Asthma, which is the most common long-term disease diagnosed in children, causes repeated episodes of wheezing, breathlessness, chest tightness and nighttime or early morning coughing.

“These symptoms lead to disrupted activities, sleeplessness and missed school days,” says Dr. Rebecca Gruchalla, director of allergy and immunology clinical services at Children’s Medical Center Dallas.

In 2003, Children’s Medical Center diagnosed 640 new cases of asthma, making it the hospital’s no. 1 patient diagnosis. In addition, in 2003, the hospital logged more than 1,200 inpatient admissions for asthma treatment (128 cases admitted to the pediatric ICU) and more than 4,000 emergency room visits for asthma treatment.

When a child has an asthma attack, the airways that carry air to the lungs become inflamed and swollen, muscles around the airway tighten so less air passes in and out of the lungs, and excess mucus forms in the airways.

Examples of substances in the air that can cause an attack include smoke, dust, chemicals and pet dander. To help reduce these factors:

• Declare war on dust mites. Help limit dust mites by getting rid of carpeting; covering pillows, mattresses and box springs with airtight covers; washing all bedding and stuffed toys in hot water every week; vacuuming every few days; and wiping surfaces with a damp cloth.
• Think twice before getting a pet. If the patient with asthma has known pet allergies, these pets should not be kept in the home.
• Snuff out secondhand smoke. Secondhand smoke increases breathing problems. If you can’t quit smoking, reduce your child’s health risks by smoking outside.
• Filter out pollutants. Central HEPA (high-efficiency particulate air) filters may help to decrease allergen levels in the home.
• Check your home for water leaks. Most commonly found in basements, kitchens and bathrooms, mold and mildew are best controlled by keeping the air circulated and reducing the amount of humidity in the home.

The first step in treating children with asthma is to educate them and their families, Dr. Gruchalla says. Steps should be taken to avoid exposure to triggers that may aggravate asthma. Pharmacological treatments, which are either long-term control or quick-relief agents, also may be used, depending on the severity of asthma.

The Dallas Asthma Consortium, a nonprofit corporation whose mission is to “improve the health and well-being of people with asthma,” suggests using the Rules of Two™ to determine whether your child’s asthma is under control. Ask the following questions:

• Does my child use his or her rescue bronchodilator inhaler more than two times a week?
• Does my child wake up more than twice a month because of asthma?
• Does my child use more than two canisters of rescue bronchodilator a year?

If you answered “yes” to any of the questions, you should contact your child’s physician about anti-inflammatory medicines to help improve breathing and prevent hospitalization.