Tag: cough

Childhood Asthma (1) – Symptoms and Trigger factors

Some parents do not believe that children even toddlers can have asthma! However this is true! It is important therefore for parents to know and understand childhood asthma.

Additionally unlike most other child health issues where we as paediatricians frown on self-medication by parents, in asthma we actually encourage that! Shocked? It is true and indeed a common saying is that parents actually manage asthma in children, doctors only support!

This article and the second part will explain all you need to know about childhood asthma.

What is asthma?

Asthma is a chronic condition characterized by reversible obstruction of the airways. This is because the airway of an individual with asthma is programmed to react this way when exposed to some substances or conditions. These substances / conditions are what we call triggers.

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers such as inhaling airborne pollen or catching a cold or other respiratory infection.

Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, poorly managed asthma can cause dangerous asthma attacks.

Childhood asthma is not a different disease from asthma in adults. However, children tend to face unique challenges. Asthma in children is a leading cause of emergency department visits, hospitalizations and missed school days.

Among children and adolescents aged 5-17 years, asthma accounts for a loss of 10 million school days annually and costs caretakers $726.1 million per year because of work absence. So the burden of asthma extends beyond the child to the caregivers and affects productivity.

COMMON CHILDHOOD ASTHMA SIGNS AND SYMPTOMS INCLUDE:

WHEEZING : Wheezing is a musical, high-pitched whistling sound produced by obstruction to airflow. It is one of the most common symptoms of asthma. The wheezing is usually during exhalation (expiration or breathing out).

COUGH: Usually, the cough is nonproductive and non paroxysmal; coughing may be present with wheezing.

COUGH AT NIGHT OR WITH EXERCISE :Cough at night or with exercise may be the only symptom of asthma especially in cases of exercise-induced or nocturnal asthma. Children with nocturnal asthma tend to cough after midnight or during the early hours of morning

SHOTNESS OF BREATH OR TIGHT CHEST: A history of tightness or pain in the chest may be present with or without other symptoms of asthma, especially in exercise-induced or nocturnal asthma

What causes asthma?

ENVIRONMENTAL AND GENETIC FACTORS
Asthma tends to run in families. It has a genetic component. History of asthma in the maternal family is associated with a higher risk of asthma. Asthma is also commoner in males

Environmental and genetic factors have been associated with the development of asthma. Interactions between environmental and genetic factors result in airway inflammation, which limits airflow and leads to changes in the function and structure of the airways.

TRIGGERS
In most cases of asthma in children, multiple triggers or precipitants are recognized, and the patterns of reactivity may change with age. Triggers include:

1. Viral infections such as common cold
2. Exposure to air pollutants
3. Allergies to dust mites
4. Pet dander
5. Pollen or mold
6. Physical activity
7. Changes in weather or cold air
8. Previous allergic reactions including skin reactions
9. Food allergy or hay fever (allergic rhinitis)
10. Hives or eczema
11. Living in an urban area with increased exposure to air pollution
12. Obesity
13. Emotions

Any child with the symptoms listed above needs to be evaluated by a Paediatrician. At the least do see a general practitioner.

In the second and concluding part of this article, we will look at what to do when a child has an asthma attacks and how to prevent asthma attacks.

CHILDHOOD KILLER DISEASES – PNEUMONIA

Key Facts about pneumonia!!

  • Pneumonia accounts for 16% of all deaths of children under 5 years old, killing 920 136 children in 2015. pneumonia
  • Pneumonia can be caused by viruses, bacteria, or fungi.
  • It can be prevented by immunization, adequate nutrition, and by addressing environmental factors.
  • Furthermore, it is caused by bacteria can be treated with antibiotics, but only one-third of children with pneumonia receive the antibiotics they need.

What is Pneumonia?

Pneumonia is a general term for lung infections that can be caused by a variety of germs (viruses, bacteria, fungi, and parasites).

The most common bacterial causes are Streptococcus pneumonia  and Haemophilus influenza type b (Hib).  Respiratory syncytial virus is the most common viral cause.

Pneumonia is a contagious diseases that can be spread in a number of ways.

The viruses and bacteria that are commonly found in a child’s nose or throat, can infect the lungs if they are inhaled.

They may also spread via air-borne droplets from a cough or sneeze.

In addition, pneumonia may spread through blood, especially during and shortly after birth.

Risk Factors for Pneumonia

Most healthy children can fight infections with their natural immunity.

Children whose immune systems are compromised are at higher risk of developing pneumonia.

  • A child’s immune system may be weakened by malnutrition
  • Failure to exclusively breastfeed infants
  • Presence of other illnesses such as HIV infections and measles also increase a child’s risk of contracting pneumonia.
  • Indoor air pollution caused by cooking and heating with biomass fuels such as wood or dung
  • Overcrowding – living in crowded homes
  • Parental smoking.
  • Daycare attendance

Signs and Symptoms of Pneumonia

  • fever usually high and sometimes associated with chills,
  • cough,
  • very fast breathing (in some cases, this is the only symptom)
  • Noisy breathing with grunting or wheezing sounds
  • Difficulty with breathing – that is working hard to breathe; this can include flaring of the nostrils, belly breathing, or movement of the muscles between the ribs
  • Vomiting
  • Chest pain in older children who can complain
  • Abdominal pain, which often happens because a child is coughing and working hard to breathe
  • Weakness – less activity
  • Loss of appetite (in older kids) or poor feeding (in infants), which may lead to dehydration
  • In extreme cases, bluish or gray color of the lips and fingernails

Children with pneumonia caused by bacteria usually become sick fairly quickly, starting with a sudden high fever and unusually fast breathing. Those with pneumonia caused by viruses probably will have symptoms that appear more gradually and are less severe, wheezing can be more common.

What to do in a child with suspected Pneumonia?

  1. Take to the hospital immediately! A doctor needs to examine the child to confirm the diagnosis of pneumonia. Delay in diagnosis and treatment is responsible for the high number of deaths from pneumonia especially in the under-five children.
  2. Treatment is usually with antibiotics. For those who presented to the hospital early, treatment with antibiotics by mouth is okay but for those with severe symptoms especially breathing difficulty, they will require hospital admissions and antibiotics given into the veins (intravenous antibiotics).
  3. Some children may need other supportive treatment like oxygen, intravenous fluids (drips) and drugs to bring down the fever (antipyretics).

Prevention of Pneumonia

There is no reason any child should die from pneumonia. There are well-known preventive strategies

  1. Exclusive breastfeeding for the first 6 months of life protects the child from respiratory infections including pneumonia
  2. Immunization – especially the Pneumococcal Conjugate Vaccine (PCV), the Haemophilus Influenza Type B Vaccine (HIB) usually part of the PENTA vaccine and Measles vaccines are especially targetted to preventing pneumonia.
  3. Avoid overcrowding. Make sure that children sleep in well-ventilated rooms
  4. Avoidance of air-pollution – no parental smoking! No cooking with firewood and stoves in the room close to children. Keep children away from smokes and insecticides sprays
  5. Ensure that children eat adequate meals and are well-nourished.
  6. Keep children away from adults with upper respiratory tract infections. Also keep children at home when they have respiratory infections.
  7. Go to Hospital early if a child has cough and is breathing fast. PLEASE DO NOT RELY on Cough syrup!!! Take the child to hospital immediately. Early diagnosis and treatment will prevent the child from dying from pneumonia.

Join us in ensuring that no child dies from Pneumonia!!