Thursday, August 22, 2013

Combating Toddler Asthma


One of the more recent epidemic childhood ailments has been the dramatic increase in toddler asthma. This is a very recent phenomena that has risen dramatically only over the last few decades and is closely related to the evolving health issue of Indoor Air Quality (IAQ). In efforts to conserve fuel and combat rising fuel costs, home construction and improvements have focused on air efficiency and keeping cold air out and hot air in during the winter months and the converse in the summer months with air conditioning. What has essentially been created is a perfect self-contained trap for the most common allergens, which are dust mites, pollen, pet dander and mold. The developing lung capacity and high energy levels of toddlers make them more susceptible to these allergens than adults and the dramatic increase in toddler asthma supports this position.

The alarming concern is that the focus is now centered on treating the symptoms in toddlers with asthma medicines which are now being proven to have terrible side-effects on our children. Thus begins a lifetime journey to dependency on prescription drugs, which, of course, is of significant benefit to the medical profession and the manufactures of prescription drugs. The focus of this article is dealing with the neglected issue of Indoor Air Quality rather that the medical issue of treating symptoms but one type of medication that is becoming all too common, is treating asthma with drugs like albuterol. First of all, little regard is given to drug dosage in childhood pediatrics. A general half-teaspoon dose is prescribed for most toddlers in the range of 2-4 years old regardless of sex, size, body weight or level of activity. This is common with almost every drug, as the industry finds it too costly to include those parameters in research studies prior to approval.

If you even casually explore forums dedicated to parents with toddlers prescribed albuterol, you will be alarmed at the number who report horrible side-effects such as an out-of-control, irritable personality, totally contrary to the unmedicated one. Behavior becomes disruptive and unfocused and it results in ADD-like symptoms. These symptoms later get misdiagnosed in preschool and many parent then turn to Ritalin to treat these new symptoms. Then the sedated Ritalin children later gets diagnosed as depressed and so starts the move to anti-depressants type drugs. Most parents only have to think back to their own childhood and recall the absence of classroom disruptive behavior, unmotivated, drugged children and the teen suicide and crime increases.

Getting back to the focus of the article and the IAQ of most home environments, where the toddler spends the greater percentage of their time in, especially during sleeping, when more open-mouth breathing occurs. The number one night time allergen is dust mites, more specifically, dust mites carcasses, which are the breakdown components of dead dust mites. Mites can number in the millions and have a short life span, so they provide a constant supply. Every mattress over a year old has dust mites to some degree and it is not a reflection on household sanity. There is virtually impossible to eliminate them. Every toss and turn, jump on the bed or even falling into the mattress out of exhaustion creates an invisible cloud of dust mite body parts, which are small enough to enter the passage ways of children and begin the road to asthma. The body makes a valiant attempt to rid itself of these through coughing, running nose mucus and phlegm, but it is a futile battle as the mites win by sheer numbers.

The only proven effective way to contain mites and the body components is to use a dust mite cover for the box spring and mattress. These will not totally kill all mites, but will do so to the majority, and it will not allow the release of body parts into the bedroom air. These can be purchased online or at most retailers in varying price ranges depending on size of the bedding and the quality of the material with respect to comfort. Simply, it is a non-permeable, plastic enclosure with small enough pore size to contain the allergens. When cleaning or emptying the covers, which do not need to be done often, it should be done so away from the room, preferably outside. This alone, will go a long way to eliminating one of the major allergens contributing to the child's symptoms. A $50 cover in lieu of a long string of prescription drugs to address allergy symptoms.

Most homes now have pets, and many have multiple pets, sometimes mixtures of cats and dogs. Pet dander, like mites, has a very small particle size and is difficult to capture and remove. On a bright, sunlit day, you can actually view the cloud of allergens circulating in the air, all of varying particle sizes. Now picture that cloud passing through the airways of a toddler on a constant basis. It is helpful when pets are both indoors and outdoors, where they can release some of the dander outside while running or playing. Avoiding indoor vigorous play with a dog is helpful. The full-time indoor pets present more of a dander problem. Convention vacuuming does little to remove dander, and most allergens, like dust mites. Actually, it makes the problem worse for the short term when the wrong type of vacuum is used. Most vacuums, even pricy models, are not equipped to capture small particles and do nothing more than throw the stationary allergens back into the air for the child to breathe again. Canister types like the Dyson- type canister do a better job but without a HEPA filter system, do not eliminate the problem either. It is very important not to vacuum around a toddler or even with the toddler in the house. This can result in an acute allergic reaction, as their system is overwhelmed with allergens. Doing it with them out of the house for a few hours, at least allows the majority of particles to resettle.

HEPA filters on vacuums, an acronym for 'High Efficiency Particulate Air', is the best known filter for removing at least 99.97% of particulates such as dust, animal dander, smoke, mold and other allergens that are 0.3 microns or larger, from the air and thus improving air quality. There are many generic HEPA filtration filters on the market today, but a true HEPA filter will display its efficiency ratings on the packaging. Other similar filters may not meet the same efficiency standards. These tend to be pricey but represent one of the best investments a household can make towards improving air quality and eliminating allergens. Care should also be taken not to feather dust or even using a non-disposable dusting cloth, like a towel or rag. Feather dusting defeats the purpose of capture by again throwing the particles back into the air. Dust rags, even when used with liquid cleaners, do the same when they become dry as they do nothing but become a haven for previously collected allergens. Using a damp disposable paper towel as the first step in dusting is critical and they should be disposed of quickly.

If a household has a smoker, extreme care should be taken, as nicotine particles are extremely allergic to toddlers. Even if smoking is confined to an area such as a porch, away from the child, those surfaces should be wiped routinely to capture the settled particles. This holds true for the interior of car surfaces and the smokers clothing which may come into contact with a toddler after smoking. Every child's room should also have a high quality air cleaning system, like the Sharper Image ionic model which does not rely on air movement, but on static capture. This should be cleaned regularly and the amount of allergens captured on the panels will be alarming when viewed from the point that material could have easily entered the child's airway.

Mold is another issue, especially in older homes, and homes with a lot of shade and limited sun exposure. Most are impossible to uncover, but if treated with some of the above methods, can be manageable. If a toddler spends substantial time with another caregiver, such as day care or with grandparents, they should be alerted to these methods which can also be taken in that setting to some degree. Day care is more difficult to protect against, but if the home environment is addressed, most of the allergens can be eliminated. Most day care center, especially new ones, address some of these issues.

All of the above methods can likely be addressed by a household for under $1000 and with little inconvenience. When compared to the constant, anguishing symptoms the toddler has to endure and the negative side effects of the drugs used to combat the symptoms, it is a vital and sensible alternative. The health of your children, as well as you own, will show dramatic improvement in a very short time.

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