Respiratory disorders, in which bronchial conduction is impaired, leads to the development of bronchial obstructive syndrome. With a long course, this condition turns into asthma.
What it is?
Several different causes lead to the development of respiratory disorders. In bronchial asthma, there is an increased reactivity of the bronchi to certain substances, which leads to the development of bronchial obstruction (blockage). Air with oxygen dissolved in it passes poorly through the narrowed bronchi. As a result, this leads to impaired air exchange between the blood, lung tissue and the environment.
After exposure to various provoking factors, a violation of bronchial conduction occurs. This condition is called bronchial obstructive syndrome. If this process lasts a long time, then the course of the disease becomes chronic. In this case, bronchial obstructive syndrome becomes bronchial asthma.
According to statistics, this disease occurs in 10% of children. Boys get sick more often than girls. The peak incidence occurs at the age of 4-10 years.
Bronchial asthma is found not only in pediatrics. Adults can also get sick. The first signs of the disease can occur at any age.
The course of bronchial asthma is undulating. Periods of exacerbation are replaced by remissions. The duration of a calm period can be different. This mainly depends on the state of the immune system and the presence of concomitant chronic diseases in the child. Weakened babies have much more exacerbations than children who undergo regular rehabilitation.
Various provocateurs can lead to the development of bronchial asthma. In some situations, the effect of several provoking factors has a more pronounced effect, leading to persistent bronchial obstructive syndrome.
Among the most significant risk factors:
- Genetic predisposition. If one of the parents has bronchial asthma, then the risk of having a sick baby is 25%. In cases where dad and mom are both sick, the risk of a child with respiratory failure is already 75%. Not in all cases, a genetic predisposition leads to the development of the disease. If the child is not affected by other adverse factors, then he may not develop the disease throughout his life.
- Contaminated air. Children who live near industrial plants and factories, as well as close to major highways, have a higher risk of developing bronchial asthma. The smallest particles of toxic products can remain in the air for quite some time. If it enters the mucous membranes of the upper respiratory tract, they easily cause inflammation, leading to bronchial obstruction.
- Dust and house mites that live in pillows and blankets. These seemingly harmless factors often lead to the development of persistent symptoms of bronchial obstruction. The smallest ticks constantly come into contact with the skin, causing severe allergies. Ultimately, this leads to severe respiratory failure.
- Animals. The most dangerous pets that live at home. Wool, fluff, and also animal dander often become a source of a pronounced allergic reaction. It is manifested not only by the appearance of specific rashes on the skin, but also characterized by the presence of impaired breathing.
- Food products. Especially food cooked industrially. In such products there are a lot of synthetic additives, dyes and aromatic components. Once in the gastrointestinal tract, they cause severe allergic reactions. This contributes to the development of systemic adverse symptoms: cough with sputum and wheezing when breathing.
- Household chemicals. Many synthetic products contain a fair amount of various perfume additives and fragrances. They substances have a pronounced irritant effect on the respiratory tract. With prolonged contact with such products, the risk of developing bronchial obstruction in a child greatly increases.
- Individual sensitivity to flowering herbs. Usually attacks of bronchial asthma in this condition have a clear seasonality. The baby's health worsens in the spring and autumn. It was at this time that weeds and meadow herbs bloomed, as well as various trees and shrubs.
- Strong humidity and dampness in the room. This condition provokes the development of mold. In wet and damp conditions, they grow and multiply rapidly. Large colonies of molds can cause severe respiratory failure in the baby.
- Infection with viruses and bacteria. Currently, more and more doctors began to register a virus-induced form of bronchial asthma. In a frequently ill child with reduced immunity, the consequence of a viral infection often develops bronchial obstructive syndrome. Also, in some cases, bacterial infections lead to asthmatic respiratory failure.
- Ingestion of tobacco smoke. The effect of passive smoking on the development of bronchial asthma has been scientifically proven. If one of the parents constantly smokes in the apartment or room where the child is, then the risk of developing bronchial asthma increases at times.
- Strong physical exertion leading to exhaustion. Excessive training, chosen incorrectly, can lead to disruptions in the immune system. After prolonged stress, the child develops respiratory failure and shortness of breath occurs.
Causes of occurrence
Bronchial asthma most often develops with a child's initial genetic predisposition. With additional exposure to adverse environmental factors, the course of the disease worsens and the transition to a chronic form.
The development of asthmatic respiratory failure lead to:
- Eating hypeallergenic foods. Most often these are: citrus fruits, chocolate, sweets, seafood, fish, honey and others. The ingestion of allergenic products into the body leads to the development of an allergic reaction. It can be manifested in particular by severe syndrome of bronchial obstruction.
- Inhalation of contaminated air. Toxic industrial products and exhaust gases have a toxic effect on the epithelial cells of the upper respiratory tract. These substances cause a strong spasm of the bronchi, which leads to a narrowing of their lumen and respiratory failure.
- Allergic diseases. Often, these pathologies are secondary and develop in the background with concomitant chronic diseases. The development of bronchial asthma is caused by persistent dysbiosis, pathology of the gastrointestinal tract, gallbladder dyskinesia and chronic hepatitis.
- The use of medicines without prior medical advice or improperly selected. All medicines may have side effects. Many of them are capable of causing persistent obstruction of the bronchi. If the child has a genetic predisposition to bronchial asthma, this can lead to the development of the disease.
- Severe traumatic situation or stress. Cases of the development of the disease after moving to a new place of residence, divorce of parents, as well as the death of close relatives in early childhood are noted. Severe stress contributes to the production of increased amounts of hormones. They cause narrowing of the bronchi, which leads to respiratory failure.
- Improper treatment of chronic respiratory diseases. Frequent bronchitis, especially occurring with a pronounced bronchial obstructive component, ultimately lead to the development of bronchial asthma. If a child often coughs and has a cold up to 4-5 times a year, then parents should think about the presence of bronchial asthma in the baby.
All forms of allergic asthma can be divided into several groups. This classification is based on the causes that cause the disease. This separation is very important in pediatric pulmonology. This classification helps doctors prescribe the right treatment.
Given the leading cause, bronchial asthma can be:
- Allergic. The development of this form of the disease leads to the ingestion of allergens into the body, which provoke the development of adverse systemic manifestations. In the presence of individual hypersensitivity to foreign substances, the baby's level of immunoglobulins E. increases. These components lead to severe bronchospasm, which is manifested by the appearance of cough.
- Non-atopic. With this form of the disease, spasm in the bronchi occurs due to any exposure, but not an allergen. This variant of asthma develops as a result of severe stress, hypothermia, or as a result of excessive and improperly selected physical activity.
- Mixed. May occur as a result of exposure to both allergic and non-atopic causes. It is characterized by the appearance of numerous symptoms. The course of the disease is usually the most calm. Periods of remission can be quite long.
- Asthmatic status. This extremely dangerous emergency condition stands out as a separate form of bronchial asthma. During the life of the baby, several such attacks may occur. This condition is extremely serious, in which the symptoms of respiratory failure sharply increase. In this case, emergency treatment is required.
The course of bronchial asthma can be different. This is influenced by several factors:
- the age at which the baby had the first signs of the disease;
- state of immunity;
- the presence of concomitant chronic diseases;
- region of residence;
- the adequacy of the selected treatment.
All forms of the disease can be divided into several groups, taking into account the particular severity:
- With a light episodic course. With this form of external respiration functions are not observed. Attacks of impaired breathing occur less often than once a week. The period without seizures can be quite long.
- With a slight persistent course. It is characterized by the appearance of attacks of impaired breathing several times during the week. There is no daily deterioration in well-being. When an attack occurs, breathing is disturbed, an annoying cough appears, shortness of breath increases. Spirometry does not show any abnormalities.
- With a moderate course. Deterioration of health occurs almost every day. During such attacks, the child is disturbed in sleep, and severe respiratory failure is observed, leading to severe shortness of breath. In the treatment of the condition, daily use of bronchodilators is required. Spirometry shows deviations from the norm by 20-40%.
- With a severe course. They are dangerous for the development of several attacks in one day. Also, such deterioration can occur at night. Therapy with short-acting bronchodilators does not bring a pronounced effect. To control the course of the disease, the appointment of hormones is required. Spirometry shows a deviation from normal respiration by more than 40%.
What is bronchial asthma in children, Dr. Komarovsky will explain in detail in the next video.
It is quite difficult to recognize bronchial asthma at the initial stage. Quite often, parents believe that the child simply has an allergy or bronchial obstructive bronchitis. In the interictal period, sometimes even an experienced doctor often cannot determine asthma in a child. Further development of the disease is manifested by the development of characteristic adverse symptoms that should alert parents.
For bronchial asthma in the period of exacerbation is characteristic:
- The appearance of shortness of breath. It is expiratory in nature. In this case, exhalation is noticeably difficult. You can check for shortness of breath at home yourself. This is evidenced by the increase in the number of respiratory movements in one minute by more than 10% of the age norm.
- Cough with difficult sputum. Mostly this symptom bothers the child during the day. At night, the cough decreases slightly. Sputum in bronchial asthma is quite viscous, "vitreous." When trying to cough her, the child may even have soreness in the chest.
- Palpitations. Even in the absence of physical activity, the child develops tachycardia. Usually this symptom is associated with shortness of breath. The more pronounced it is, the more the number of heart contractions in one minute increases.
- The appearance of dry wheezing during breathing. In severe cases, such breathing noises become audible from the side, without the use of a phonendoscope. Wheezing is mostly dry and wheezing. It is believed that with bronchial asthma "an accordion plays in the chest."
- The appearance of a boxed sound during percussion. This method is carried out to clarify the diagnosis. When you tap your fingers on the chest, a characteristic sound is heard that resembles hitting an empty box. The appearance of this symptom manifests itself already in the distant stages of the disease and indicates an increased filling of the lungs with air.
- The lack of effect of conventional drugs used to eliminate cough. Only bronchodilators and hormonal agents have a visible therapeutic effect. With an allergic form of bronchial asthma, antihistamines bring a pronounced effect.
Symptoms of an attack
- The well-being of the child during the worsening of the disease is greatly impaired. The kid becomes more moody, scared. Some babies, especially in the first months after birth, begin to cry, more are asked in their arms. In kids, appetite almost completely disappears, they refuse to eat.
- During an attack, expiratory dyspnea increases in the child. To alleviate this condition, often the baby takes a forced position. He leans forward a lot. The head may be slightly tilted.
- Often, asthmatic babies try to lean their hands on a chair or even a bed railing during an attack. This forced position somewhat facilitates sputum discharge and helps to improve breathing.
- With a severe attack,the baby manifests symptoms of respiratory failure. The lips become pale, and in some cases even cyanotic. Hands and feet are cold to the touch. The child has a paradoxical pulse. With this violation of the rhythm, the number of contractions of the heart during inhalation and exhalation changes.
- Some babies try to take a sitting position. This helps them breathe better. Even from the side, the participation of the auxiliary respiratory muscles during breathing is visible. The child breathes deeply and often. The condition worsens by a strong nagging cough. In some cases, it even leads to the fact that the child begins to cry.
- After the attack, the baby feels overwhelmed. Some children can not calm down for a long time. They have disturbed sleep. The duration of the attack can be different. With the late use of inhalers, a dangerous and life-threatening condition can develop - asthmatic status. In this situation, it is impossible to cope with the elimination of adverse symptoms at home - medical ambulance is required.
How is it manifested in infants?
The course of bronchial asthma in an infant can also occur in different ways: from mild to severe. Infants often have asthma attacks on fermented milk products and molds. The second most common is food allergy.
Usually the first symptoms of bronchial asthma in an infant appear by the age of 5-6 months. At this time, the baby begins to receive new foods as lure. If the child has an individual intolerance or hypersensitivity to any substance, he may develop symptoms of bronchial obstruction.
A striking symptom of asthma in an infant is the occurrence of cough. The baby begins to cough both day and night. In some cases, shortness of breath joins. Even while in bed, without physical exertion, the number of breaths and heart contractions in one minute becomes more frequent in the child.
Babies begin to suck poorly, the effectiveness of breastfeeding is reduced. Such children lose weight and are somewhat behind peers in terms of physical development. Silent crying is also one of the symptoms of bronchial asthma in a baby of the first year of life. The child becomes lethargic, asks poorly in his arms. Some babies fall asleep badly and often wake up during a night's sleep.
In order to make a correct diagnosis, only collecting an anamnesis and conducting a medical examination of the child will not be enough. To identify persistent bronchial obstruction, additional tests and examinations are required. Only carrying out different diagnostic tests will help establish the correct diagnosis.
To diagnose asthma, you will need:
- General blood analysis. An increase in leukocytes and moderate eosinophilia (an increase in the number of eosinophils in the leukocyte formula) indicate increased allergization. Such changes are characteristic mainly for the allergic form of bronchial asthma.
- Sputum examination. The detection of specific Charcot-Leiden crystals, Curshman spirals, an increase in the number of desquamated epithelial cells, as well as an increased level of eosinophils indicate the presence of persistent bronchial obstruction.
- Conducting a study on the ratio of blood gases. With a prolonged course of bronchial asthma, there is a decrease in dissolved oxygen and a slight increase in carbon dioxide. Such changes indicate the presence in the body of severe hypoxia or oxygen starvation of cells.
- Spirometry. Reflects indicators of external respiration. Evaluation of forced expiration and general indicators of vital capacity of the lungs help to identify persistent bronchial obstruction in the body, leading to a change in the parameters of the respiratory function of the lungs. The decrease in these parameters is estimated as a percentage of the age norm.
- Carrying out scarification tests. They help to identify all possible allergens that cause the child to develop bronchial obstruction. The study is carried out only by an allergist. The test is only possible in babies older than five years.
- Chest x-ray. Helps to establish secondary signs of bronchial obstruction: increased airiness of the lungs and a change in the diameter of large bronchi.
- Bronchoscopy. It is used in limited cases, mainly for differential diagnosis in order to exclude similar diseases that occur, like bronchial asthma with symptoms of bronchial obstruction.
The development of the adverse effects of bronchial asthma depends on many factors. The most important of them is timely diagnostics and correctly prescribed treatment. With an inadequately selected treatment regimen, a child can experience numerous adverse effects of the disease.
Among the most commonly reported complications of asthma are:
- The development of asthmatic status.
- Sudden onset of symptoms of acute respiratory failure.
- Spontaneous pneumothorax. In this condition, the capsule ruptures on the outside of the lungs. This condition usually occurs during a severe attack.
- The increase in shock. The development of acute respiratory failure leads to a sharp drop in blood pressure. This condition is extremely unfavorable and requires emergency treatment and hospitalization in a hospital.
- Pneumonia. It appears when bacterial flora is attached to the inflammatory process. It is characterized by a fairly severe course. Antibiotics are required to resolve the symptoms.
- Emphysema. It develops in asthmatics with experience. It is characterized by increased air filling of the lung tissue. At the same time, the respiratory function of the lungs is significantly reduced, which leads to the appearance of symptoms of respiratory failure.
- The formation of cardiovascular failure. It is an extremely unfavorable complication. In this condition, the appointment of several types of drugs, including cardiac glycosides, is required.
According to clinical guidelines for the treatment of asthma, treatment of various forms of the disease should be stepwise. Modern medical standards provide for the gradual administration of drugs.
The selection of necessary drugs is carried out only after a comprehensive examination of the child. Before choosing the necessary inhalers or tablets, it is necessary to accurately identify the form of bronchial asthma and determine the severity of the disease.
Treatment of a baby with bronchial asthma is carried out by a pulmonologist. With an allergic form of a child, you should definitely show it to an allergist. This doctor will help draw up a more individual treatment, taking into account the characteristics of the immune system.
Treatment in a pulmonary clinic is carried out only for complex cases of the disease. With a mild course, regular visits to the clinic and outpatient consultations with doctors are sufficient.
The treatment of bronchial asthma includes several basic principles:
- The appointment of symptomatic agents. In this case, drugs are used only during an attack in order to eliminate acute adverse symptoms of the disease. Typically, various inhalers are used for these purposes.
- Selection of basic therapy. These funds are already assigned for continuous reception. They help prevent new attacks and improve the course of the disease. Monitoring the effectiveness of drugs is carried out using spirometry. At home, a special portable device - a peak flow meter, is perfect for this purpose.
- The exception to everyday life of all types of allergens. Compliance with a hypoallergenic diet, the use of special bedding, as well as the limitations of games with soft toys will help prevent new attacks and the development of asthmatic status.
- Using special humidifiers. These devices help create the optimal indoor climate. Too dry air irritates the airways, causing respiratory failure and new asthma attacks.
- The use of antitussive and expectorant drugs. These funds help to eliminate a pronounced nagging cough. If the child does not have allergies, medicinal herbs are also suitable: coltsfoot, thyme, calendula, and others. Phytotherapy should be used only after consulting a doctor.
- Limit games with animals. For a baby suffering from bronchial asthma, it is better not to make furry home friends. The coat and down of animals can adversely affect the child's health and cause new attacks.
- Regular disinfecting treatment. Cleaning in the visit where the child is located should be daily. Use caustic and too aggressive chemicals for this should not be. It is better to choose detergents that do not contain pronounced aromatic additives. The best option is household cleaning products that have a special label on the safety of use, even in children's rooms.
- Strengthening the immune system. Active walks in the fresh air, exercise therapy complexes, respiratory gymnastics, as well as various tempering are perfect for this. Properly harden the child should be from the very early years of his life. Hardening should be regular. A set of these measures will help strengthen the weakened immunity of the baby, which will help reduce asthma attacks in the future.
As a basic treatment, various groups of drugs are used. Among them:
- Mast cell membrane stabilizers. They help reduce the amount of pro-inflammatory biologically active substances that appear during allergic inflammation. The effect does not occur immediately. It usually takes from 14 days to several months to achieve the effect. These drugs include: Ketotifen, Cromogen, Cromohexane, Nedocromil, Intal and others.
- Antihistamines. They help eliminate edema from smooth muscle cells of the bronchi. This helps to improve sputum discharge and reduce inflammation. Assigned by an allergist. To control bronchial asthma, Suprastin, Loratadin, Zirtek, Claritin and others are suitable.
- Hormonal. They are prescribed for severe asthma, as well as in cases where the previous regimen was ineffective. They have a pronounced anti-inflammatory effect. With prolonged use, they can cause side effects. They can be prescribed in the form of inhalers or in tablets (in severe cases).
For symptomatic treatment and the elimination of adverse, acute symptoms of bronchial obstruction, drugs with a bronchilithic effect are used. They help to quickly eliminate bronchial spasm and improve breathing.
These funds are prescribed as aerosols, which are available in the form of various inhalers, spacers and nebulizers. They help to distribute the active substance as quickly and efficiently as possible. The smallest particles of the medicine reach the bronchi in the shortest possible time. Usually the effect is achieved within the first 5 minutes of use.
The following groups of drugs have bronchodilator effects:
- Adrenomimetics. Block adrenergic receptors that are located on the surface of bronchial cells. May be short and prolonged action. Salbutamol-based drugs eliminate bronchial spasm in 5-10 minutes. Foradil, Serevent and Valmaks help eliminate obstruction in the airways for 10-12 hours.
- Anticholinergics. They have a pronounced effect. May cause systemic side effects. Often greatly reduce blood pressure. These include: Atropine, Atrovent, Platifillin and others.
- Xanthines. Not a drug of choice. They are prescribed only if the previously selected therapy is ineffective. Often used in combination treatment regimens for bronchial asthma. These include: theophyllines, Eufillin and others.
- Combined. The combination of anticholinergic and adrenergic agonist allows you to achieve a quick effect and keep it for a long time. These include: Berodual, Ditek, Intal plus, Symbicort, Seretide and others. Assigned to 1-2 inhalations per day. With prolonged use, dose adjustment or replacement with other drugs may be required.
Clinical nutrition plays an important role in the treatment of bronchial asthma. Of particular importance is the diet with an allergic form. In order for the child not to have new bouts of the disease, he should follow a hypoallergenic diet regularly. It was developed by the Union of Pediatricians for the treatment of various diseases in which there is a tendency to develop allergic reactions.
Babies suffering from asthma should completely exclude highly allergenic foods from their diet. These include:
- Red meats and poultry.
- Tropical fruits.
- Vegetables and fruits of yellow, orange and red colors.
- Seafood and sea fish.
- Sweets and fizzy drinks.
- Industrial food with a high content of spices, as well as preservatives and colorings.
In babies with lactase intolerance, an attack of bronchial asthma can occur after consuming fermented milk products and cow's milk. In such cases, it is better to switch to the use of goat cottage cheese and cheese. These products will be safer for an asthmatic baby.
The optimal menu for a child with asthma should contain hypoallergenic protein foods, cereals and enough fiber. As proteins are suitable: chicken breast, rabbit, turkey (in the absence of allergy to chicken eggs). For garnish you can cook porridge or mashed potatoes made from potatoes or cauliflower.
All cereals can be included in the children's diet. Limitations can only be barley and oatmeal in case of gluten intolerance. As vegetables, any vegetables and root vegetables of white and green colors are suitable. Dessert can be apples and pears. Try to choose green varieties grown in the region of residence.
Harbingers of the coming attack
Before a severe sudden deterioration in well-being begins, the child develops some borderline symptoms. They are also called "aura." Before the development of an asthmatic attack, a child may experience severe sneezing, sore throat, runny nose.
The baby is growing anxiety. In some cases, even panic. The behavior of the child may change. He becomes more silent, refuses to make contact. Many children try to be in their own room, as this brings them more peace of mind.
The appearance of dry cough indicates a transition of the borderline state into a real attack. In the next few hours, all symptoms worsen. Cough begins to build up and numerous dry wheezing, and shortness of breath, appear.
After a few hours, the child develops a strong heartbeat and general weakness increases.
First aid for an attack
To successfully stop a sudden deterioration in the condition, parents should know what to do and how to help their baby. To do this, use the following tips and algorithm of actions:
- Do not leave the child alone when he has the first signs of deterioration. An older baby should be asked what worries him and where it hurts.
- Pay attention to whether the child has shortness of breath. To do this, count the number of respiratory movements in one minute. This is very easy to evaluate: observe the movement of the ribs during breathing. If the number of breaths is more than 20 per minute, then this indicates the presence of shortness of breath in the baby.
- Help your baby take a comfortable position. Do not lay your child on his back if he is uncomfortable breathing. This situation can only aggravate the development of an attack.
- Provide airflow. If the room is too stuffy, then open the window or window. Try to prevent the child from catching a cold at this time.
- To relieve symptoms, use the inhaler recommended by the doctor before. Usually, medications that have a quick effect are used to eliminate seizures. Often salbutamol-based inhalers are used for this.
- If, despite the use of the medicine, the baby continues to have shortness of breath, a pronounced cyanosis of the nasolabial triangle appears, and blood pressure decreases markedly, then this is an occasion to call an ambulance team.
- Do not use 3-4 or more inhalations at a time in an attempt to achieve an effect. Such irrational use can only lead to the development of a dangerous condition that requires hospitalization of the baby in a hospital. Large doses of adrenergic agonists block receptors, which further prevents the bronchi from fully functioning. To eliminate this effect, it may require the introduction of hormones intravenously.
The implementation of rehabilitation measures in the interictal period will improve the course of the disease, as well as significantly affect the prognosis. If bronchial asthma was registered in a baby for the first time and for a long time proceeded only in a mild course, then competent rehabilitation will help to practically lead to recovery, and in some cases even to remove the diagnosis.
Rehabilitation measures include:
- breathing exercises;
- physiotherapeutic techniques (ultrasound treatment, speleocameras, ultraphonophoresis, hydrotherapy, magnetotherapy, electrophoresis with medicinal bronchodilators and others);
- Spa treatment;
- a complex of therapeutic physical exercises.
All of these methods together help to achieve a pronounced therapeutic effect. To achieve persistent remission of bronchial asthma, rehabilitation should be carried out regularly, throughout the period without exacerbations. An individual scheme of rehabilitation measures is drawn up for each baby. Performance monitoring is assessed using spirometry and other examinations.
Strengthening immunity and rehabilitation of the bronchi are important components of the basic treatment and rehabilitation of bronchial asthma. A vacation with a child in a pulmonary sanatorium will be an excellent option for improving health. You can go on vacation at any time of the year. Choosing a sanatorium should be based on the profile of the services provided.
In Russia, there are a huge number of different health resorts that are involved in the treatment and rehabilitation of babies with bronchial asthma. Usually they are located in close proximity to the sea or in beautiful pine forests. Air in such places has a pronounced therapeutic effect on the respiratory system. Trips to pulmonary sanatoriums are usually designed for 21 days.
Young patients with disabilities due to bronchial asthma with severe bronchial obstruction can receive free accommodation and treatment in such health centers. Usually vouchers are issued every year. During treatment in the sanatorium, the child's indices of external respiration improve and immunity is restored.
In order for the child not to have new bouts of the disease, a few simple recommendations should be observed:
- Regular use of properly selected inhalers to stop seizures.
- Compliance with a hypoallergenic diet.
- Carrying out daily wet cleaning of the children's room.
- Careful selection of bedding, mattress, pillows and blankets. They should not be made of materials that can cause allergic reactions in the baby.
- Implementation of rehabilitation measures in the interictal period.
- The exception to everyday life of all possible allergens.
- Regular visits to a pulmonologist and allergist.
By: Eric Teller, MD