If you have a child with asthma, you’ve probably noticed certain seasons or settings set off symptoms. But thunderstorms, pet turtles, dried fruit and Facebook? The darnedest things can bring on asthma attacks. Read on for more surprising childhood asthma triggers, and how to avoid them. Plus, test your asthma IQ with our quiz…
One night 1-1/2 years ago, Kathleen Olowin was vacationing with her family in New York State when severe thunderstorms rolled in.
“There was a lot of lightning with thunder that rattled dishes,” Olowin recalls. The storm also brought high winds and torrential rain.
Then, she heard an odd noise from the bedroom where her three sons were sleeping. There, she found her youngest, 4-year-old Tristan, who has asthma, “gasping for air with a terrified look on his face,” Olowin says.
In the past, Tristan had occasional mild asthma symptoms when pollen levels were high or he had a cold. But this time the attack was so severe that he was rushed in an ambulance to an emergency room.
The trigger for Tristan’s life-threatening asthma attack? The thunderstorm.
Common asthma triggers include respiratory infections, allergy-causing substances, irritating gases and particles in the air.
But sometimes – as it was with Tristan – sources aren’t easy to identify.
“Unusual things can sometimes be triggers,” says Asriani Chiu, M.D., a pediatric allergist at Children’s Hospital of Wisconsin in Milwaukee.
That’s why parents should “keep a journal of their child’s asthma symptoms to watch for patterns, Chiu advises.
From violent storms to boisterous laughter, here are 10 often-overlooked triggers of childhood asthma and tips on how to manage them:
Surprising Childhood Asthma Trigger #1: Thunderstorms The connection between the storm and Olowin’s son’s asthma attack wasn’t as farfetched as it sounds. Over the past 25 years, several studies have linked an increase in serious asthma attacks with thunderstorms.
When a 2008 Emory University study published in Thorax, a leading respiratory medicine journal, looked at emergency room visits in the Atlanta area over 12 years, it showed a 3% increase in asthma-related ER visits on days after thunderstorms.
“One hypothesis is that the heavy rains and winds that come with thunderstorms may increase levels of pollen and mold in the air,” says researcher Stefanie Sarnat, Sc.D., an assistant professor of environmental health at Emory University in Atlanta.
That can cause an allergic reaction and set off asthma attacks in people sensitive to these substances.
Another theory: Lightning leaves higher levels of nitrogen dioxide and ozone in the air, and these gases can irritate lungs.
Smart solution: You can’t control weather, so watch for symptoms of labored breathing or wheezing in your child with asthma when a storm’s brewing.
Also, “limit outdoor time to the day after a thunderstorm” Sarnat advises, especially if they've triggered asthma in your child before.
Surprising Childhood Asthma Trigger #2: Play ClothesKids love to play outdoors when the weather’s warm, but they pick up a lot of pollen on their clothes in the process.
In early spring, pollen from trees is the main culprit in seasonal allergies and asthma. Later, it’s from grasses, and in late summer and autumn, weeds.
Smart solution: “If your child has pollen allergies, take off their play clothes as soon as they return inside,” Chiu says.
Do this in a bathroom to keep pollen-covered clothes out of your child’s bedroom. Also, brush off shoes and rinse eyeglasses, and then have your child hit the shower to wash away pollen clinging to skin and hair.
Surprising Childhood Asthma Trigger #3: Hamsters, Parrots and TurtlesYou probably know cats and dogs can be asthma triggers in kids with pet allergies. But other animals can be a problem for children with asthma too.
That’s because small furry animals – hamsters, guinea pigs, rabbits and mice – have proteins in their urine that can set off allergic reactions. (Mouse allergies also can be triggered by pests.)
Sensitivity to these animals isn’t unusual. In a 2004 study of more than 200 suburban children with asthma, 12% tested positive for mouse allergy, compared to 11% for dog allergy.
Feathered friends can be a problem too.
“Birds have mold and mites in their feathers, so every time they flap their wings, they’re throwing these allergens into the air,” says Raoul Wolf, M.D., medical director of asthma medicine at La Rabida Children’s Hospital in Chicago.
Even turtles and snakes aren’t a safe bet.
“Turtles are covered in mold,” Wolf says. “Snakes may have mold and mites in their tank too.”
Smart solution: Don’t get a pet in the first place – or find it another home, if you already have one.
What if Johnny can’t bear to part with Tweety?
Then, “don’t have your child clean out the cage,” Wolf advises.
And keep the pet out of your child’s bedroom.
Surprising Childhood Asthma Trigger #4: Dried FruitA handful of dried fruit seems like a healthy snack for children, right? Not if your child has asthma.
“The sulfites added to dried fruit can create asthma triggers in people sensitive to this additive,” says John Winder, M.D., an allergist in Toledo, Ohio, and chair of the Nationwide Asthma Screening Program.
That’s because sulfites, which help keep dried fruit brighter and fresher, emit a gas called sulfur dioxide. It’s inhaled when your child eats the food, and can irritate lungs and set off an asthma attack.
Smart solution: Buy sulfite-free dried fruit.
Surprising Childhood Asthma Trigger #5: Third-Hand SmokeYou know it’s a bad idea to smoke around children – especially those with asthma – and that secondhand smoke increases the frequency and severity of asthma attacks.
Also, watch out for third-hand smoke: The tobacco byproducts that cling to clothes, hair and household surfaces – can harm babies and young children.
“If you smoke all day at work, then come home and pick up your baby, you’re holding their face in the remains of cigarette smoke,” Wolf says.
Smart solution: If you smoke, quit. At a minimum, make places where your children hang out – your home and car, for example – smoke-free zones.
And if you’re exposed to a smoke-filled environment, change your clothes and shower before coming into contact with your kids.
Surprising Childhood Asthma Trigger #6: Indoor PoolsSwimming is often considered the ideal exercise for children with asthma, because exercise-induced bronchoconstriction (EIB) is less likely to flare up when they’re breathing warm, moist air.
But there’s the catch.
“Around heavily chlorinated indoor pools, there’s often a high level of chlorine in the air that’s very irritating to the airways,” Wolf says.
Smart solution: If possible, kids should swim in an outdoor pool, where chlorine isn’t trapped within a confined space.
Surprising Childhood Asthma Trigger #7: Laughing and CryingLaughing, crying or yelling may trigger an attack of coughing and wheezing in children with asthma. They have a physical effect on airways much like exercise does.
Of course, laughter, tears and the occasional tantrum are a normal part of every child’s life.
“You want your child to be able to laugh!” Chiu says.
Smart solution: Talk to your child’s doctor if yelling, laughing or crying hard sets off symptoms. It may be a sign that your child’s asthma isn’t well controlled and the treatment plan needs to be adjusted.
Surprising Childhood Asthma Trigger #8: FacebookIf just thinking about what your teens are posting on Facebook makes you hyperventilate, imagine the effect it might have on them.
The stress triggered by social media sites might also set off asthma attacks, according to a case report published in The Lancet medical journal last year. It described an 18-year-old Italian man, whose mother noticed that his asthma worsened when he checked his ex-girlfriend’s Facebook page, where she was “friending” other men.
Smart solution: There’s no need to cut off access to Facebook and other social media sites, advises Chiu. Children with asthma, like all kids, will hit rocky patches.
That's why parents should "teach children ways to manage stress and calm themselves, such as taking deep breaths,” Chiu says.
Surprising Childhood Asthma Trigger #9: Stuffed AnimalsYour child’s teddy bear may look cuddly, but it’s probably a reservoir for dust mites. These microscopic insects are the No. 1 trigger of allergy-related asthma, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI).
Smart solution: Deep-freeze Teddy to kill off dust mites.
“Enclose stuffed animals in a [plastic zip] bag, put them in the freezer and leave them there overnight,” Chiu says.
Repeat once a week.
Also, wash blankets and bedding weekly in hot (130˚F or higher) water and dried in a hot dryer to get rid of dust mites.
Surprising Childhood Asthma Trigger #10: SportsRegular physical activity is healthy for everyone, including those with childhood asthma. However, some kids have EIB – asthma symptoms brought on by exercise.
Activities that involve sustained running, such as soccer, are particularly likely to trigger EIB. With soccer, kids are also exposed to pollen and mold on the field.
Once temperatures turn brisk, there’s another problem: “Kids with EIB tend to be particularly sensitive to exercise in cold air,” Chiu says.
Smart solution: To prevent asthma attacks, your child might be advised to use an inhaler 15-20 minutes before exercising.
“Your child should also do a warm-up beforehand,” Chiu says.
Although research has shown that a 10- to 15-minute warm-up may decrease EIB symptoms, the reason is still being debated. One hypothesis is that mild exercise during a warm-up triggers the release of catecholamines, hormones that help relax and widen the airways.
Limit outdoor activity when pollen counts are high, temperatures are low or your child has a respiratory infection.
Sports that require shorter bursts of energy – such as baseball and short-distance track events – are less likely to trigger asthma symptoms. Activities in which it’s easy to vary the intensity and slow down as needed – such as leisure biking, walking and hiking – are also good choices for kids with EIB, according to the AAAAI.