Management of asthma in young children.

Asthma and recurrent airway symptoms in a young child can result in significant morbidity and reduced quality of life. There is significant variability in asthma severity. Even for those who will "outgrow" asthma, regular problems can be minimized with appropriate pharmacotherapy, education, and environmental control. Success with primary prevention through environmental control for children at high risk for asthma has been limited. Avoidance of passive tobacco smoke exposure has primary and secondary prevention benefits. An inhaled short-acting bronchodilator should be available for use as needed. Patients with regular symptoms should receive maintenance anti-inflammatory medication. Add-on therapy can be considered for those with inadequate control on inhaled corticosteroid. Physicians should regularly review drug delivery technique and compliance and provide all patients with a written asthma action plan to guide symptom monitoring and medication use. Physicians should also establish a partnership with the child and family, providing self-management training to enhance skills and confidence.