asthma rate in those under age 18 dropped from 9.3% in 2010 to 8.3% in 2013, the last year for which there is available data. The authors say more data is needed to determine if this is a reversal in the epidemic or just a smaller trend.

For reasons not currently understood, there are three groups of kids whose asthma rates continue to rise: those who live in the South, those between the ages of 10 and 17, and those of lower socio-economic status.

Possible trends and statistics aside, there is consistent advice for parents and grandparents of a child or teen with asthma, beginning with being under the continual care of a doctor or another healthcare professional. Most children with asthma are prescribed a combination of long-term control medications that reduce inflammation in their airways and quick-relief medications (taken with a hand-held inhaler during an attack) that open their swollen airways.

While an asthma diagnosis can be difficult for both the child and parent to hear, Vero’s Dr. Velasquez says the good news is that the vast majority of kids respond very well to treatment – the goal of which is to keep symptoms under control, and to effectively treat an asthma attack if one should occur.

The child’s doctor may talk about lifestyle habits; if not, the parent should initiate the conversation. Discussion topics should include the importance of staying active and regular exercise, maintaining a healthy weight, and following a diet that lessens the chance of acid reflux (which can worsen asthma symptoms).

As a condition, asthma does not come and go. If the child has it, they have it all of the time, but the symptoms can be controlled. Well-controlled asthma means the child has:

• Minimal or no symptoms

• Few or no asthma flare-ups

• No limitations on physical activities or exercise

• Minimal use of quick-relief (rescue) inhalers, such as albuterol

• Few or no side effects from medications

In addition to the right medication and healthy lifestyle habits, avoiding the child’s environmental triggers will lessen the possibility of attacks. Although triggers differ child-by-child, here is some good general guidance, courtesy of the Mayo Clinic:

• Maintain low humidity at home. If the child lives in a damp climate, a dehumidifier may help (it’s important to first get approval from the child’s doctor).

• Keep indoor air clean. Have a heating and air conditioning professional check the air conditioning system every year. Furnace and air conditioner filters should be changed according to the manufacturer’s instructions. A “small-particle filter” in the ventilation system may help.

• Reduce pet dander. If the child is allergic to dander, it’s best to avoid pets with fur or feathers. Regularly bathing or grooming pets also may reduce the amount of dander in the child’s surroundings.

• Air conditioning helps. It reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce the child’s exposure to dust mites. If the house where the child lives doesn’t have air conditioning, as much as is possible, windows should be kept closed during pollen season. (Related tip: it’s good to maintain an indoor temperature of between 68 and 72, since mold spores and dust mites love to grow in hot and humid houses.)

• Keep dust to a minimum. Making changes in the child’s bedroom can help reduce dust and relieve nighttime symptoms. For example: pillows, mattresses, and box springs can be put in dust-proof covers; curtains and blinds should be washable. Dr. Velasquez says carpeting can be replaced with hardwood flooring or tile, or specially-made hypo-allergenic carpet.

• Clean regularly. The home of a child with asthma must be keep very clean, to eliminate dust and allergens. Also, keep clutter to a minimum – stuffed animals, books, and knick-knacks collect dust very quickly.

• Reduce the child’s exposure to cold air. If the child’s asthma is worsened by cold, dry air, wearing a face mask outside can help.

Dr. Velasquez says a child’s individual triggers are often easy to identify, even without full allergy testing. “If you bring a cat into the house, and the child has flare-ups, is wheezing, and has itchy eyes, it’s a no-brainer that the cat needs to get out of the house,” he says.

Dr. Velasquez’s office is located at 1155 35th Lane, Suite 201, in Vero Beach; the phone number is 772-794-3364.

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