/publications/issue/2007/2007-11/2007-11-8285

ASTHMA WATCH

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Breast-feeding and Weight Linked to Risk of Asthma

New research shows that children who are breast-fed for fewer than 3 months and who are overweight have a greater risk of developing asthma. In a study of >700 children aged 8 to 10 years old, researchers found that the combination of being breast-fed for fewer than 12 weeks and excess weight gain in childhood raised a child's asthma risk by 80%.

The duration of breast-feeding was not a factor on its own, however. The investigators speculate that the shorter nursing time could be a factor in the extra weight gain of the children, which in turn raised their asthma risk. The findings were published in the September 2007 issue of the Journal of Allergy and Clinical Immunology.

The general standard for breast-feeding is to nurse exclusively for the first 6 months, then combine nursing with solid foods for at least 12 months. Parents in the study were asked about breast-feeding and other factors in the child's environment. They found that short-duration breast-feeding was linked to the risk of the children becoming overweight, and these children had a greater risk of asthma.


New Guidelines Emphasize Disease Control

The National Heart, Lung, and Blood Institute (NHLBI) issued new guidelines for asthma that are aimed at helping patients breathe easier and maintain an active lifestyle. Elizabeth G. Nabel, MD, director of the NHLBI, stated that, with proper medical care, healthy environments, and better informed patients, asthma can be controlled and patients can lead active lives. "As health care providers and patients, we really should accept nothing less," she said.

The guidelines call for a stronger emphasis on asthma monitoring, which should focus on the severity of a patient's symptoms each day. Both patients and doctors need to be aware of daily symptoms, as well as the risk of future attacks, loss of lung function, and side effects from medication.

The guidelines also established revised patient age categories: infants to 4 years old; 5 to 11 years old; and 12 years and older. The 5- to 11-year-old group, once combined with the adult group, was formed after new evidence showed that this age group responds differently to asthma medication than adults do. The NHLBI also encourages schools to allow children to bring their rescue inhalers to school.


Parents? Anxiety over Meds Hampers Treatment

Parents who are overly concerned about the side effects of their children's asthma medications may be withholding them unnecessarily, depriving children of much-needed symptom relief. According to the results of a study at the University of Rochester Medical Center, 1 in 6 parents of children with asthma is more concerned about the side effects of asthma medications than a child's need for them. Approximately 10 million children in the United States have asthma, yet only half of them take their prescribed medications daily as directed. The findings were published in the September 2007 issue of Pediatrics.

Researchers interviewed the parents of 622 children who reported using at least 1 preventive asthma medication. The parents completed a "Beliefs About Medication" questionnaire, which compared the parents' belief in the need for medication with their concerns about taking it on a regular basis. These concerns included the possibility of side effects or that the drug might be habit-forming.

Even though 77% of the parents felt that the need for the medicine outweighed any concerns they may have had about it, 17% still believed that the medication could do more harm than good to their children. About 6% were undecided.


Use of Spray Cleaners Can Raise Asthma Risk

Using household spray cleaners and air fresheners, even as little as once a week, can raise the risk of developing asthma in adults. These products have been associated with higher asthma rates in professional cleaners, but this was the first study to focus on nonprofessional use of these products.

Investigators from the Centre for Research in Environmental Epidemiology at the Municipal Institute of Medical Research in Barcelona, Spain, used baseline data from the first phase of the European Community Respiratory Health Survey and interviews conducted during the follow-up phase. The study included more than 3500 patients across 22 centers in 10 European countries who were assessed for current asthma, current wheeze, doctor-diagnosed asthma, and allergy at follow-up, an average of about 9 years after initial assessment. The patients were asked to report how often they used cleaning products.

The risk of developing asthma increased with the frequency of exposure to different cleaning products each week. The average was in the range of 30% to 50% higher in people who were regularly exposed to cleaning sprays than those who were not. The researchers found that glass cleaners, furniture polishes, and air fresheners tended to have the strongest effect. The findings were published in the second October (2007) issue of the American Journal of Respiratory and Critical Care Medicine.

F A S T   F A C T : Asthma is the leading cause of school absenteeism attributed to chronic conditions in children.