Children Living with Asthma: Recent Research on Causes and Treatment

Nearly 9 million children under age 18 (12 percent) now have asthma, according to the latest figures from the Centers for Disease Control and Prevention (CDC).

“Asthma appears to be increasing worldwide in both prevalence and severity,” says Robert B. Mellins, M.D., professor of pediatrics at Columbia University.

While it is still unclear why childhood asthma has become such an epidemic, new research on potential causes and best practices in treatment may help.

One recent study found links between asthma and phthalates, chemical compounds used to make plastics flexible. Phthalates are found in children’s toys, food containers, shower curtains, skin moisturizers and numerous other products found in every home. Phthalates leach from these products into food, water and the air. Parallels between the dramatic rise in asthma rates and the skyrocketing use of plastics over the past several decades prompted this research.

The European Union has banned the use of phthalates in toys and childcare products. World Health Organization member states are calling on industry to assess the risks of these common substances and to stop putting products into the market that contain substances that have or may have adverse effects on children’s health or the environment.

A second recent study links antibiotics and asthma. The human stomach normally contains "good bacteria" that help the immune system decide what to ignore and what to attack in the body. Antibiotics kill these good bacteria along with the bad. Then when we eat, drink or inhale anything with environmental contaminants, we have no good microbes to deal with them and we can have an allergic/asthmatic reaction. The researchers recommend a diet rich in fruits, vegetables, whole grains, beans, seeds, and nuts to help protect these microbes after a course of antibiotics, as junk food has been shown to alter the type of microbes found in the stomach.

While research on causes of asthma continues, certain approaches can result in high success rates in controlling asthma. These include having a written treatment plan; educating and communicating with children about asthma, their triggers, symptoms, treatment plan and proper uses of medication; and working with the child’s school to manage asthma while at school.

“Parents should seek out a clinician who will give them a written treatment plan that adheres to the National Institutes of Health (NIH) guidelines,” says Dr. Mellins.

The Asthma & Allergy Foundation of America provides a template for an Asthma Action Plan (see sidebar). This plan should be updated regularly. As kids grow and change, so will their symptoms and medical needs.

"Controlling asthma requires a partnership between patient and physician," says Luis Rodriguez, M.D., pediatric pulmonologist and asthma specialist at Elmhurst Hospital. He advises parents to help their children understand asthma and how to properly use their medications to give them greater control.

A new book from the EPA, Help Your Child Gain Control Over Asthma, offers information on warning signs, triggers and Asthma Action Plans. The American Lung Association’s "Asthmabusters" online club for kids with asthma can help kids better understand the disease (see sidebar). Ask your child’s physician for other educational materials.

Review your child’s Asthma Action Plan with his or her teachers and the school nurse to ensure they know how to help your child manage asthma at school. Discuss possible school-based triggers with your child and your child’s teachers.

The "Kids with Asthma Bill of Rights" (American Lung Association) can prompt frank discussions between parents, children, and school personnel, to help change biases about asthma (see sidebar). Unfortunately, the hardest aspect of asthma for a child may be the tendency for parents, teachers and others to be overly protective, limiting the child’s ability to participate in activities and, sometimes, hurting the child’s self-esteem.

Says Dr. Mellins, “While children don’t usually outgrow asthma, with proper management they can live normal, fully active lives.”




• The Asthma & Allergy Action Plan for Kids: A Complete Program to Help Your Child Live a Full and Active Life, by Allen J. Dozor, M.D. and Kate Kelly

• JayJo Books — books for children on coping with asthma:

Web resources: • American Lung Association: • Asthmabusters online club for kids: • Kids with Asthma Bill of Rights: • "Open Airways for Schools" (OAS) program (American Lung Association): • Resources for parents, cargivers, and schools: • Asthma Action Plan:

Note: The New York City Department of Health and Mental Hygiene also offers a popular and widely distributed Asthma Action Plan for New Yorkers. See

• Asthma & Allergy Foundation of America educational materials: • CDC — "Healthy Youth" initiative for schools: • Environmental Protection Agency — "Help Your Child Gain Control Over Asthma": • National Institutes of Health resources:

Recent research: Phthalates & asthma: Environmental Health Perspectives, October, 2004 Antibiotics & asthma: Infection and Immunity, December, 2004