Most people with out-of-control asthma do not have to put up with it. Now is the perfect time for people with asthma to reassess how well controlled their asthma actually is.
In Australia, one in every ten children has asthma. It is one of the most common reasons children visit the doctor and go to hospital.
It is not fully understood why children develop asthma, though people with asthma often have a family history of asthma, eczema and hayfever (allergic rhinitis).
There are many causes of wheeze and cough in early childhood. Infants with a wheezing illness do not necessarily go on to have asthma.
Information from parents can help a doctor decide if a child has asthma. The doctor will ask about:
- the child’s/family history of asthma and allergy; and
- a description of the child’s symptoms.
Lung function tests are used to diagnose asthma, however very young children are unable to perform this. Lung function tests can be attempted from the age of six years. A trial of asthma medication is sometimes needed to determine if a child has asthma.
Everyone’s asthma is different. Symptoms often vary from person to person and can change over time. Sometimes people with asthma will have no symptoms, especially when their asthma is well controlled.
Young children with asthma can have a range of symptoms. Children describe these symptoms in different ways, for example:
- Sore chest
- ‘Frog’ in their throat
- Sore tummy
Parents/carers might notice symptoms such as:
- Shortness of breath
- Persistent cough – often at night, early in the morning or during/after activity
Recognising these symptoms as asthma means you will be able to respond in the best way.
What makes the child’s asthma worse?
A trigger is something that sets off/starts or worsens asthma symptoms. Not all children have the same triggers. Colds and respiratory viruses are by far the most common triggers of asthma symptoms in young children. Cigarette smoke is another common asthma trigger. Children exposed to cigarette smoke are more likely to have asthma and flare-ups are more likely to be severe.
It can be helpful to make a note of when a child’s symptoms appear worse and what may have set off their asthma symptoms. Being able to identify these triggers can help parents/carers and the doctor ensure the child has the best asthma plan for staying safe and well.
Written asthma action plans
An important part of providing the best care for a child with asthma is having a written asthma action plan that explains what medications the child needs to take for his/her asthma, and what to do if asthma symptoms worsen, including how to manage asthma during a cold/virus or flu. Ask the doctor to provide a written asthma plan and review it twice a year.
Will my child need asthma medications?
The doctor may suggest asthma medication. The type of medication will depend on:
- How frequently the child has symptoms
How unwell they become with asthma
All children with asthma should have a blue/grey reliever medication (such as Ventolin, Asmol, Airomir or Bricanyl). Some children only need to take this medication to relieve symptoms now and again. If a blue/grey reliever is needed more than two days per week, see the child’s doctor as soon as possible.
Some children need to take daily medication to achieve good control of asthma symptoms. These medications are called preventers and are used every day, even when the child is well. This may be for a set period, for example over winter, or all year round. There are a wide range of preventer medications available for children, including puffers, inhalers or chewable tablets.
Asthma medications come in a range of devices. Young children using a puffer (inhaler) will require a small spacer to help get the medications into their lungs. Very young children also need a mask.
Giving inhaled medication to young children can be challenging, especially if the child doesn’t like it or if you aren’t confident. The device needs to be used correctly and preventer medication given regularly as prescribed or the child may receive a reduced dose making the treatment less effective.
It is a good idea to explain what is happening when you give a child the puffer and spacer. Try and make it fun. There are stickers for spacers that can be used and children’s picture books to explain what is happening. The child may like to try giving medication to a favourite teddy and role playing. Using rewards such as sticker charts or playing a favourite game can be encouraging. Offering lots of praise at the time of giving the medication can make it a much more rewarding experience.
Always keep a blue/grey reliever puffer, spacer, (and mask, if needed) with the child for treating worsening symptoms or an asthma attack
What to do in an asthma emergency
An asthma flare-up can happen to anyone with asthma, at any time. Asthma flare-ups can get worse very quickly; some people call this an asthma attack. Asthma first aid can be provided as soon as you notice that someone’s asthma is worsening. Do not wait until asthma is severe to start first aid.
Signs of severe or life-threatening asthma may include:
- cannot speak a full sentence in one breath or unable to speak
- obvious difficulty breathing
- lethargic, exhausted, drowsy or confused
- collapsed or unconscious
- tugging in of skin at ribs and throat
- cough or wheeze may no longer be present
- lips turn blue or discolouration
- little or no improvement from reliever puffer
If someone is having an asthma flare up or asthma attack, follow their asthma action plan. In the absence of a plan use the Asthma First Aid protocol.