When the Wheezing Child Does Not Improve…

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Treating AsthmaSo your child is taking inhalers daily as per the doctor’s advice since few months now but still has attacks which need the reliever inhaler and nebulization. Why is this happening despite the daily inhaler treatment?

What actually is asthma?


Asthma is a condition of the air tubes within the lungs and the chest cage, whose walls swell up and which become narrow in response to certain items in the environment and food, and cause cough and breathlessness in the patient.

• Have your child checked for asthma if she or she has repeated cough attacks, cough for more than 15 days, or breathlessness after playing or exercise, disturbed sleep at night due to breathlessness or cough or a family history of asthma.

• Childhood asthma is easy and safe to treat. The doctor will check for the items in the food and environment which may be causing this and also check for other medical conditions side by side which may need to also be treated to control asthma.

• Childhood asthma is genetic in nature, not infectious and need not necessarily be hereditary; if treated properly, the child need not suffer life long

Treating Asthma in children

The goal of asthma treatment is to keep symptoms under control all of the time. Well-controlled asthma means that your child has:

• Minimal or no symptoms

• Few or no asthma flare-ups

• No limitations on physical activities or exercise

• Minimal use of quick-relief (rescue) inhalers, such as albuterol

• Few or no side effects from medications

When treatment does not work

Sometimes a child may continue to show symptoms in spite of religiously following the doctor’s advice. This situation can arise due to several reasons – it is possible that the child may not be asthmatic and the initial diagnosis was wrong. Do a re-evaluation and get a second opinion from the doctor. Also consider the possibility that the diagnosis is correct but:

• The technique of giving the inhaler is incorrect

• The medicine in the inhaler spray is exhausted (does not contain any more medicine)

• The child is not taking the inhaler regularly – has missed doses

• There is some co-existing condition triggering the attacks – such as allergic rhinitis, sinusitis, adenoids enlarged etc which needs to be treated

• The child has exposed to triggers in the food he / she is eating which is triggering the attacks, such as cold drinks, ice cream, etc

• The child is exposed to triggers in the environment, such as pollen, household dust, insecticidal spray, air fresheners, perfumes, exhaust fumes, pollen, animal fur or feathers, cockroaches, exposure to cigarette smoke, dust from civil repairs, etc

• The child’s asthma is triggered by exercise or physical training or use of the gym by adolescent asthmatics.

Setting rules and limits

Parents often find it difficult to completely monitor and control their child’s eating and lifestyle habits. There is just too much temptation these days.

Symptoms and treating asthma attack in progress. Preventive, long-term control medications reduce the inflammation in your child’s airways that leads to symptoms. Quick-relief medications quickly open swollen airways that are limiting breathing. Most children with persistent asthma use a combination of long-term control medications and quick-relief medications, taken with a hand-held inhaler.

In some cases, medications to treat allergies also are needed. The right medication for your child depends on a number of things, including his or her age, symptoms, asthma triggers and what seems to work best to keep his or her asthma under control.

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