Asthma in Children
Almost all children with asthma have intermittent cough, wheeze and about a quarter of children with asthma have exercise-induced asthma.
Common complaints in children with asthma:
- My child cannot run for as long as normal in their football game
- I have noticed that my child is coughing throughout the night
- My son is getting very breathless when walking up the stairs and making a funny noise
- My daughter is complaining of a tight band around her chest, this has been going on for a few weeks now
A wheeze in a child increases the probability of asthma.
When diagnosing asthma in a child under 5 years or sometimes older it is too difficult to perform lung function tests (Spirometry or peak flow). So guidelines recommend that a monitored initiation of treatment is performed. For example, the Doctor or Nurse may initiate a corticosteroid inhaler twice a day for 6 weeks.
Observation over 6 weeks will need to be made by a parent or family member and if there is improvement in symptoms, a diagnosis of asthma will be made. If there is an improvement with the initiated treatment, this will be continued.
It is essential for a child with asthma to be monitored regularly and if there is a deterioration in symptoms they need to have an asthma review to ensure they on the appropriate treatment. Another vital aspect of treatment is to ensure that they are on the minimal dose of inhaled steroid required, to ensure they are not taking too much (BTS, 2016).
If children are started on inhalers, they must be taken regularly as prescribed. This will allow the nurse or Doctor to assess their control and see if they need a change in their medication dose or type.
If a child has asthma they should be reviewed at least annually in primary care by the Nurse.
If the device they are using can be used with a spacer (aerochamber or volumatic) then it must be used to help the medication get to the right place in the lungs. Poor inhaler technique can affect the amount of medication entering the lungs and can result in poorly controlled asthma.
Parents or family member smoking in the house or around the child can make asthma symptoms worse and can cause damage to their lungs from passive smoking. Please do not smoke around children.
At School, please ensure that your child’s teacher is aware of their asthma and treatment. Inhalers should be taken to school and kept in a place where the child can access them easily. Staff should be told of the symptoms and management of asthma.
If the clinician thinks that a diagnosis is unlikely, they will investigate the symptoms to try and get an alternative diagnosis (Asthma UK, 2016).
Things to remember
- A history of other atopic conditions such as eczema or hay fever increases the probability of asthma.
- A family history of atopy is the most common risk factor for asthma in children.
Word from our GP
“Boys are more likely to grow out of asthma during adolescence than girls."
Read our coffee break interview with Dr Geraghty here.