Advice Column, Health, Parenting

Spring allergies and breathing difficulties

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While families are gearing up for spring after a cold winter, planning picnics and hikes with children, others are dreading the allergy season and the medical difficulties it brings along with it. Lets focus on the two most common respiratory related conditions children suffer from and are most prevalent in the winter and early spring seasons, asthma and croup.

While both affect your child’s breathing and the symptoms may seem similar, the conditions are very different and often the methods treatment too.

Lets start with croup. Croup is classified as an upper respiratory condition, which means, unlike asthma, the constriction of the airways happens higher up, in the trachea (windpipe) and larynx (voice box). It most commonly affects children aging from six months to three years however younger babies may develop it as well as children into their early teens, it is less common though. A virus called parainfluenza causes it. Despite the name it is not what we know as flu but can cause result in a runny nose, fever and cough. While this is the most common cause, allergies are also a trigger.

Although croup is often a rapid onset, parents who are aware that their child suffers from croup can help prevent it by steering the child clear of known allergies such as dust, pollen, certain food additives such as Tartrazine as well as monitoring colds the child may develop.  It is identified by a barking cough, horse voice and stridor (grating breathing sounds).

If croup is caught early or a mild case is experienced, simply encouraging the child to inhale steam over a basin or in a shower may well ease the constriction. In more aggressive cases, a trip to the emergency room may be necessary for oxygen therapy and a course of corticosteroids such as prednisone. Do not play the “waiting game” as croup tends to worsen as the temperature drops at night.

Remember to try keeping the child calm. They will be distressed and panic as well as crying often worsens the symptoms.

Asthma on the other hand is a lower respiratory condition and affects the bronchioles (small tubes delivering air through the lungs). Asthma is considered a lifetime condition, especially is it develops in adulthood however children are known to “grow out of it”, however it may return later in life due to lifestyle changes or menopause. It is common for children to suffer from asthma if there is a history of it in the family however there are many other causes including pre-birth risks and environmental influences.

Triggers are causes for attacks to take place and range from a cold, chest infection, environmental aspects such as change in season to allergies, emotional stress, open fires, mold and exercise and is identified by wheezing, coughing, difficulty in breathing and a tight chest

Sadly asthma kills up to 45% of suffers before they reach hospital which is why, when symptoms develop and are considered “out of control” (an inhaler or nebulizer does not ease symptoms considerably), it is important that we take the child to hospital or call an ambulance timeously.

Should your child have been diagnosed with asthma, it is imperative that we carry an inhaler on us at all times. For young children, a spacer (plastic adaptor) should be placed on the front of the inhaler to hold the burst of medication, as it is more difficult for them to synchronize their breath with the inhaler. Be careful not to confuse the two different types of inhalers. One is used when an attack is  experienced; inhalers such as Asthavent or Ventolin are rapid acting and ease the constriction for almost instant relief and can be bought over the counter. The other is a steroid based inhaler such as Budeflam and is used for long-term treatment. This will not provide the relief the child needs in the case of an attack. Nebulizers are often used during an attack and provide similar relief as inhalers. The nebulizer is a machine, which reduces the same drugs you find in inhalers from a liquid form to a mist, which the child then inhales. Studies have shown that children under the age of five, using an inhaler with the correct spacer often benefit more than using a nebulizer. The inhaler administers a lower dosage of medication, however in a far shorter space of time, the nebulizers, which take up to 15 minutes to administer the metered dosage also has a loss rate of over 90% which means the child only inhales less than 10% of the medication versus the 10-40% when using an inhaler. This is not to say nebulizers are not recommended. They are great when dealing with a child who either refuses or is too young to inhale spay from an inhaler. Be aware that a rapid heart rate is also associated with the nebulizer and far less often with the inhaler. While the use of steam like in croup for treatment has never really been clinically proven to be effective, it may help some sufferers, but also worsen others so be careful if choosing to use this method. If you suspect the environment the child is in may be causing the attack, remove them from the environment as quickly as possible. Try and keep them calm and “coach” their breathing, crying may also exacerbate the symptoms.

Always be prepared for known respiratory conditions. Both the conditions we have discussed, if not preventable, are treatable if the correct action is taken timeously. Don’t ever think you are being dramatic by calling an ambulance or taking a child to hospital if you are concerned. They are your children and quick, decisive actions and training will save their lives.

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