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Asthma / Treatment Guidelines

Recurrent wheezing, also known as asthma or reactive airway disease, is very common in young children. In response to a trigger, the small airways in the lungs become inflamed with mucous and the child develops cough, wheeze and sometimes trouble breathing.

The triggers can be a common cold virus, an indoor or outdoor allergen, and exercise or cold air. Some children have a strong family history of asthma. Individual episodes are usually mild or moderate but occasionally severe. Many children go on to ‘outgrow’ their asthma, while others remain on medication, sometimes year-round but in other cases, only during a flare up or seasonally.

It is important to recognize the signs of asthma:

  • Persistent cough
  • Difficulty breathing
  • Wheezing
  • Shortness of breath
  • Chest tightness
  • Trouble exercising


Early treatment is most effective and works the fastest to reverse the symptoms.

At the first episode of wheezing, we typically treat your child with two kinds of medicine and will teach both child and family how and when to use the medications at home. The first one is a bronchodilator (Xopenex or Albuterol), which works quickly to open up the airways and relieve symptoms. This is also called a ‘rescue’ medicine and is usually repeated every 4 to 6 hours until the symptoms resolve.

The second type of medicine is a steroid (Budesonide, QVAR or Flovent), also called a ‘controller’ medicine, which works to reduce inflammation in the small breathing tubes during the acute phase of asthma, and is a preventative medicine once the acute symptoms resolve. Steroid medications are quite safe when used under our direction.

Depending on the child’s age, asthma medications are administered via a portable electric “nebulizer” for younger children, or alternatively by a hand-held inhaler with spacer for older children. We will individualize each child’s treatment plan, known as an Asthma Action Plan, and will emphasize prevention.

If high fever, difficulty breathing or barky cough develop, consult our office about the use of Albuterol or Xopenex.

Please keep track of your medication supply and contact our office during regular office hours to request refills.

Follow-Up Visits

Once we begin treatment for asthma symptoms with either of the above methods, we will call to check on your child every few days until symptoms are under good control. We will adjust the medical regimen based on each patient’s individual response. Some children may require a chest X-ray or referral to a pediatric specialist in pulmonology or allergy.