Information for parents

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Asthma affects many children and adolescents: About 5 to 10 out of every 100 adolescents have asthmatic symptoms. It is normal for parents to become concerned. However, asthma can be managed well with medication and supportive measures.

It is not necessary to change the entire family routine because of the disease. It is important that a child learns how to cope with the disease on his or her own. As a parent, you can help to control the disease through good treatment. And you can help your child accept the disease and lead as normal a life as possible.

How can I tell if my child has asthma? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Asthma is difficult to detect in young children. Many young children often have colds or bronchitis . These are diseases of the respiratory tract caused by viruses, which can be accompanied by coughing and slightly whistling or humming breathing. Inflammation of the bronchial tubes (bronchitis) in young children is often difficult to distinguish from the onset of asthma. However, asthma-like symptoms of bronchitis become rarer with increasing age.

To determine whether your child really does have asthma, the doctor will do certain breathing tests with him or her. Pulmonary function tests such as peak flow measurement and spirometry can tell you if your child’s lungs are working normally and if the air they breathe is flowing freely and unobstructed through the bronchial tubes. These tests require the child’s cooperation and are therefore usually only suitable for somewhat older children.

Can asthma "grow out of control? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Asthma is a chronic, or permanent, condition for many people. But not all children with asthma will have symptoms later as adults . Why this is so is not known. It is also not known whether a particular treatment causes some children to "outgrow" the condition.

Asthma progresses in phases. So there can always be long periods of time when a child is doing well. Sometimes no symptoms occur at all after puberty. The readiness of the respiratory tract to react to certain stimuli with constriction and corresponding complaints usually persists, however, even then.

Asthma is therefore not a disease that automatically worsens over time – especially if it is treated well. Asthma can also be very mild or moderate in severity. Severe asthma is rare in childhood.

My child has asthma – what should I pay attention to?? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

When a child has moderate or severe asthma, it can put a lot of stress on a family. Child’s shortness-of-breath attacks cause concern or even anxiety. Following through with treatment is also sometimes exhausting. Small children often cannot yet understand why they have to take medication regularly. Dealing with a chronic illness takes a lot out of children and can take away their lightheartedness.

As a parent or caregiver of a child with asthma, there are things you can do to help your child cope with his or her condition. The goal is for it to have no or as few symptoms as possible and to grow up largely undisturbed. This includes helping the child take the medication. It is also important to make sure that the child can move around "normally" in the family, among friends, in the neighborhood and at school. Many children are initially very uncertain about how to deal with asthma . They may even be ashamed of it and want to hide it from others. Fear of asthma attacks is also a constant companion for many children. The support of parents plays an important role for them.

By making sure your child grows up in a smoke-free environment, you protect them from a key asthma trigger. Cigarette smoke damages your child’s lungs and increases his or her symptoms. There are several therapies that can make weaning a little easier for you or other family members.

There are asthma education classes where parents and children can learn to cope with asthma . Training is offered in individual age groups according to the child’s development.

How can asthma medication help my child?? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Two groups of medications are available to treat asthma:

  • Continuous medication (controller)These are medications that reduce the inflammation of the bronchial tubes and therefore prevent asthma symptoms in the long term. They usually contain cortisone and are used regularly every day, even if the child has no symptoms.
  • Medication on demand ( Reliever )These are medicines that rapidly dilate the respiratory tract and relieve acute symptoms. They help your child during an acute asthma attack, but can also be used as a preventive measure before physical exertion, for example.

Which medications are considered depends on how well the symptoms can be controlled. For mild complaints, it is usually sufficient to take a medication only when needed. More severe symptoms can usually only be controlled by taking one or more medications every day.

In allergic asthma, specific immunotherapy can also relieve symptoms. This treatment lasts a few years and can make people less sensitive to allergy-related asthma triggers.

Can asthma medications harm my child? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Many parents worry about possible side effects when the doctor recommends corticosteroids for their child. In severe asthma, however, asthma attacks pose a much greater risk than the side effects of permanent medication. Most asthma medications, including corticosteroids, can be inhaled. As a spray or powder inhalation, the remedies have far fewer side effects than in tablet or injection form.

In children, there is concern that long-term cortisone treatment may affect growth. However, cortisone sprays are unlikely to have a lasting effect on body size in children. While previous studies show that children grow slightly less quickly in the first year of treatment. However, in the following years they develop normally. This suggests that they will grow as large in adulthood as children with asthma who do not inhale corticosteroids. Nevertheless, as a precaution, these medications are used in adolescents in the smallest amounts possible and only for inhalation whenever possible.

How to protect my child from asthma triggers? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

On the one hand, asthma triggers can be components of the air we breathe that also irritate the respiratory tract in other people, such as fragrances, smoke and other harmful substances. In people with asthma, they can trigger serious symptoms. On the other hand, even normally harmless substances and environmental conditions such as house dust , plant pollen , animal dander or temperature changes irritate the sensitive airways of a person with asthma to an exuberant reaction.

To be able to protect a child, you must first know the triggers of their asthma. It helps to observe when or by what means the child’s complaints occur or are intensified. But here it is important to keep a sense of proportion. Mistaking something for a trigger can unnecessarily restrict the child. Also, precautions that may protect your child but prevent him or her from meeting friends, pursuing interests, and going to kindergarten or school may do more harm than good.

Animal dander can trigger allergy. If your child is allergic to a beloved pet, you can try separating living areas or washing the pet frequently. Only if this does not help, it must be surrendered. However, special measures are only advisable if a child develops asthma symptoms when coming into contact with animals. That not having pets prevents a predisposition to asthma has not been proven.

Asthma is a complex disease. It may be that trying to avoid triggers is not worth the effort and sacrifice that some measures may mean for a child. For example, it is almost impossible to completely eliminate house dust mites. Individual measures hardly bring anything. You may be able to reduce exposure by combining several measures: damp mopping the floor, using a mite-proof mattress cover, washing bedding regularly at more than 55° C, and removing dust traps such as old upholstered furniture or rugs.

For most children with asthma, if they take their continuous medications properly, triggers usually become less important.

What to watch out for during sports? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

If your child has asthma, it does not mean that he or she has to give up playing with friends or going to school or club sports. For many children and adolescents with asthma, exercise is an essential part of their daily lives.

A lot of exercise is important for the physical development of children. For children with asthma, exercise and sports can have additional benefits. You can make the lungs more efficient and improve overall fitness. Asthma attacks may also become less frequent through exercise and sport. Asthma should be treated (one also says: adjusted) in such a way that a child can play and do sports spontaneously. You can discuss with your doctor whether it makes sense for your child to take medication, if necessary, to prevent asthma symptoms caused by physical exertion (so-called exercise-induced asthma).

It is impossible to say for sure whether certain types of sports are particularly beneficial for asthma. Swimming, for example, is probably less likely to trigger exercise-induced asthma than winter sports, for example. This is mainly because cold, dry air is more likely to cause asthma attacks. In the indoor swimming pool, on the other hand, the air is warm and humid. It is important that the sport is fun for the child.

By the way, there are many top athletes who have asthma. Maybe it helps your child to know such athletes.

Can my child participate in school trips? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Even a child with asthma wants to take part in everything the others do, for example, participate in school trips or children’s camps. It is important that caregivers, teachers, friends and, last but not least, your child himself are well informed about the disease and the necessary preventive as well as emergency measures. This is a good precondition for your child to be able to cope with difficult situations when you are not there.

If your child has allergic asthma, it’s hard to avoid exposure to triggers that can cause discomfort on a school trip. Discuss with the doctor whether, for example, preventive cortisone treatment might be useful for this period of time. If your child is already taking regular medication, he or she may forget to take it on a school trip. It helps if accompanying persons are informed, remind the child and – if complaints occur – ask whether the child has taken his or her medication regularly.

If your child always has his or her treatment and emergency plan with information about the condition and the necessary medications, it makes it easier for medical helpers to respond properly in an emergency.

How to help my child through adolescence? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Puberty can be a time of conflict for all parents and children. It is then often difficult for young people with asthma to comply with the special rules and requirements that the treatment of their chronic disease requires.

In general, young people with asthma seem to think that their symptoms are less serious than their parents do. The opposite is true for quality of life: parents often underestimate how much their adolescent children feel limited by asthma treatment.

Smoking can become a particular issue. When friends smoke, even self-confident teens often adapt. Then it can be difficult to make it clear to a young person that smoking is a particularly heavy burden for people with asthma.

In general, puberty is a time when adolescents try many things, even things they actually know are not good for them. Researchers call this "age-typical risk behavior". There is evidence that it is particularly pronounced in young people with chronic illnesses. Young people with asthma may be more tempted to smoke than their peers, even if it harms them more. However, the family can help prevent a teen from taking up smoking.

You cannot protect your child from all the dangers to which they are exposed. But if you manage to stay in contact with him and maybe also with his friends, this can mean important support and security for your child.

German Medical Association (BaK), National Association of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies (AWMF). National health care guideline: Asthma . AWMF registry no.: nvl-002. 21.09.2018.

Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma . Cochrane Database Syst Rev 2013; (9): CD001116.

Peterson-Sweeney K, McMullen A, Yoos HL, Kitzman H. Parental perceptions of their child’s asthma: management and medication use . Pediatr Health Care 2003; 17(3): 118-125.

IQWiG health information is designed to help people understand the advantages and disadvantages of important treatment options and health care offerings.

Whether one of the options we have described is actually useful in a particular case can be clarified by talking to a doctor. Health can support, but not replace, discussions with doctors and other professionals. We do not offer individual advice.

Our information is based on the results of high-quality studies. They are written by a team of authors from the medical, scientific and editorial communities and peer-reviewed by experts outside IQWiG. We describe in detail how we develop our texts and keep them up to date in our methods .

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