Does your child wheeze or have shortness of breath? Have you ever wondered if it might be asthma?
Many children will start to show symptoms of asthma in their early years but it can be difficult to diagnose definitively until they are older because there are many causes of wheeze and younger children may ‘grow out of’ it’.
Asthma is also a condition that changes all the time; the symptoms can vary from child to child, and from episode to episode, so it can be tricky for parents and carers. The most important thing to remember is that children with any degree of asthma can experience severe life-threatening attacks or flare-ups, so it must be taken seriously.
The best piece of advice we give to patients and families is to always keep in mind that they should be in control of their asthma and to not let it control them!
What is asthma?
A child with asthma has airways (breathing tubes) which are more sensitive than normal. When their hypersensitive airways are exposed to certain triggers, such as a cold or cigarette smoke, their airways overreact and become narrow and inflamed, making it hard to breathe. This is called an ‘episode’ of asthma or an asthma attack. However, preschool children have relatively small airways and can develop wheeze from other causes such as viruses, inhaled foreign bodies and allergic reactions, so it is important that you seek medical advice for diagnosis.
How do I know my child has asthma?
The symptoms of asthma can vary greatly between children and also from episode to the next. A child does not need to have all the symptoms present at any one time.
The main signs and symptoms of asthma are:
- wheezing (a high pitched raspy sound or whistle when breathing out)
- shortness of breath
- tightness in the chest.
- coughing – cough may occur especially at night or early in the morning, or be associated with exercise or activity. Please note that if your child has a cough without any of the other signs or symptoms above, it may not be due to asthma.
What can trigger asthma?
The most common trigger in children is a cold or respiratory (chest) infection caused by a virus. Viral infections are very common in young children and happen about six to eight times a year. If your child is prone to asthma they are likely to wheeze and cough at these times.
Other common trigger factors include: smoke (cigarette or fire), animals, dust, pollen, moulds, activity and exercise, changes in temperature and emotions (e.g. stress or laughter). Triggers may be different for each person.
Treatment and types of medication
The good news is that asthma can be managed and children can lead a full and active life. The best way of controlling asthma is through medications. These are usually taken by breathing in the medication so it goes straight into the lungs. If your child has asthma, your doctor will prescribe medications that will best control their asthma.
There are three types of medication:
1. Relievers (Blue-coloured devices e.g. Ventolin, Asmol, Epaq, Airomir, Bricanyl)
These relieve the symptoms of asthma by quickly opening abnormally narrowed airways so it is easier to breathe. It works very quickly (in about four minutes) and lasts up to four hours.
Relievers should only be used when your child has symptoms, in an emergency, or before exercise if prescribed for exercise-induced chest tightness. They should not be used at other times ‘just in case’. Using a reliever too often is a sign that your child’s asthma is poorly controlled – your child may need regular preventer medicine.
2. Preventers (Autumn-coloured devices e.g. Pulmicort, Qvar, Flixotide, Singulair, Alvesco)
As the name suggests, these prevent asthma attacks by treating the inflammation in the airways, or more specifically reducing the amount of swelling and mucus in the airways. Preventers can be inhaled or taken in tablet form.
Combination preventers also contain a second medicine that helps keep narrow airways open for a longer time.
Preventers must be taken every day even if your child feels well. The medication doesn’t work straight away, but your child will start to feel better in a few weeks.
3. Combination medications (Purple and red/white-coloured devices e.g. Seretide, Symbicort)
These combine a preventer and a long-acting reliever (symptom controller) in one device.
Spacers
Puffer medications are best given to children with a spacer. These portable plastic cylinder-shaped devices attach to the puffer at one end with the other end going to your child’s mouth. Older children can place their mouth over this end or a connected mask surrounds the mouth of younger children. A spacer helps get more medication into the lungs, they are easier to use than a puffer, and there are fewer side effects from the medication.
Asthma action plan
After your child has been diagnosed with asthma, your doctor will prepare an tailored asthma action plan that provides instructions on how to prevent asthma attacks or flare-ups, and how to manage them when they do occur. The plan should be kept in a safe place where you can find it easily and quickly when needed. It’s important to share the plan with anyone who will care for your child, including their school teachers.
Tips for dealing with your child’s asthma
- Make sure you or your child knows how to take the medication
- Make sure your child has their medication with them at all times.
- Make sure people caring for your child know your child has asthma and what to do during an asthma attack or flare up.
- If your child is finding it difficult to breathe, follow their asthma action plan
- Exercise is very important. If your child is fit and healthy, they will cope better if they have an asthma attack.
When to see a doctor or seek urgent medical attention?
You should see your GP or paediatrician if:
- your child is not improving on a daily basis.
- your child is requiring the reliever more frequently than your child’s Asthma Action Plan suggests.
- you are at all concerned that something may be wrong with your child.
Seek urgent medical advice if:
- Your child is having a bad asthma attack and you are worried.
- Your child repeatedly needs reliever medication sooner than three hours (always give reliever medication before going for medical assistance).
- Symptoms do not improve (settle) after 24 hours.
- Your child gets little or no relief from the reliever, or symptoms worsen suddenly. In this instance, you should contact the Queensland Ambulance Service (dial 000) immediately.
If it’s not an emergency but you have concerns, you should speak to your GP. You can also contact 13 HEALTH (13 43 25 84) to speak to a registered nurse, 24 hours a day, seven days a week.
In an emergency, always call 000.