Asthma in Women, Asthma in Pregnancy (cont.)

In terms of asthma in children, research is growing daily that strongly suggest that if we abolished exposure of children to cigarette smoking we could actually prevent some cases of asthma. Exposure to cigarette smoke is a risk factor for asthma. Pregnant asthmatics should avoid not only smoking but also exposure to side-stream tobacco smoke.

In families with strong atopic (asthma, allergic eczema rashes, hay fever) tendencies, it is recommended that the infant be fed exclusively with breastmilk as opposed to formula, to decrease the infants risk of getting allergic food sensitivities. Smoking is a well-known asthma attack trigger. Smoking (even just being around someone who is smoking), feathers, mold, and cold air are frequent culprits that should be avoided if possible.

Unfortunately, respiratory viruses are very common triggers of asthma and are often not preventable. It is a good idea to avoid people with known respiratory infections. Influenza vaccination is recommended for asthmatics who will be in the second and third trimesters of pregnancy at the time of annual influenza seasons. Rhinitis (hay fever, reaction to trees and grasses), sinusitis, and gastroesophageal reflux (irritation of the esophagus caused by the gastric contents, see above) can also contribute to asthma.

Respiratory reactions to food can occur when people do not recognize that their trigger food is hidden in the food they are eating. Smoke from food cooking, or a wood-burning fireplace, can also trigger an asthma attack.

Exercise can cause bronchoconstriction in about 70% of asthmatics. This is thought to be partly because exercise prevents the nose from warming and humidifying the air, since mouth-breathing is common during exercise. However, a physician's role is to instruct a woman on how to use appropriate treatments so that she will be able to exercise without having the asthma stop her from achieving her desired activity level. There is medication available to use right before exercise to help prevent exercise-induced symptoms. Changes in the weather can trigger asthma. Dry cold air may be especially bothersome.

Strong smells or sprays can trigger asthma and should be avoided when possible. These things can irritate people without asthma, but people with asthma are even more sensitive to them. Soaps or shampoos also often contain perfume and should be avoided.

A recent report from the Nurses' Health Study found that increasing weight (as adjusted for height) was associated with increasing risk of asthma in women. The study also found that weight gain after age 18 was strongly associated with risk of adult-onset asthma.

Some people's asthma is triggered by aspirin, though these people represent a very small portion of asthmatics overall. A physician can help determine which particular asthma patients are at risk for aspirin-induced asthma.

Avoiding triggers may help both in averting the acute asthma attack and also over time in improving asthma control.

Treatment Overview

Asthma can be controlled. It requires good communication with a treating physician. There is no reason to settle for lack of improvement in asthma symptoms. Taking care of asthma means carrying out both environmental and medication plans. An asthma episode can often be halted if treated early with medication. People who do not realize or believe that are at risk of dying from asthma. Research confirms that in the community, asthma patients usually have a good prognosis in other words that they have similar survival compared to people in the community without asthma.

Many of the hospitalizations and deaths resulting from asthma can be prevented, but only if people: recognize the symptoms, act on symptoms quickly, avoid asthma triggers, take the correct medications regularly and in correct fashion, and get good education regarding asthma and asthma medications. Some ways to accomplish these goals are discussed below.

Non Pharmacologic (Non-Medication) Intervention

Dust can have mold, animal dander, and dust mites in it. The dust mite is a tiny creature that lives in bedding and furniture as well as carpet. Dust mites are more plentiful in the summer and have trouble surviving in the winter. Dust mite waste products are the cause of allergic reactions. Although dust may cause inflammation in most people, in asthmatics it can cause bronchial constriction (narrow of the airways) and hyper-responsiveness (excessive "twitchiness" of the airways, tendency of the airways to spasm). It is recommended that people susceptible to asthma attempt to eliminate dust sources. Methods to do this include eliminating carpeting, covering mattresses and pillows with special allergy covers (plastic with a zipper, available in many major linen store chains), and washing bedding frequently in hot water. Hot temperatures are necessary for killing the dust mites. Feathers and down are probably not wise to have around asthmatics, nor is wool. As much as possible furniture should be minimal and not upholstered, and dust-prone venetian blinds should be restricted. Curtains should be washed weekly in hot water. Use of pillows or mattresses made of straw is not recommended. Extra throw rugs and old moldy dusty stuffed animals or throw pillows should probably be removed. The best toys are probably those made of washable materials that are not likely to hold dust. Wood is a good toy material from the asthma standpoint.

Although open windows can allow pollens and other triggers into the house, there may be a trigger in the house, such as smoke, that necessitates opening a window.

Pets with fur should be kept out of the bedroom. If pets are to be kept in the household, they should be bathed twice weekly to reduce the amount of allergens (substances with potential to cause asthma or allergy symptoms). An asthmatic may be allergic not only to the animal itself but also to danders or pollens that the pet carries in from the outside.


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