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April Showers Bring May Flowers (and Allergies, Asthma)


The following Healthy Kids column originally appeared in the May 10, 2004 edition of the St. Louis Post-Dispatch.

Shhh, listen….hear that wheezing?   It’s the sound that accompanies the arrival of national Allergy and Asthma Month.  

As May’s flowers bloom so, too, do the accompanying respiratory difficulties that result from plants and trees increasing their production of pollens.   As these substances become thicker in the air, allergy sufferers may experience sneezing; congestion; runny noses; and eye, nose and throat itchiness.

If this sounds like you, you’re not alone.   In fact, the American Academy of Allergy, Asthma and Immunology ( estimates that spring allergies afflict some 35.9 million Americans.

Asthma sufferers are less numerous, but just as miserable.   The 14 million U.S. adults and nine million children who have asthma experience frequent coughing spells, decreased energy, rapid breathing, wheezing, fatigue, and tightness in the chest and neck.   It’s important to note that asthma symptoms can vary, and that not all wheezing is related to asthma.   Also, one does not have to wheeze to have asthma. Still, if your child has trouble breathing, it’s best to consult a doctor.

“Asthma and allergies can be a nuisance, and in some cases they can even be dangerous, but they can be controlled if managed properly,” says allergist Brad Becker, M.D., FAAAAI, Co-director of the Asthma Center for Children at SSM Cardinal Glennon Children’s Hospital, and an associate professor of pediatrics at Saint Louis University.

Dr. Becker says proper management of spring allergies may include antihistamines, steroids taken by inhalers, or allergen immunotherapy in cases where the former therapies are ineffective.   Allergen immunotherapy involves the injection of certain allergens into a patient’s skin, leading the body to decrease its reactivity to the symptom-causing allergen.

Proper management of asthma, Dr. Becker says, involves development of an asthma action plan, prescription of asthma medications, and lots of patient and parent education on the various “triggers” that lead to asthmatic episodes.

Asthma medications are sometimes given using a home nebulizer, or “breathing machine.” The machine turns liquid asthma medications into a mist, which is then breathed in through a facemask. The treatments are given several times a day, with each session lasting around 15 minutes.   Another dosing instrument is the metered dose inhaler, which allows a child to breathe the asthma medication into his lungs from a pressurized canister.

Locally, the St. Louis chapter of the Asthma and Allergy Foundation of America ( provides financial assistance to families whose children need nebulizers or inhalers.   Last year the organization helped to pay for more than 17,000 prescriptions, as well as a large number of machines to help with asthma treatment.

“The work of this organization is vital. Many kids don’t get the preventive care they need because it’s too expensive, then they end up in hospital emergency rooms because their breathing problems have gone untreated,” says Dr. Becker, who serves as volunteer for the St. Louis AAFA.  “The number one thing children and their parents can do in preventing serious asthma and allergy problems is to arm themselves with knowledge.   Find out what the triggers are that cause your child to become ill, then counteract those triggers by avoiding them, or if that’s not possible, medicating against them.”

One question asked by many asthma patients is whether they can continue to engage in sports and vigorous exercise activities.   By following a few simple guidelines, asthma sufferers can make exercise a regular part of their healthy lifestyle. For example:

Exercise regularly and build up strength and endurance over time.
Use caution when exercising in cold weather.
Warm up before an athletic event. Several short, intense warm-up sprints can help you get past the point at which asthma symptoms occur.
Use bronchodilator medicine (Ventolin, Proventil, Brethine) taken by a spacer (e.g., Optihaler or Aerochamber) 15 minutes before event.
In cold weather, some athletes with asthma find it helpful to wear ski masks or surgical masks to warm up the inspired (breathed in) air.
With summer quickly approaching, children will soon be spending much more time outdoors among their allergy and asthma triggers.   But by avoiding those triggers, taking the proper medication and monitoring their symptoms, kids with allergies and asthma can lead a normal and healthy lifestyle.

Dr. Bob Wilmott is Chief of Pediatrics at SSM Cardinal Glennon Children’s Hospital and is a Professor of Pediatric Medicine at St. Louis University School of Medicine. If you have a child health question for Dr. Wilmott, go to the “ Ask Dr. Bob” section of the Cardinal Glennon Web site at

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