The determination of specific IgE antibody by skin or in vitro tests is useful to evaluate potential allergic trigger factors in children with asthma or when a history suspicious of atopic etiology is obtained. Allergy testing can be used even in infancy, but it is most commonly useful in children over two years of age. Aspects of responsibility for treatment may apply to all environments in which the child spends a significant amount of time, such as preschool, school, or day care. Environmental control for the child includes limiting exposure to cigarette smoke and other irritants, as well as to house dust mite, cockroach, mold, animal, and pollen allergens. The greatest effort is spent in relation to the bedroom, where children spend a major part of their time.
Nedocromil sodium is approved for use beginning in adolescence.
Spacers with a face mask can be helpful for delivery of medications through metered dose inhalers in very young children. Present data are inadequate to establish if inhaled steroids pose a risk for a more complicated course with varicella or other viral infections in children. Immunotherapy can be safe and effective for children with well-defined allergies whose clinical symptoms correlate with the sensitivities identified on allergy testing. Exercise-induced bronchospasm is common in children. Optimal control of chronic asthma by anti-inflammatory therapy also can decrease the frequency and intensity of exercise induced asthma.