three day Do attacks begin after the child has been around a cat, dog, horse, or other animal with fur? Do attacks come in certain seasons (such as during tree, grass, or ragweed pollination)? Be alert to these and other possible causes of allergies. The difficult breathing characteristic of asthma occurs when the bronchioles (small respiratory tubes) constrict or become clogged with mucus or when the membranes lining the tubes become swollen. Stale air is trapped in the tiny air sacs, called alveoli, and less fresh air can be inhaled. ? HOME CARE The first time your child has an attack that might be asthma, do t trv to care for the child at home. Contact your doctor immediately. Xhe doctor will determine if the child has asthma and will select a specific treatment. After a doctor has diagnosed asthma, home care is important. Prescribed medications should be given as soon as an attack begins. Medicines are less effective if an attack is under way. Rid your home of any identified causes of asthma allergy-pets, feather pillows and comforters, house dust, and sources of mold. Avoid exposing your child to airborne irritants such as insecticides, smoke, and paint fumes. PRECAUTIONS • Do not use overthecounter aerosol medications on children. They can be dangerous and make other medications less effective. • Do not use aminophylline or theophylline given in the form of rectal suppositories. Rectal medications are not reliably absorbed, and the child may receive an improper dose (either too little or too much). • Do not let an asthma attack go untreated. Frequent attacks of asthma that are untreated or improperly treated can cause permanent damage to the lungs and bronchial tubes. • Not all wheezing is caused by asthma. Have your doctor check your child if you suspect asthma. MEDICAL TREATMENT The treatment for asthma should produce good results. Your doctor will begin treatment by taking a detailed medical history and performing a general physical examination. A chest xray examination may be ordered. The diagnosis can be confirmed if asthma medicines relieve the symptoms. Medicines to treat asthma may be taken by mouth during an attack or may be inhaled. The same drugs may be recommended for daily use to prevent attacks. The doctor may also order a series of skin tests of materials to which the child may be allergic. The substances identified as causes of allergic asthma must be removed from the child's surroundings wherever possible. Children also may be desensitized to substances that cause allergic reactions. Desensitization involves giving weekly to monthly injections of increasing amounts of the irritating substances over a period of one to ten years. Severe attacks may require hospitalization for administration of oxygen and of intravenous medications and fluids. incubation