Managing Childhood Asthma: Effective Treatments and Concerns

Pediatric Asthma

Dear Dr.
Chang,
Hello, I have a 6-year-old son who has been suffering from asthma and has been receiving treatment at Mackay Memorial Hospital for 2 years.
The improvement has not been very satisfactory, as he still catches colds more frequently than other children, which triggers his asthma.
The medications prescribed by Mackay are as follows:
1.
Nasal irrigation twice daily (due to allergic rhinitis) + Budesonide (one spray in the morning and one in the evening) - maintenance, must not be interrupted.
2.
Seretide (one inhalation in the morning and one in the evening) - maintenance, must not be interrupted.
3.
For runny nose (using Secorine), cough (using Secorine + Meptin), phlegm, asthma, and peak flow meter readings in the yellow zone (using Secorine + Meptin + Prednisolone).
I understand that asthma treatment worldwide follows these standard protocols, and since asthma is a chronic condition, it cannot be cured but can be effectively controlled.
However, I feel that the frequent use of Prednisolone (oral) results in decreased immunity and resistance, leading to my child catching colds often and requiring prolonged use of Prednisolone, creating a vicious cycle.
Therefore, I have the following questions and would greatly appreciate your answers:
1.
I understand there is a new medication called "Xingliu" that can effectively inhibit leukotrienes and reduce the need for steroids.
However, Mackay believes it is ineffective and does not use it, citing potential liver function abnormalities.
2.
There is another product classified as a health supplement called "Lyprinol," which is derived from fresh green-lipped mussels.
It is claimed to effectively inhibit leukotrienes and is marketed as a natural, non-synthetic, non-toxic product with no side effects, suitable for long-term use.
3.
I would like to know if there are better medications available in the early stages of a cold to prevent worsening to the point of requiring oral Prednisolone.
4.
Is Traditional Chinese Medicine combined with Sanfu plaster helpful for asthma?
5.
Are antioxidant health supplements, such as grape seed extract, beneficial for asthma? I know a mother whose 7-year-old child had severe asthma, and after giving him grape seed extract (adult dosage), his asthma improved, and he has not had an episode for six months.
However, I am aware that grape seed extract can be toxic and must be dosed according to weight, and there are no grape seed products specifically for children on the market, so I have not dared to try it.
Thank you for your kind help.
Best regards,
Vicky

vicky, 40~49 year old female. Ask Date: 2005/10/13

Dr. Zhang Wenwang reply Pediatrics

Hello Vicky,
1.
When a new drug is launched, some physicians may choose to wait for long-term usage data before prescribing it, but its approval indicates that it has therapeutic effects, depending on whether the physician and the patient's family can cooperate.
2.
I am not very familiar with traditional Chinese medicine, so I cannot provide an answer.
3.
Anything other than medications can be considered nutritional supplements.
While a diverse intake may strengthen the immune system, one should not blindly believe in its therapeutic effects on asthma.
It is advisable to discuss this with a professional nutritionist.
4.
Don't forget to take care of the daily routines of children with asthma.
Enhancing chest care may be an important aspect that parents should pay attention to, aside from medication.
Wishing you health and well-being,
Zhang Wen-Wang

Reply Date: 2005/10/13

More Info

Managing childhood asthma is a multifaceted challenge that requires careful consideration of treatment options, potential side effects, and the overall health of the child. Your concerns regarding the medications your child is currently taking, particularly the use of oral Prednisolone, are valid and warrant a thorough discussion.

1. Understanding Asthma Management: Asthma is a chronic condition that can significantly impact a child's quality of life. The primary goal of asthma management is to control symptoms, prevent exacerbations, and maintain normal lung function. The medications you mentioned, including Budesonide (a corticosteroid), Seretide (a combination of a corticosteroid and a long-acting beta-agonist), and oral Prednisolone, are commonly used in asthma management. However, the frequent use of oral corticosteroids like Prednisolone can lead to side effects, including immune suppression, which may explain your child's increased susceptibility to infections.

2. Concerns with Long-term Corticosteroid Use: Long-term use of oral corticosteroids can indeed lead to a range of side effects, including growth suppression, weight gain, and increased risk of infections. It is crucial to minimize the use of oral corticosteroids and explore alternative therapies that can help manage asthma symptoms without the associated risks.

3. Exploring New Medications: You mentioned a new medication, “欣流” (likely referring to a leukotriene receptor antagonist), which can help reduce the need for corticosteroids. While it is true that some newer medications may not be universally accepted or used by all practitioners, it is essential to have an open discussion with your healthcare provider about the potential benefits and risks of such treatments. If your current provider is hesitant to prescribe it, consider seeking a second opinion from a pediatric pulmonologist or an allergist who specializes in asthma management.

4. Natural Supplements and Alternative Therapies: The use of “利筋諾 Lyprinol” derived from green-lipped mussels is an interesting approach, as it is marketed as a natural anti-inflammatory. However, the efficacy and safety of such supplements in children are not well-studied, and it is crucial to consult with a healthcare provider before starting any new supplement, especially in young children.

5. Managing Acute Symptoms: For managing acute symptoms, especially during the early stages of a cold, it is essential to have a plan in place. Over-the-counter antihistamines or decongestants may help alleviate symptoms, but they should be used cautiously and under the guidance of a healthcare provider. Additionally, ensuring that your child is up to date with vaccinations, including the flu vaccine, can help reduce the incidence of respiratory infections that may exacerbate asthma.

6. Complementary Approaches: The use of traditional Chinese medicine, including herbal remedies and therapies like 三伏貼 (Sanfu Tie), may provide some benefit for asthma management, but scientific evidence supporting their efficacy is limited. It is essential to approach these therapies with caution and discuss them with your healthcare provider to ensure they do not interfere with conventional treatments.

7. Antioxidants and Dietary Considerations: Regarding the use of antioxidants like grape seed extract, while some studies suggest potential benefits for respiratory health, the safety and appropriate dosing in children remain concerns. As you noted, the toxicity of certain supplements can pose risks, and it is crucial to avoid giving adult doses to children.

In conclusion, managing your child's asthma effectively requires a comprehensive approach that includes regular monitoring, open communication with healthcare providers, and a willingness to explore various treatment options. It is essential to prioritize treatments that minimize side effects while effectively controlling asthma symptoms. Always consult with a healthcare professional before making any changes to your child's medication regimen or introducing new therapies. Your child's health and well-being are paramount, and with the right management plan, it is possible to achieve better control of asthma symptoms.

Similar Q&A

Managing Asthma and Eczema in Young Children: Effective Strategies

Hello, Dr. Hsiao. My little boy is almost five years old and has atopic dermatitis. Since he was nearly four, he has had severe coughing whenever he catches a cold, which can last all day. Sometimes he needs to take antibiotics to recover. After visiting a medical center for a ye...

Dr. Xiao Kaiwen reply Pediatrics
For children with allergic bronchitis, swimming is indeed the best form of exercise, as it has a moderate breathing rate and the humidity of the inhaled air does not irritate the airways. The management of allergic asthma is a significant challenge and will not be elaborated on h...

Understanding Childhood Asthma: Causes, Types, and Care Tips

1. Why do children develop asthma? 2. What are the different types of asthma? 3. How can I care for them?

Dr. Zhang Jinglong reply Pediatrics
Dear Parents, 1. The primary cause of allergic asthma is a combination of a hereditary predisposition to allergies and exposure to allergens. Asthma is a chronic inflammatory response of the bronchial tubes. The persistence of this inflammatory response is closely related to the...

Managing Allergies in Children: Long-Term Treatment and Considerations

Dear Director Zhao Yongkang, My child (born in 1997) has been diagnosed by a doctor with allergic rhinitis and atopic dermatitis, indicating an allergic constitution. The doctor has suggested a long-term medication treatment (approximately six months). I would like to ask a few ...

Dr. Zhao Yongkang reply Pediatrics
Dear Ms. Bonnie, 1. Generally speaking, for children with allergic predispositions, the earlier a diagnosis is confirmed and treatment begins, the greater the likelihood of recovery. Of course, the long-term use of inhaled medications can improve a child's allergic conditio...

Managing Childhood Asthma: Traditional vs. Western Medicine Solutions

The child is over 5 years old and has been diagnosed with asthma, with allergies to dust and other allergens. They often cough, and sometimes the coughing leads to wheezing. What medications or emergency supplies should be prepared at home? What are the effects of seeing traditio...

Dr. Xiao Kaiwen reply Pediatrics
1. Asthma attacks can range from mild to severe and should not be neglected. It is advisable to keep a rescue inhaler (bronchodilator) at home, which can be used in emergencies when breathing becomes difficult (children over 5 years old can be taught to use it or use a spacer). G...