Reducing Triggers in Pediatric Asthma

  • One of the first things you need to learn when dealing with pediatric asthma is determining  your child's individual triggers.  This process can seem daunting because there are so many things that can trigger an asthma attack.  In this blog I will talk about some of the main triggers, but this is by no means an exhaustive list.  If you need more help determining triggers, it can be beneficial to start a journal for your child with activities, foods and how they felt that day.   Talk with your physician if additional testing is needed to identify other triggers.

    Smoke

    Smoke of any kind can be a huge trigger for children with asthma.  If you are a smoker then NOW is the time to quit.  Secondhand smoke can be extremely dangerous for children with asthma and results in poorer treatment outcomes.  Remember smoke from camp fires, controlled burns, fireplaces or other sources can also be very hard on children with asthma because it irritates the airways.  In most cases it is best to avoid these situations.

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    Pet Dander

    Many children with asthma can be affected by pet dander.  This is not just limited to cats and dogs, but can also be an issue with other animals, like horses.  Your allergist should be able to do testing that can help determine if this is an issue for your child.  If your child comes into contact with pet dander, teach them to wash their hands immediately and to keep their hands out of their eyes, mouth or nose, which can hasten an allergic response.

    Insects

    This may sound like a joke, but there are actually two insects that can play a huge role in triggering asthma symptoms: the dust mite and cockroach.  Dust mites are tiny insects found in every home and are often in bedding, mattresses or pillows.  They feed off of dead skin that everyone sheds each night.  Using pillow cases and mattress covers that provide a barrier between your child and the dust mites can help immensely.   It is also important to wash bedding in hot water at least once per week.  Stuffed animals can also be culprits, so purchase ones that are washable.

    Cockroaches leave droppings that can be detrimental to children with asthma.  These nasty creatures come in looking for food and water.  You can limit their attraction to your home by removing any water sources or standing water and vacuuming up food or crumbs immediately.  Traps can also be set to catch cockroaches--but for an extreme problem you may need to contact an exterminator.  If pesticides have to be used in your home, have any spraying done when your child is not in the house and allow the appropriate time to air out the house before your child returns.

    Environmental

    There are many environmental air quality issues that can affect children with asthma.  One of the issues is pollen or mold levels in the outside air.  You can check these readings on many sites like the Weather Channel Allergy map that tells you the readings in your area. 

    Air pollution can also be an asthma trigger.  If you live in a big city with lots of pollution the Environmental Protection Agency has a site that can help you determine whether daily levels will be an issue for your child.  It is best to stay inside on days with poor air quality.


  • Sometimes there are things in the environment that you can't plan for.  The lady next to you with way too much perfume or someone who just smoked a cigarette. Carry your child's rescue inhaler when you are away from home.

    Indoor Mold

    Mold can be an issue whether it is in the outside air, but especially when it is a daily issue in your home.  You can have your house tested for mold if you think there might be a larger issue.  Keeping the humidity at a constant 40-50 percent can help limit the growth of mold, as well as other bacteria or viruses.  This constant humidity can be accomplished by using a dehumidifier and measuring the humidity with a hydrometer when in a humid climate.  We bought one for less than $15 at our local hardware store.  Air that is too dry can also be an issue, so don't skip the hydrometer.

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    GERD

    Gastroesophageal Reflux Disease is a condition in which the acidic stomach contents bounce back into the esophagus causing pain or "heartburn" symptoms.  This acidic liquid can also aggravate the lungs and trigger an asthma attack.  For more information on this topic check out my blog on Asthma and GERD

    Cold Air

    Cold winter air can trigger symptoms in some children.  When the air is bitterly cold, opt for hats and scarves and teach your asthmatic child to cover their mouth and nose while breathing outside.  Avoiding excessive time outside in the cold can help to reduce symptoms.   Again,  keep that rescue inhaler handy if you know cold weather could be a potential problem for your child.

    Food Allergies

    Food allergies or intolerances can trigger asthma symptoms in some children.  Children who have asthma and food allergies are also at a higher risk for anaphylactic reactions.  Anaphylactic shock is a life-threatening allergic reaction in which the airway can completely close.  If your child has food allergies and asthma, you should always have two EpiPens and a rescue inhaler handy in case of an emergency.  Physicians used to recommend Benadryl as a first line of defense in these types of reactions, but recent research indicated it may not be as effective as once thought.  Talk with your child's physician about what to do in this instance and seek medical attention immediately following any injection of epinephrine.

    Illness

    Children with asthma are more susceptible to upper respiratory infections.  These can be severe like pneumonia or simple colds.  Either way, these infections can trigger additional symptoms in children with asthma and may result in asthma flare-ups even once the actual illness has subsided.  Some children may require oral steroids, additional scheduled breathing treatments, or close monitoring of their oxygen levels during illnesses.  If you think your child is having difficulty breathing, additional coughing, lethargy, or fever please have your physician evaluate their condition.  Pneumonia can become serious quickly.

    Additional Tips

    A  high efficiency particulate air (HEPA) filter can also help to limit exposure to allergens in the home.  These filters can be placed on your existing central heat and air, used in your vacuum, or used as part of a free standing air purifier.  Don't underestimate the value of these filters.  We noticed a significant change in our daughter's home symptoms when we replaced our filters with HEPA filters and purchased a free standing air purifier.


  • All children are different and what triggers symptoms in one child may not be an issue for another. Your physician or allergist can help you to more closely determine what might be triggering your child's asthma and how to eliminate that trigger from their lives for better asthma control.

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Published On: August 13, 2014