An effective way to keep symptoms down is to avoid triggers that cause asthma symptoms to appear. These triggers can be found everywhere — in your home, in daycare facilities, and even outside. (See Chapter 4.) But you can take a few steps to make sure these triggers don't have the upper hand in aggravating your child's asthma.
Viral infections are among the most common asthma triggers among young children. Unfortunately, they are difficult to avoid.
You can take at least one step to avoid a viral infection by getting a flu shot each year. Prior to each year's flu season, the NIH guidelines call for the use of an inactivated flu vaccine for children six months of age or older.
The Centers for Disease Control and Prevention (CDC) has called for individuals with asthma to be vaccinated because they may be at an increased risk of getting complications from the flu. These risks include increased hospitalizations and increased use of antibiotics.
The CDC noted that among asthmatic children in 2005, one-third of children who were ages two to four years had a flu shot. This was the highest among all children. However, the CDC noted that this figure is still low.
The NIH guideline panel has cautioned, though, that the flu vaccine should not be given to a patient with the expectation that it will reduce either the frequency or severity of an asthma episode during the flu season.
Triggers at Home
Research has shown that removal of allergic triggers in the home — ranging from dust mites to cockroaches to mold — can sometimes be as effective as medication in controlling asthma symptoms. (See Chapters 4 and 16.)
For the young child, special attention should be paid to blankets, mattresses, and pillows where triggers, particularly dust mites, can hide. Washing bedding materials in hot water (over 130° Fahrenheit) at least weekly can help, along with using allergy-preventing mattress and pillow covers. Cleaning hard-surfaced toys and laundering stuffed animals weekly can also help reduce triggers.
It's never too early to emphasize to young children the importance of washing their hands. Whether crawling on the floor or playing with toys, they can pick up germs and viruses that could lead to upper respiratory infections.
Exposure to Danders
Sometimes, exposure to a trigger may lead to the opposite effect and maybe reduce asthma symptoms. Take dogs, for example. Recent research has found that exposure to dogs in infancy and early childhood decreased symptoms later in life.
The research, part of the Childhood Origins of ASThma (COAST) project, evaluated the relationship of pet ownership on asthma diagnosis and wheezing in children. Dog exposure was found to significantly reduce the number of children who had tested positive for allergens.
Of the children studied, 18 percent of the children who had dogs at both birth and age three were diagnosed with asthma symptoms by age six; meanwhile, 34 percent of children who didn't have dogs at either age were diagnosed. Those with dogs at age three but not at birth had a 31 percent asthma rate, while those with dogs at birth only had a 25 percent rate.
The COAST project also explored cat ownership, but did not find such a correlation between cat ownership and reduced asthma rates. However, ongoing research is needed to confirm or reject this information and is continuing in this study and others. No recommendation has been made to own — or not own — any animal in attempting to prevent or minimize asthma in children.
Exposure to secondhand smoke can often trigger asthma attacks, make asthma symptoms more severe, and lead to increased use of medications. Approximately 11 percent of children age six years or younger are exposed to secondhand smoke in their homes on a regular basis (about four or more days per week), according to recent studies.
While an infant or young child with asthma may or may not cough or wheeze when exposed to tobacco smoke, research has shown that it still is irritating her lungs. Even in children without asthma, tobacco smoke can cause problems with chronic cough, congestion, and ear infections. However, when exposure is eliminated, a child's asthma symptoms usually improve.