Asthma

Asthma is an inflammatory disease that affects the lungs and airways. It can be triggered by allergens, cold air, respiratory infections, exercise, air pollution, airborne irritants or tobacco smoke.

What is asthma?

• The majority of children with asthma have an allergy that triggers their asthma.
• More than 22 million people in the United States are diagnosed with asthma.
• 6.5 million children in the United States have asthma.
• Asthma is the most common chronic condition among children in the United States.
• In 2007, there were 157,000 hospitalizations for asthma among children, according to the Centers for Disease Control and Prevention. 
• Treatments cannot cure asthma, but it can help keep it under control.
• Currently there is no cure for asthma, but it can be controlled and managed with proper use of medication and vigilantly avoiding irritants.
• Asthma is usually a manageable condition if your child complies with specific medication regiments, and is vigilant about reducing their exposure to irritants.

How Children’s Hospital Boston approaches asthma

Our Allergy and Asthma Program evaluates and treats children with various allergic disorders to inhaled allergens, food, insect stings and drugs, with approaches ranging from oral and inhaled medications to immunotherapy (also known as allergy shots, or allergen desensitization). We also conduct skin testing to determine what your child is allergic to.  The Asthma Programs at Children’s Hospital all follow the latest guidelines from the National Institutes of Health for the treatment of asthma, and develop individualized programs for each child to minimize asthma symptoms and minimize side effects from medications.  The goals of the treatment program for each child are to prevent asthma attacks, prevent emergency room visits and to maximize peace of mind. 

Asthma and allergies are separate, but related conditions. About 80 percent of children with asthma have allergies. Allergic reactions can make asthma worse by increasing the swelling in a child’s airways. So it’s important that your child be cared for in a place that treats both allergies and asthma, and whose specialists understand how they are related to each other.

Our team is staffed by allergists, dermatologists and psychologists, who team up with Children’s researchers to conduct clinical trials to evaluate new approaches to treating children with allergic conditions. Our Asthma Program team provides children and the community with comprehensive care, prevention, evaluation, treatment, parental support, case management, training and education and policy advocacy.

To treat hospitalized children with asthma, our asthma team works with physicians and nurses in the hospital who provide around the clock treatments for asthma, to ensure the rapid resolution of asthma symptoms.  In children with the most severe asthma attacks, Children’s sometimes uses anesthesia ventilators with inhaled anesthetics.  

In the outpatient setting, Children's Center for Aero-Digestive Disorders provides medical and surgical treatments for complex airway problems that may result from asthma. For example, some children have asthma that is worsened or caused by gastroesophageal reflux, or who aspirate food into their lungs, which causes worsening of asthma or recurrent pneumonia.  The Asthma Programs also work with the Otolaryngology Clinic, since many children with asthma may have enlarged tonsils or adenoids that may worsen asthma symptoms.  Other children can have recurrent infections in the ears and sinuses that also can worsen asthma, and that need treatment by otolaryngologists.  Rarely, children have problems with their vocal cords, which may cause symptoms that resemble asthma.    

Asthma management solutions

Children’s reaches out to communities that lack sufficient asthma management resources and offers various solutions that help patients and families manage asthma.

• Community Asthma Initiative (CAI) offers a comprehensive care package of care plans, case managers, home visits and environmental remediation.
• Children's Hospital Primary Care Center offers an asthma medical home program, and an Asthma Action Team to empower and educate children on how to live active, healthy lives.
• Asthma nurses are specially trained to educate patients and families, coordinate care and follow up on other outpatient services.
• Children's Pediatric Asthma Center is a new multidisciplinary team innovating new approaches to asthma care, education and research.
• Electronic registry keeps hospital care providers informed on the details of each child’s case history and asthma management plan.

Asthma: Reviewed by Dale Umetsu, MD and Lynda Schneider, MD

© Children’s Hospital Boston; posted in 2011