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Healthy
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How Asthma-Friendly is
Your Childcare Setting?
Asthma is the most common chronic childhood illness in the United States, affecting more than five million children This includes about 1.3 million children under age five years. Asthma is so common that the average childcare program is likely to include one or more children with asthma, and each individual childcare program may provide care to many children with asthma.
Although asthma can and should be controlled, asthma continues to kill children every year. It is a potentially serious illness. Each year, asthma results in more than three million doctor visits, 570,000 emergency department visits, and nearly 170,000 hospitalizations for children under age 15. The number of young children with asthma has increased 160 percent since 1980. Although the reasons for the increase in asthma cases are not entirely understood, it is known that preventing asthma episodes can lessen doctor visits, hospitalizations, and deaths. Childcare providers are part of the solution. Teamwork, education, prevention, and early intervention are the keys to successful asthma management.
What is Asthma?
Asthma is a chronic inflammatory disorder of the airways. Environmental and other factors "cause" or provoke the airway inflammation in people with asthma. Examples include inhaled allergens to which the patient is sensitive, cold air, and respiratory viruses. Although asthma is not an emotional illness, physical, or emotional stress may trigger an asthma episode. Airway inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night and in the early morning, or other times when lying down. Asthma can change over time requiring more active management. This includes assessing and monitoring symptoms, using and changing asthma medications properly, eliminating or reducing exposure to certain factors in the child's home and childcare environment, and educating parents and caregivers to create an asthma management partnership. Childcare providers are an important part of this partnership.
What does it take to provide asthma-friendly child care environment? You can make your childcare program friendly for children (and adults!) with asthma by following these rules.
- No tobacco smoke, anytime, ever!
- Maintain good indoor air quality. Make sure that the heating and air-conditioning systems are working properly, and filters are changed frequently.
- Reduce or eliminate allergens and irritants that can make asthma worse. These include the dander from fur or feathered animals, molds, dust mites, cockroaches, and strong fumes from products such as pesticides, paint, perfumes, and cleaning chemicals.
- Provide cots or mats for naps and minimize the carpeted areas to reduce exposure to irritants.
- Provide medicines as recommended by the child's physician and parent. Learn how to administer medicines and how to help children age four and older monitor their airways with a peak flow meter.
Keep a written emergency plan, or "asthma action plan" for each child with asthma. Be aware that although shortness of breath, wheezing, and coughing are the most common symptoms, each child is unique, and each child may need a personalized plan. Make sure all caregivers know how to carry out these plans. A sample plan is included in Breathing Easy with Child Care published by the Allergy and Asthma Network/Mothers of Asthmatics, Inc. (see Resources).
Obtain education about asthma for yourself and other caregivers. The training program Asthma and Allergy Essentials for Child Care Providers is available from the Asthma and Allergy Foundation of America (see Resources).
Teach asthma awareness to all children. Young children want and need to be accepted by their peers. Children with asthma may need extra assistance if they have missed social interactions because of their illness. Young children should be taught about diversity, including health problems and disabilities. A is for Asthma, a Sesame Street video, features a new child in the neighborhood who has asthma (see Resources).
Be prepared to modify your activity plan to help children with asthma participate in appropriate physical activities when they are recovering from asthma symptoms. It is important to understand that children with asthma should not be excluded, but they might require some special attention. Their parents or your local pediatricians or allergists can help you develop an appropriate plan.
These are all important steps you can take to make sure your center or home is a safe and friendly place for children with asthma. For more information on asthma, you can consult with a local nurse or pediatrician. Both the American Academy of Pediatrics and the National Association of Pediatric Nurses Associates and Practitioners train their members to consult to childcare programs and can help you find a local asthma expert.
By Lani S.M. Wheeler, MD, FAAP, FASHA, Pediatric and School Health Consultant
Anne Arundel County Department of Health, Annapolis, MD
and Nancy Sander, President, Allergy and Asthma Network/Mothers of Asthmatics, Inc.
Resources
Allergy and Asthma Network/Mothers of Asthmatics, Inc. (AAN/MA), 2751 Prosperity Avenue, Suite 150, Fairfax, VA 22031; 800-878-4403, 703-641-9595; www.aanma.org; email: (aanma@aol.com.)
Breathing Easy with Child Care (booklet)
The MA Report (monthly newsletter)
A Parent's Guide to Asthma (book)
Baby Breaths (video)
So You Have Asthma, too (video)
Go Blow your Nose, Robert (book)
How Asthma Makes Me Feel (book)
Asthma & Allergy Foundation of America (AAFA),
1125 15th Street, NW Suite 502, Washington, DC 20005; 800-7ASTHMA; 202-466-7643; www.aafa.org
Asthma and Allergy Essential for Child Care Providers (Training Program)
The Lion Who Had Asthma, Furry, Winning over Asthma (books for children)
Asthma-friendly Child Care: A checklist for parents and providers (AAFA-NE 617-965-7771)
American Lung Association (ALA); 800-LUNG USA; www.lungusa.org
A is for Asthma (Sesame Street video)
Childhood Asthma, a Matter of Control (booklet)
Wee Wheezers (Education program for parents of young children)
ALA Family Guide to Asthma and Allergies (book)
The National Asthma Education and Prevention Program (NAEPP); The National Heart, Lung, and Blood Institute Information Center; PO. Box 30105; Bethesda, MD 20824-0105; 301-251-1222; www.nhlbi.nih.gov/health/public/lung/asthma/chc_chk.htm
How Asthma-Friendly is your Child Care Setting? (Checklist and assessment tool)
American Academy of Pediatrics (AAP); PO Box 747; Elk Grove Village, IL 60009-0747; 800-433-9016; 847-228-5005; www.aap.org; www.schoolhealth.org
Caring for our Children: Health and Safety Guidelines for Child Care (book)
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