The statistics are startling: One in 10 school-age American children now suffer from asthma, a number that has doubled since the 1980s. It is also the third-leading cause of hospitalization for children under age 15, and results in 13 million missed school days per year. How come? Experts believe a variety of factors are to blame. "We're using more cleaning products and hand sanitizer than ever before, so one theory is that kids aren't encountering as many allergens at a young age, making them more sensitive to immune system-related conditions as they grow up," explains Adriana Matiz, M.D., a pediatrician and medical director of the WIN for Asthma Program at New York-Presbyterian/Morgan Stanley Children's Hospital in New York City. "Meanwhile, kids are surrounded by greater levels of air pollutants and other triggers. If they're genetically susceptible, this degree of exposure makes it more likely they'll have problems."
And helping a tween or teen deal with asthma brings on a whole new set of challenges. "We often feel overprotective of kids with health problems like asthma," says Noreen Clark, Ph.D., director of the Center for Managing Chronic Disease at the University of Michigan in Ann Arbor, who has studied more than 1,200 kids ages 10 to 13 with asthma. "But this is a group that wants and needs to build their independence. It's also the most important time for them to learn to manage their condition." Whether your kid is packing up for his first sleepover at a friend's house or just landed a spot on the varsity cross-country team, make sure he fully understands what specific factors may aggravate his asthma and the best ways to handle an attack.
Here are ways that asthma could be affecting your tween's or teen's health—and what you can do to help.
Challenge #1: She's sitting on the sidelines.
As many as 90% of asthmatic kids will experience exercise-induced asthma as they get older, says Frank Virant, M.D., chief of the allergy division at Seattle Children's Hospital. "We often see exercise being a trigger by age 10. As kids get bigger and can do more physically, flare-ups tend to increase." This might mean your child struggles to get field time at soccer practice because she's easily winded. "Coaches may mistakenly think a kid with asthma can't do certain activities at a high level," says Dr. Virant. "Plus, some kids are hesitant to complain about symptoms because they don't want to seem 'wimpy.'"
Explain to your tween or teen that wheezing and coughing aren't signs of weakness or being out of shape—they're signals that her immune system is overreacting and needs to be calmed down. Have your doctor write a note to your child's gym teachers and coaches letting them know she can participate in sports and has medicine on hand.
Be proactive and ask gym teachers to plan activities indoors on very cold or very hot and humid days, which can also minimize problems. And say this: "My child is on an effective medical regimen and can participate in sports. But if you notice symptoms, please let me know. Her doctor can adjust her meds."
Challenge #2: He's waking up at night.
"Kids spend a third to half of their time in their bedrooms, which only increases as they get older," says Dr. Virant. "So it's the most important room in the house to asthma-proof." Soft furnishings are dust mite magnets, so trade out drapes and carpets for blinds and wood floors. Minimize piles of stuffed animals and pillows—and kill the dust mites that thrive on them by washing them in hot water or putting them in the freezer for a few hours each week. Bedding should be laundered in hot water weekly, and use pillow protectors and mattress covers to reduce dust mite exposure.
If your kid is also allergic to animal dander, make sure her room is a pet-free zone. Whenever her symptoms are severe, confine your pet to the kitchen, basement, and other easy-to-clean areas, so dander doesn't accumulate.
Challenge #3: She can't use the same beauty products as her friends.
Do your teen's asthma symptoms step up after a trip to Sephora or her morning hairspray routine? If so, she may suffer from fragrance sensitivity—the airborne particles released by chemicals in a wide variety of personal care products and cleaning supplies can cause muscles in the airways to tighten, making breathing difficult, says Dr. Matiz. This sensitivity is less well known than other causes, so it may catch teens and parents off guard—especially in girls who never suffered from asthma until puberty. "There's a relationship between asthma and estrogen levels, and in many girls asthma symptoms sometimes appear when they get their first period," says Clark. "There's also speculation that increased use of heavily fragranced beauty products may be another reason we see more new cases of asthma in teen girls than boys."
If scents trigger symptoms, help your daughter choose hypoallergenic products and avoid anything with "fragrance" or "parfum" listed as ingredients. And be sympathetic. The girls in Clark's study were more likely than boys to feel embarrassed by asthma.
The key is talking to your child so she's empowered to manage her asthma when you're not around. "Encourage her to identify exactly what causes problems," says Clark. Asthma may be something she has to deal with for the rest of her life, so now's the time to teach her that she's in control.
Obesity and Asthma
New research shows a direct link between childhood asthma and obesity: "Overweight or obese kids are more likely to experience asthma symptoms and end up in the ER," says Clark. But experts can't say yet whether asthma makes a kid more susceptible to obesity or if weighing more increases the likelihood of breathing troubles. Either way, parents need to know that it's vital to keep asthmatic tweens and teens exercising and eating nutritiously, says Dr. Matiz.
Treat It and Beat It
While kids are diagnosed with asthma at every age, the condition is most likely to develop in boys before they hit age 11, and in girls around puberty. Warning signs to look out for include complaints about chest tightness and a nighttime cough that lasts longer than 10 to 14 days. Ask your child's doctor if the following tips might help ease symptoms.
Have Inhalers on Hand Daily use of an inhaled corticosteroid like Advair or Flovent can prevent symptoms, and albuterol can be used as a rescue medication.
Get Further Testing Treat the underlying cause of asthma in addition to controlling symptoms, says Dr. Virant. "This means pinpointing whether your child also has allergic rhinitis, chronic sinusitis or another respiratory condition that causes asthma attacks, and finding a treatment that addresses that problem."
Consider Allergy Shots Allergy shots may help kids with allergic rhinitis-induced asthma. One study of kids ages 6 to 17 found that those who received allergy shots were able to reduce their dependence on inhaled corticosteroids by 50%.
Originally published in the November 1, 2010, issue of Family Circle magazine.
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