From what you have described, I think your doctor is correct in making the diagnosis of asthma. Although you didn’t want your daughter to be sick like you when you were growing up, better knowledge nowadays about the triggers of asthma and more effective medications have made these children more healthy. If you can follow your doctor’s recommendations as well as some of the suggestions that I am giving you here, there is a very good chance that she can be healthy most of the time instead of being sick.

Asthma is the most common chronic illness in children. Research has shown that as many as 20% of children in the Maritimes have asthma. We don’t completely understand the reason for this high percentage, although we know that the genes play an important role in asthma as well as allergies. Both indoor and outdoor environment can trigger asthma in children.

Dust is probably the greatest challenge for children with asthma. What I am referring to is not the dirt that children carry in from outside. I am talking about dust particles that collect indoors in all homes, but they accumulate in greater amounts in carpets, mattress, pillows, bedding, stuffed toys (like teddy bears), as well as forced-air heating system.

In the indoor dust particles are very tiny insects called dust mites. They feed on the skin cells that we shed everyday from our skin. It is the dropping (or poop) of these dust mites that trigger allergy and asthma symptoms in adults and children. As a result, reducing dust mites is one of the most effective ways of controlling asthma. This can be done by sealing mattress and pillows in plastic covers that have zippers so that dust mites cannot get through. Because dust mites are microscopic, fabric covers are probably not effective. I also suggest parents to wash all bedding weekly to prevent dust mites from accumulating.

Removing carpet is also very important. Wall-to-wall carpets are especially problematic because large amount of dust mites can be collected inside and the carpet can still appear to be nice and clean. Vacuuming the carpet is not effective in removing dust mites. Many families have struggled with their children’s asthma until the carpets in bedrooms or living rooms are removed.

Soft stuffed toys cause another challenge. Family and friends buy them as presents, and children become attached to them. They collect lots of dust mites over time, even though they still look nice and clean. I do recommend parents to remove most of these stuffed toys, especially the larger ones. For the small ones, it is possible to put them through the washer and dryer weekly to remove dust mites. However, the larger ones cannot be effectively dried in the dryer and moisture can accumulate inside, allowing molds to grow, which will cause an additional danger. I also suggest family and friends not to buy stuffed toys as presents in future.

Forced-air heating system is another great concern because large amount of dust can accumulate in the ducts. Parents have tried to vacuum where they can, but it really doesn’t work. There are a few ways to reduce the dust. One way is to turn the thermostat down to 18-20C so that the furnace won’t kick on as often and circulate the dust. You can also replace the filter at the furnace with a high efficiency one that is more effective in trapping dust and mold particles. Similar filters can be placed at registers where hot air blows out. There are also duct-cleaning companies that can remove dust collected in the ductal system. A hot-water radiator system would eliminate this problem completely.

Mold is another important trigger for many children with asthma. Molds are fungi that can grow where there is moisture. This is especially important in basements which are often damp. Many parents don’t realize how damp their basements are until they put a dehumidifier there and see how much water the dehumidifier removes.

In the last few years, cost of furnace oil has skyrocketed. Many people began buying wood stoves and wood furnaces, and putting wood in basement. This is especially dangerous because molds grow on wood; putting wood in basement brings in moisture and mold. If there are children in the house with allergy and asthma, burning wood may save a few dollars in heating, but can increase health care cost.

It is also important to check around the windows for moisture. Molds will grow around windows that are moist. Bathroom is another place where molds can grow if there is no exhaust fan to remove moisture in the air.

In the past few years, parents have found that air-purifiers with HEPA (high-efficiency particulate air) filters can reduce asthma symptoms in their children. These units are typically placed in children’s bedroom where they spend many hours each day, as well as in living room and playroom. They suck air through the HEPA filter, removing dust mites and mold particles in the air. It is worthwhile to try if your child doesn’t get better with all the other measures.

I hope the information that I have given here will help you to keep your daughter healthy. You should work closely with your doctor because medicine is very important in the treatment and prevention of asthma. You can ask for a referral to the local Asthma Education Centre, and you can go to the Lung Association website (www.lung.ca) for more information.