According to statistics from The Asthma Foundation, over the last twenty years, there has been a worldwide increase in childhood asthma. It dramatically affects the lives of one in four children and one in seven adolescents. It is also a major cause of hospitalisation in children.

Current medical opinion attributes modern environmental conditions to this worldwide increase. Dr. John Avent from the Childhood Diseases Society found that the homes of children who developed asthma had much lower levels of bacterial endotoxin, a substance which is found in dust – in other words, those homes were too clean. Whilst Dr. Avent doesn’t recommend poor cleaning practices, he does maintain that there is an argument for parents allowing their children to play in less sanitary conditions and be less vigilant in this way about their environment.

Martin McFarlane of the Asthma Sufferers’ Association has been involved in subsequent studies which have shown that children who had frequent respiratory infections were less likely to develop asthma as they grew older because of their early exposure to bacterial endotoxins. He maintains that this early exposure helped children to become stronger so they could avoid becoming overly sensitive to conditions that potentially trigger asthma. Dr. Leonie Bryce draws on this research and gives attention to recent studies into asthma which have suggested that the use of antibiotics may be instrumental in causing childhood asthma because early childhood infections protect children against asthma through the development of antibodies. As she says, “For this reason I am against the over-frequent use of antibiotics in treating childhood illnesses of any kind, particularly respiratory infections”.

On a more positive note, more than half of childhood asthma sufferers will not have asthma as adults. However, research has identified a sliding scale of the most important risk factors that can tell a doctor whether a child will have asthma into adulthood. Firstly, young girls are more than two times more prone to having asthma into their adult years. This is a very high risk factor. The next risk factor of less importance but still representing a danger is whether a child has allergies and allergic reactions to a variety of products. Next in importance is whether the child was older than five when asthma first occurred. The most overwhelming risk factor, however, that contributes to asthma in adulthood is if asthma is common in the family (if a child has a parent or sibling with asthma). In this case, there is an extremely high chance that the child will develop asthma into adulthood. Since asthma is a major cause of hospitalisation in children, parents should try to be aware of what triggers their child’s asthma and ensure that he or she is not exposed. For example, if house dust mites are a cause, parents should cover bed mattresses and pillows in vinyl covers. Weekly hot washing of bed linen is recommended and, if possible, blankets and quilts should be exposed to direct sunlight for several hours every week. Also parents are advised to avoid pillows and quilts made of feathers and wool. Smaller items can be put into a plastic bag in the freezer for four hours every fortnight and surfaces in the home should be dusted two or three times a week.

The National Asthma Council makes a number of recommendations for controlling asthma. Apart from parents ensuring that their child avoids the things that cause their asthma, their two most important tips are regular exercise and a healthy balanced diet. According to Dr Mary Tong, paediatric allergist and immunologist at the Royal Australian Hospital in Melbourne, there is no basis for the widely held view that dairy foods increase mucus production in the airways, making asthma worse. Dietary restrictions are not necessary unless there is a proven food allergy. Dr. Tong reiterates that dairy foods are an important source of calcium for strong teeth and bones and are particularly important for growing children.

Another recommendation is that parents should make sure that their family doctor is someone who has maintained a real interest in asthma – they should visit that doctor for regular review in order to check on their child’s correct use of asthma medication. They should aim to know their child’s symptoms and how best to treat them. To this end, the National Asthma Council recommends that parents of young children with asthma develop an Asthma Action Plan. The Plan, created in conjunction with their family doctor, should outline ways to monitor the asthma – by keeping a diary of asthma symptoms, for example. It should also outline the ways in which a parent can recognise worsening asthma, what to do when this happens and how and when to get medical help quickly.

By following the recommendations, parents are given the tools with which to manage, and even control, their child’s asthma.

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