Diagnose

What is asthma?

Asthma is a chronic lung condition affecting tubes called airways. These tubes carry air in and out of the lungs. In a child with asthma, airways react to certain triggers, causing:

  • The airways to swell
  • Thick, sticky mucus to fill the airways
  • The muscles that wrap around the airways to squeeze tight

In Georgia, about 1 in 10 children under age 18 has asthma. That rate is one of the highest in the nation. Asthma is the number one reason for admission to Children’s, and leads to more than half a million missed school days annually.

Download "Asthma: What you need to know"

What are the signs and symptoms of asthma?

The sooner you know whether your child has asthma, the sooner you can seek help in managing it. Common asthma symptoms include:

  • Cough with or without phlegm
  • Shortness of breath that worsens with activity
  • Chest pain, congestion or tightness
  • Wheezing or whistling when exhaling

When asthma symptoms suddenly get worse, it’s called an asthma attack. Asthma attacks are caused when the airways in your child’s lungs are bothered by an asthma trigger. You, your child and everyone who cares for your child will need to know when to use quick relief medication and when to seek emergency help.

Signs that your child may be having an asthma attack include:

  • Shortness of breath
  • Continual coughing
  • Skin between ribs or near neck that is pulling inward
  • Bluish color to lips or fingernails
  • Difficulty completing a sentence without taking a breath

What causes asthma attacks?

Asthma attacks are caused when the airways in your child’s lungs are bothered by an asthma trigger. Each child’s asthma triggers are different. It’s important to know your child’s asthma triggers so you can avoid them when possible.

Common asthma triggers include:

  • Pollen
  • Seasonal allergies
  • Cold
  • Flu
  • Weather
  • Roaches and pests
  • Molds
  • Air pollution
  • Smoke
  • Dust mites
  • Exercise
  • Pets and animals
  • Odors
  • Exposure to violence
  • Strong emotions and stress

Read our tip sheet and learn more about how to help your child avoid asthma triggers.

Download asthma triggers PDF (en Español) 

Asthma and allergies

Asthma and allergies are different conditions, but they often go hand-in-hand. Severe allergies can trigger an asthma attack.

The same substances that trigger your child's allergy symptoms can also cause asthma signs and symptoms. Common allergy-related triggers in Georgia are:

  • Pollen
  • Dust mites 
  • Pet dander

Some of these allergy and asthma triggers, such as pollen, are seasonal. Others can cause symptoms year-round. You can reduce your child’s symptoms by avoiding your child’s exposure to allergens whenever possible.

Do you suspect your child suffers from allergies along with asthma?

  • Request allergy testing to help identify specific allergies.
  • Keep all windows closed and use air conditioning during pollen season.
  • Know when the pollen count is high and consider treating your child’s allergies before symptoms start.

Most treatments are designed to treat either asthma or allergies, but a few treatments help with both conditions. Ask your child's doctor for more information, and to see if allergy shots might help.

Take Action

Steps to get help

Although asthma can’t be cured, it can be controlled. When asthma isn't well controlled, it can result in emergency department visits and can threaten your child’s life.

At Children’s, we can help you stay in control of your child's asthma:

  1. Contact your child's pediatrician to request a referral.
  2. To set up your child's first visit, call 404-785-KIDS (5437).
  3. Download the Asthma Action Plan for:

Our unique approach

Our doctors are specially trained to care for kids and teens who have asthma and breathing problems.

How can Children’s help your child?

  • We help kids manage their symptoms and live full, active lives. That means less down time and less time away from school.
  • We have a whole team—doctors, nurses and educators—that will design a personalized asthma care plan for your child.
  • We offer technology just for children. We have special diagnostic tools to measure a child’s lung capacity and function.

Children’s also offers:

  • Allergy testing, evaluation and allergy shots
  • An asthma control test at every visit
  • Communication with primary care physicians to coordinate care for best asthma management
  • Access to an after-hours, on-call asthma physician
  • Education for patients’ families and school staff
  • Partnering with asthma-related community wellness programs
  • High-Risk Asthma Program to provide closer monitoring and care to patients who have severe asthma

Learn more about what makes Children’s special

Manage

Asthma control

Kids with asthma can live active lives. Your child's doctor, school nurse and family are the keys to controlling asthma symptoms. With the right plan in place, your child can do more than just cope with asthma symptoms; he or she can take control of asthma.

What does it mean to be in control of asthma?

  • Signs of asthma happen fewer than two times a week
  • Sleep is disturbed by asthma fewer than two times a month
  • No limits on activity because of asthma
  • Fewer than two visits to the emergency department or courses of oral steroids each year

Be sure to talk to your child’s doctor about:

  • How asthma affects your child’s life
  • Signs of uncontrolled asthma
  • Problems taking medicine
  • Working together to create an asthma action plan for your child

Six ways you can help:

  1. Make sure your child uses controller medicine correctly every day
  2. Visit your child's doctor at least four times a year for asthma checkups
  3. Know what makes your child’s asthma worse and how to avoid triggers
  4. Know how to use quick relief medications during asthma attacks
  5. Have an asthma action plan and help your child follow it
  6. Give your child's school, day care and sports programs a copy of the asthma action plan and medicine schedule

Asthma action plan

If your child doesn’t have an asthma action plan, talk to his doctor about getting one. A copy of the plan should be with your child’s school, day care center, babysitter, coach, grandparent and anyone else that helps take care of your child. It will help them understand how to recognize and handle an asthma attack.

The asthma action plan should include:

  • Your child's prescribed controller and quick-relief medications
  • What to do when your child is having an asthma attack
  • How to identify warning signs of an asthma attack
  • Your child's triggers
  • Emergency contact information
  • Guidelines for treatment before activity

Download the Asthma Action Plan for:

Community outreach

The best way to fight asthma is through a community approach. The Children’s asthma team works with many community groups and programs to help care for children with asthma where they live, learn and play.

Education
We provide on-site and Web-based asthma education to:

  • School staffs
  • Parent groups
  • After-school programs
  • Other healthcare professionals
  • School nurses and clinic workers
  • Child care centers
  • Primary care physicians’ offices
  • Community groups

Equipment
We provide asthma equipment, such as spacers and nebulizers, to school nurses in Atlanta for students who have special medical and financial needs.

Camp Breathe Easy
We help plan and provide education at Camp Breathe Easy, a six-day, five-night camp for children ages 7 to 13 who have asthma.

Learn more about Camp Breathe Easy

Contact us
To learn more about our community outreach programs, contact Ginger Tuminello at 404-785-7240.

Prevent

Asthma medicines

Many different kinds of medicines can be prescribed for children who have asthma. Read on to learn more about the most common types.

Quick-relief medicines

Short-acting inhaled bronchodilators

These medicines can save your child's life during an asthma attack. They relax the muscles around airways to open the airways and help breathing. They work very quickly but only for a short amount of time, about three to six hours.

Your child should have this medicine, along with a spacer, available at all times. Talk to your child’s teacher and school nurse about where to keep quick relief medicines at school. You child should be able to get the medicines quickly and easily during an asthma attack.

Inhaled bronchodilators have many different names. No matter what the brand name is, the word "albuterol" should be on the canister. Remember "ALbuterol, ALways have it with you."

These can be given as a nebulizer breathing treatment or through an inhaler. Inhalers need to be used with a spacer. Without a spacer, your child is only getting about 35 percent of the medicine to the airways. If your child uses an inhaler, ask your doctor for a spacer.

Anticholinergics

Anticholinergics are given with short-acting inhaled bronchodilators for severe asthma attacks. Anticholinergics also relax the muscles surrounding the airways to open the airways and help breathing.

Oral corticosteroids

Oral corticosteroids are used for asthma attacks that are not relieved by short-acting inhaled bronchodilators. These medicines work to reduce the swelling in the airway.

Oral steroids are either liquid or pills and are taken by mouth. Your child should continue taking his controller medicines even if he is prescribed oral steroids.

Controller medicines

Controller medicines are taken every day. They prevent and reduce swelling on the inside of the airway, which also prevents asthma attacks or flare-ups. They do not work quickly, but they work for a long time, usually several hours.

There are three types of controller medicines:

Inhaled corticosteroids

Inhaled corticosteroids are the controller medicines that reduce and prevent airway inflammation or swelling. Used daily, inhaled corticosteroids treat the underlying part of asthma that you may not feel or see.

Combination medicines

Combination medicines contain both long-acting bronchodilator and inhaled corticosteroids. These medicines prevent and reduce swelling of the airway and relax the muscles that surround the airway for up to 12 hours.

All inhalers need to be used with a spacer. Without a spacer, your child is only getting about 35 percent of the medicine to the airway If your child uses an inhaler, ask your doctor for a spacer.

Leukotriene modifiers

These medicines block the effects of leukotrienes, which are molecules in the immune system that can cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours.

Medicines for asthma triggered by allergies

Asthma and allergies often go hand-in-hand. If your child’s allergies can be controlled, his asthma might also be controlled.

There are five types of medicines for asthma triggered by allergies:

Steroid nasal sprays

Steroid nasal sprays are used to prevent the release of substances in the body that cause inflammation or swelling. They are also used to treat nasal symptoms, like congestion, sneezing and runny nose caused by seasonal and year-round allergies.

It is important to use saline nose spray before using steroid nasal sprays. This helps remove mucus that could prevent the medicine from getting where it needs to go. Saline nose spray is available at the grocery or drug store without a prescription.

To use saline nose spray:

  • Spray both sides of the nose with several squirts of saline nose spray.
  • Ask your child to blow his nose, and repeat saline nose spray if needed. If your child cannot blow his or her nose, just let the spray drip out and wipe your child’s nose.
  • When your child’s nose is clean, use steroid nasal spray as prescribed.

Antihistamines

Antihistamines are used to reduce or block histamines, the chemicals that cause allergy symptoms. They are available both by prescription and over the counter. Some antihistamines can make your child tired, while others usually do not.

Epinephrine autoinjector

Epinephrine autoinjectors are used to treat anaphylaxis, a life-threatening allergic reaction. Epinephrine is given as an injection, where it enters the bloodstream and works quickly against serious allergy symptoms by decreasing swelling and raising blood pressure.

If your child has been diagnosed with severe allergies to insect bites, insect stings, foods or medications, he should have an epinephrine autoinjector with him at all times.

Allergy shots

Allergy shots, or immunotherapy, may be an option if avoiding allergic triggers doesn’t help control your child’s asthma.

First, your child’s allergy doctor will do testing to find out what your child is allergic to. Then your child can begin getting allergy shots. Usually these shots are given once a week for a few months, and then once a month for three to five years. Over time, your child should become less allergic.

Xolair® (Omalizumab)

This medicine can be used to treat asthma triggered by allergens in the air. If your child has allergies, his immune system makes antibodies that attack things that usually cause no harm, like pollen, dust mites and pet dander. Xolair blocks these antibodies, reducing allergy and asthma symptoms.

Xolair is given by injection every two to four weeks. It isn’t usually recommended for children under 12. In rare cases, Xolair has triggered a life-threatening allergic reaction called anaphylaxis.

Anyone who takes Xolair should be monitored closely by a healthcare professional after getting an injection in case of severe reaction.

Staying active with asthma

Exercise is important for all children and teens, including those with asthma. With the right treatment and planning, your child can be active at home and school.

Have an asthma action plan
Written by your child’s doctor, an asthma action plan gives steps to treat your child when he has asthma signs. Make sure your child’s school, coach and anyone who cares for your child has a copy of this plan.

If exercise is one of your child’s triggers, talk to your child’s doctor about pretreating with a quick-relief inhaler with a spacer 15 to 20 minutes before exercise. Pretreating could help your child breathe easier.

Encourage activity
Being active is healthy and important for good health. Let teachers, coaches and caregivers know your child has asthma, and make sure they all have a copy of the asthma action plan.

Your child should:

  • Have quick and easy access to asthma medicines at all times
  • Pretreat with a quick-relief inhaler with a spacer 15 to 20 minutes before exercise if that is part of the asthma action plan
  • Warm up and cool down for 10 minutes before and after exercise
  • Drink plenty of water before and during exercise

Know the early warning signs
Signs that your child may be having asthma problems include:

  • Chest tightness
  • Coughing
  • Difficulty doing most physical activities
  • Trouble breathing
  • Wheezing

Take a break
Stop activity if you see any early warning signs, or if your child reports any early warning signs. Signs can last for a few minutes to more than an hour. Let your child play a board game, walk or do some other relaxing activity. Use quick relief medications or seek medical help if the warning signs do not go away.

Let your child stay involved. Feeling left out could affect your child’s self-image.

Our Unique Approach

Meet our asthma team

Locations

Hughes Spalding hospital

35 Jesse Hill Jr. Drive SE

Atlanta, GA 30303

Children's at North Druid Hills

1605 Chantilly Drive NE

Atlanta, GA 30324-3269

Children's at Old Milton Parkway

3300 Old Milton Parkway

Alpharetta, GA 30005

Oak Hill Professional Park

60 Oak Hill Blvd.

Newnan, GA 30265

Pavilion at Lake Hearn

1100 Lake Hearn Drive

Atlanta, GA 30342

Resource Medical

1500 Oglethorpe Avenue, Building 600EF

Athens, GA 30606