Asthma is a very common condition worldwide, even among children. And it, like other allergic disorders, is on the increase. It is multifactorial, that is, has many causes. This article explores some childhood asthma triggers, and offers a childhood asthma treatment model that addresses the condition in a biopsychosocial approach.
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Childhood asthma is inheritable. There is a lot of evidence to this effect, including evidence collected from Twin Studies.
Nothing can be done to alter or influence the inheritability of asthma. But awareness of the fact is important, especially in the case of an initial diagnostic workup. Knowing that a child who presents with an unexplained respiratory illness has a family history of asthma or other allergy, helps in making an early diagnosis that enhances the chances of a favourable outcome.
Young children under the age of 2, usually have Food Allergy e.g. to milk, eggs, seafoods, wheat. But food allergies quickly diminish after the age of 2, to be replaced by allergy to inhaled irritants or allergens (aero-allergens). In circumstances where Allergy Testing is not easily accessible, knowledge of this childhood asthma fact is important, because management of asthma and other allergies requires knowledge of the causative or provocative factor(s) and their avoidance.
Half of asthmatic children outgrow their asthma around the time of puberty. And of those who outgrow it, half of them have it recurring in adulthood.
In this article, the focus is on inhaled allergens, especially DUST and THE HOUSE DUST MITE.
The vast majority of asthmatic children over the age of 2, have allergy to a microscopic creature that lives in house dust, the House Dust Mite or HDM. This is more true of children living in coastal than inland areas. The HDM lves warm, moist places. It thrives on dead skin cells on bedding.
Any sources of stress (physical, mental or social) on an asthmatic child, have the potential to make management of the condition more difficult, either by causing more severe or more frequent symptoms, or by causing the patient to be demotivated and/or non-adherent to treatment.
These tie in with the psychological factors.
But also, poverty or family discordance make it difficult for the treating team that consists of Healthcare Workers, the Patient, and the Family, to institute the best or agreed management plan.
Children living in polluted areas or countries with a lot of industrial activity, or countries with weak legislation to control effluents from factories, generally have very pop lung function.
A HOLISTIC CHILDHOOD ASTHMA TREATMENT PLAN
This should address all of the above mentioned factors, and more.
Allergy Testing is the starting point of a good management plan. It will tell if a child is allergic to the HDM.
Measures should then be taken, to minimise exposure of the asthmatic child to dust (and consequently to the HDM). The child should vacate a room that is being swept. Or if they are the one sweeping, should cover the mouth and nose with a cloth, doek, etc.
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A case study done by the writer of this article in 1995-96 showed that children with asthma, should not sleep on the bottom bunk of a double-bunk bed. These types of beds are commonly used by many families to conserve space. But where one of the children is asthmatic, these beds should be avoided, or the asthmatic child, especially if they suffer from HDM allergy, should sleep on the top bunk.
In terms of asthma medication, there should be an agreed Treatment Plan between the Parent and the Healthcare Professional. Written information should be provided.
Asthma inhalers are in two categories, the Relievers (blue or green cap) and the Preventers ( brown or red cap). This pharmacological treatments should always be readily available in case of an emergency. They should be kept clean, and should never be beyond their expiry date.
It is important to remember that children under the age of 8 are unable to use an asthma inhaler, and that they need to use it in conjunction with a SPACER DEVICE (above links).
Children should be spared from family feuds. Family should be sought as quickly as possible, to decrease high expressed emotion in the family. The school environment should also be a happy and healthy one for the child. Communication between parents and the stand-in parents at the school (Teachers) is vital.
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