Breathless winters

Asthma is one of the most common chronic disorders in childhood. Unfortunately, caregivers are often misinformed when they seek asthma treatment for their children, writes Dr Bharat Reddy. Cosy woollens, hot tea and sun basking — that is how winters in the city are characterised. Living in a place where summers can be extremely oppressive, the chill in the air is usually a welcome change for everyone. But not for a child suffering from asthma, for whom the cold dry winter months mean frequent attacks and severe breathing difficulties.

A chronic respiratory disease affecting 14 per cent of children around the globe, asthma is often associated with worsening of symptoms during cold winter months. Considering the fact that the lungs and airway passages of an asthmatic child are already sensitive, wherein the cold dry air and high occurrence of viruses in the cold environment are perfect to set off a major asthmatic event.

During winter months, rates of hospitalisation in children on account of asthma go up by many notches. Contrary to common perception, asthma (a reversible obstructive lung disease caused by increased reaction of the airways to various stimuli) is not an ‘old man’s disease’. Asthma is one of the most common chronic disorders in childhood, currently affecting about 7.1 million children under 18 years of age.

It is important for parents to understand that with the right treatment and medications, asthma symptoms related to cold winters can be controlled and managed to a large
extent. In asthma, due to swelling in the lining of the airways, which leads to narrowing of the airways and sticky mucus or phlegm build-up that blocks the airways, breathing is difficult and forced.

During winters, the cold air causes airways to tighten further, making it even more difficult to breath.

Unfortunately, parents and caregivers are most often misinformed when they seek asthma treatment for their child.

Asthma affects only those children who have a family history, asthma is communicable, asthma can be easily treated with fish therapy, alternative medicine is better, yoga alone can help prevent attack, asthma can be prevented just by avoiding triggers, inhaler is the last resort — these are common myths with regard to asthma treatment. It is, therefore, imperative for healthcare practitioners to educate parents and caregivers about early disease acceptance and importance of effective treatment modalities with minimal side-effects and fast action like inhaled corticosteroids — in other words, inhalation therapy.

Inhalation therapy involves an inhaler pump to administer corticosteroids into the airway passage. It has been commonly observed that the word ‘steroid’ evokes
apprehensions in the minds of parents causing them to shy away from letting their child use inhalers. They are unaware of the fact that corticosteroids in inhalers are a copy of the steroids produced naturally by our body to deal with inflammation and are absolutely safe for children and even pregnant women.

The correlation between inhalation therapy for asthma and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Inflammation of the airways requires only a small quantity of corticosteroids (about 25 to 100 microgram), but when given through the oral/intestinal route, the amount administered is very large (about 10,000 microgram), since only a fraction of the drug administered drug reaches the lungs. This means that every time an asthma patient pops a pill or a tablet, s/he is actually taking almost 200 times the amount of medication required, leading to ill-effects.

With a simple solution, it’s possible to let your little one live a better life, with inhalation therapy. And s/he can actually enjoy winters to the fullest, without giving in to asthma.

(The author is paediatric pulmonologist, K C Raju Multispecialty Hospital,
Bengaluru)