Fall can trigger allergy symptoms in children

Dr. Manav Singla, a specialist at the Asthma Allergy & Sinus Center in Baltimore.
Dr. Manav Singla, a specialist at the Asthma Allergy & Sinus Center in Baltimore. (Baltimore Sun)

The beginning of the school year is a time when allergy symptoms in children may flare up. Dr. Manav Singla, a specialist at the Asthma Allergy & Sinus Center in Baltimore, said the change in fall temperature, allergens and environment during this time can trigger an increase in mucus production as well as increased inflammation in the large and small airways of the lungs. He talks about how parents can help their children manage asthma symptoms.

What is asthma and what are the symptoms?


Asthma is a chronic condition that causes inflammation in the large and small airways of the lungs. Inflamed airways are constricted and blocked with mucus, making it difficult to breathe. Other symptoms include coughing, wheezing and a tight feeling in the chest. Nearly 25 million people suffer from asthma, 7 million of whom are children.

Why does the time around the beginning of school lead to increased asthma attacks?


Exposure to allergens and germs leads to increased asthma attacks this time of year. Ragweed pollen and airborne mold levels are high in the fall and can trigger symptoms of asthma, especially when children are outdoors. In school, children can pass germs to each other that trigger asthma. Common respiratory pathogens and influenza can cause airway inflammation, leading to coughing, wheezing and shortness of breath.

How can parents help better manage their child's asthma during this time?

Parents should monitor their child's symptoms and medication intake. Use of quick-relief inhalers more than twice a week is a sign that asthma is not controlled, and parents should talk to their child's doctor about adjusting the treatment plan. During the fall months, asthma triggers like mold and ragweed pollen tend to peak, which can cause an increase in asthma symptoms. Each asthma patient is different, so it's important to track what triggers cause your child's asthma symptoms and avoid them as much as possible.

It's helpful to keep track of your child's asthma in an asthma diary. In the asthma diary, you can record the frequency of your child's exacerbations and what symptoms they experience such as the coughing, wheezing or chest tightness. Asthma diaries not only help parents identify triggers and track symptoms, but also help improve communication between parents and their child's doctor.

Additionally, an action plan is crucial to asthma management and helps parents and teachers respond when a child has an attack. See your child's doctor before school starts or early in the school year to stay up to date on proper treatment and work with him or her to complete the action plan and share it with the school nurse.

Asthma diaries and action plans as well as downloadable doctor discussion guides can be found online at GetSmartAboutAsthma.com.

What are the consequences of not managing your child's asthma?

Uncontrolled asthma has an impact. Fourteen million school days are lost to asthma every year — about 36,000 kids per day. Missed school days can affect children's academic performance and participation in school activities.

Nighttime symptoms are also a sign of uncontrolled asthma: Children can wake up due to coughing and asthma attacks.

Proper treatment can prevent these symptoms, so that children can fully participate in school and sleep through the night.

Why is it important to treat asthma even if there are no symptoms such as wheezing?

Asthma is a chronic condition, so inflammation is always present in the lungs, even when there is no wheezing. Often people can tire easily, have less energy and may not feel like participating in sports. These symptoms can be easy to overlook, when in fact they are a signal that asthma is a bigger problem.


Daily controller medications help alleviate these symptoms.

How do you know if your child's asthma is under control?

If your child uses a quick-relief inhaler for an asthma attack more than twice a week, his asthma is not controlled, and you should talk to your doctor about a daily prevention medicine or controller inhaler.

Every child's asthma is unique and can change over time, so it's important to see your child's doctor regularly to make sure the treatment plan is effective. Understanding your child's triggers, symptoms, and treatment is an essential component of managing asthma.

What are some of the newer technologies for diagnosis and assessment of asthma?

Older tests, like spirometry, or pulmonary function tests, are a great way to measure the size of the airways. This test measures the amount of air in the lungs, which may be compromised from inflammation, but it does not measure inflammation directly.

Newer technologies give doctors more information about airway inflammation. One of the most exciting has been exhaled nitric oxide. This is a breathing test that measures the amount of nitric oxide in the air a patient exhales. When present, it suggests that the airways are filled with inflammation, which can then be treated with daily controller inhalers. Impulse oscillometry is another new breathing test that measures both the large and small airways.


Recommended on Baltimore Sun