Infants or young children should have written asthma action plans prepared by their health care providers that can be used to monitor and manage their asthma just like older children with asthma. However, infants will need some special considerations particularly because they can’t use peak flow meters to gauge how much air is moving in and out of their lungs. Instead, you will need to review other signs such as their asthma symptoms and breathing rate to determine if they are in one of three zones:
- The green zone means the child is doing well in terms of breathing and her asthma symptoms appear well-controlled. There is no coughing or wheezing. Only routine controller asthma medicines are used, or in many babies, no medicine is needed here.
- The yellow zone means some symptoms are present, such as wheezing or mild coughing, and caution is needed. An inhaled quick-relief medication might be prescribed by your health care provider, in addition to any controller asthma medications if they have been prescribed in the past, to help with your child’s breathing. The plan should state when to contact your health care provider and what to do if your child’s symptoms fail to improve.
- The red zone can potentially mean an emergency is occurring. Even just one of these symptoms such as persistent coughing, breathing difficulties that interfere with eating or sleeping, sucking in of the chest, or flared nostrils means the child is in the red zone. In addition to the quick-relief medication, your health care provider might add an oral corticosteroid. An emergency contact for your health care provider should be listed, along with information on how and when to call 911 or emergency help.
Remember to keep this asthma action plan with you at all times, and to distribute it to relatives, daycare workers, babysitters, or other individuals who take care of your child. Also, remember to continually update the document as your child gets older noting changes in symptoms and medications.
As your infant and young child grows and develops, her asthma action plan and peak flow meter readings (if she is old enough to perform them) should include her updated “personal best” rate.
An asthma action plan for a young child can give you an idea of what your child’s breathing capacity should be. This is helpful as you determine what zone your child is in. Finding the breathing capacity for young children is different when compared with older children. Lung function or spirometry tests are breathing tests conducted in a health care provider’s office or health care facility that measures a child’s lung capacity when he blows into a tube connected to a computer that measures many aspects of his breathing capacities.
This type of test, though, is difficult for young children to use. New technology, called an impulse oscillometry system, is now being used at some major medical centers. In some studies, it has demonstrated airway abnormalities in children as young as two years old. The test can show how severe a young child’s asthma is, and can assist health care providers in initiating appropriate treatments.