Reactive Airway Disease in Children

Some practitioners prefer to call it Asthma. Others call it Bronchitis. Some of us call it reactive airway disease (RAD). I prefer reactive airway when speaking of wheezing that occurs seasonally.

Reactive airway disease is wheezing that occurs when a child is subjected to allergens that cause his/her airway to react, hence the name reactive airway disease.

Asthma is an ongoing condition that also has the same symptoms but it can be more severe and at times life threatening. About 70% of asthmatics suffer from allergies. Often times, asthma attacks are brought on by contact with allergens. There is much in common between these two respiratory issues.

The recipe for reactive airway disease has a couple of ingredients. First, you need a child that is allergic to pollens or molds (the trigger). Second, you need to place the child in an allergy rich environment or expose them to their trigger. Allergens differ in various parts of our country. Once these two ingredients blend, the airway tissue starts to swell. This is the allergic response and mucous begins to develop. Behold, you have a wheezing child. Common triggers that cause RAD are the following:

1.     Allergens like pollen, molds, dust, dust mites and roaches (it is the bug droppings that are the culprit).

2.     Irritants like smoking (first and second hand), car/bus exhaust, wood stoves, fireplaces and air pollution.

3.     Cold air- when a child plays or exercises, they become mouth breathers and the cold air gets into their airway.

4.     Any substance a child is allergic to such as peanuts, bee stings, etc.

5.     Sulfides - this is usually used in dried fruits or processed baked goods.

Some of these children may develop into asthmatics. Studies show that children who are frequently seen for upper respiratory infection are at higher risk for asthma. Facts about asthma are the following:

1.     It is the leading chronic illness in children

2.     10-15% of children are affected

3.     15% of all pediatric ER visits are due to it

4.     9 million children suffer from asthma

5.     Asthma can kill a child

I included statistics on asthma because there is so much in common with RAD. One of my missions is to get the word out that asthma should always be taken seriously. If your child has any of the following symptoms, they should be evaluated by a health care provider. They may determine it to be RAD or Asthma. Your medical professional in either case will need to prescribe medication. Once again, I cannot stress enough how important it is to follow medical instructions especially in the case of asthma. Here are the symptoms to look for:

1.     Children under the age of 2 - eczema, which can be red scaly raised patches often seen behind the knees or other joints.

2.     Over 2 years of age- coughing especially at night.

3.     Frequent upper respiratory infections.

4.     Chest pain associated with play or exercise.

If your child meets any of these previous symptoms, go see a medical professional. The goal for maintaining a symptom free existence requires a commitment from both child and parent/guardian to understand the cause and effect relationship of allergies to the airway. Both parent and child must adhere to medical protocols for care once a wheeze is present. Both commitment and medication used appropriately are paramount. Children and adults must know how to use inhalers with spacers. They might be prescribed for short term usage. Don’t be afraid to let your child play or exercise. Play is important physically, mentally and emotionally. Your care provider may suggest your child use an inhaler prior to strenuous activity. Of course, your health care provider will evaluate your child for allergies (usually before the age of 5) if RAD or asthma is suspected. If Asthma is diagnosed, educate the teacher, babysitter or anyone involved in your child’s care on how to use an inhaler and when to seek help. I cannot stress enough that prevention of allergic exposure is the best form of care. This means taking allergy medication and prescribed medication accordingly. Stay well.