Treating Hard To Control Asthma

Does your child have asthma?

Are his asthma symptoms easy to control or are they getting in the way of doing routine things, like sleeping through the night or playing outside with friends?

What Triggers Your Child’s Asthma?

As with many other childhood conditions, it is often better to avoid asthma flareups instead of trying to treat them.

That doesn’t necessarily mean it is easy though.

Still, you might try to avoid common asthma triggers, such as:

  • allergies – dust mites, pet dander, mold, pollen, etc.
  • exercise
  • infections
  • smoke
  • pollution
  • weather changes

Keep track of your child’s symptoms to see if you can identify any triggers.

Asthma Treatments for Kids

The most common treatment for asthma symptoms are the quick-relief medications, including albuterol (ProAir, Ventolin, Proventil) and levalbuterol (Xopenex). Either with a nebulizer, inhaler with a spacer, or inhaler alone, they can help when your child is coughing and wheezing.

If your child has severe or frequent asthma symptoms or attacks, the next treatment step is to use a long-term control medication, starting with an inhaled steroid (Alvesco, Asmanex, Flovent, Pulmicort, Qvar) and moving to a combined inhaled steroid and long acting beta-agonist (Advair, Dulera, Symbicort) if necessary.

Other asthma treatments can include:

  • oral steroids – often used short term for asthma flares with quick-relief medications
  • leukotriene modifiers – Singulair (montelukast) is a once-a-day pill that can be used to prevent both allergies and asthma in some kids

An asthma action plan can help make sure you know how and when to use your child’s asthma medications.

Treating Hard To Control Asthma

What do you do if your child’s asthma medicines aren’t working?

If your child continues to have regular asthma symptoms or attacks, ask yourself these questions and share the answers with your pediatrician:

  • Is your child really using his inhaler? Non-compliance is the most common reason for kids to have poorly controlled asthma. Remember, long-term control medications are used every day, even when your child doesn’t have any asthma symptoms. They prevent asthma attacks and asthma symptoms that can be treated with the as need use of your child’s quick-relief medications.
  • Is your child using his inhaler correctly? If not, his asthma medicine might not be making it to his lungs where it needs to go to work.
  • Is your child with exercise-induced asthma using his quick-relief inhaler before exercise?
  • Does your child need a step-up in therapy? Long-term control medications are available in a variety of strengths and your child may need a higher dosage if she is still having asthma symptoms. Or she may need to move from an inhaled steroid to a combined inhaled steroid and long acting beta-agonist inhaler.
  • Would allergy testing help you identify your child’s triggers?
  • Does your child have acid reflux?
  • Could stress be triggering your child’s asthma symptoms?
  • Does your child really have asthma? Both vocal cord dysfunction and exercise-induced laryngeal obstruction are asthma mimics that can be misdiagnosed as asthma.

A pediatric allergist and/or a pediatric pulmonologist can help your child with hard to control asthma.

What To Know About Treating Hard To Control Asthma

Asthma can be a life-threatening condition, so be sure to seek extra help if your child has difficult to control symptoms, especially if you have already tried many of these classic asthma treatments.

For More Information About Treating Hard To Control Asthma

Last Updated on December 3, 2016 by Vincent Iannelli, MD

Author: Vincent Iannelli, MD

Vincent Iannelli, MD

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