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Everything you need to know about asthma in children

Everything you need to know about asthma in children

August 8, 2016 - By Dr Antony Zardis

Dr Antony Zardis on what you really need to know to keep your child safe.

Asthma is the most common breathing disorder of childhood and it affects up to 1 in 10 of school children... I was one of them!

It affects boys twice as much as girls, a ratio which soon equalises by adolescence. It is responsible for up to 20 percent of paediatric hospital admissions, however this is thankfully on the decrease as better control over the symptoms of asthma has been established over the years.

Asthma is responsible for up to 20 percent of paediatric hospital admissions.

What causes asthma?

Asthma affects the smaller airways of the lungs by narrowing them and preventing air flow in and out of the them. This narrowing is caused by inflammation of the airways. It is not known why this occurs, however we do know that certain genetic and environmental factors can predispose your child to it.

When the hay fever season is well under way, it is inevitable that our young asthmatics may be aggravated by the high pollen count and freshly cut grass that is in abundance at this time of year, but these are not the only predisposing factors to be aware of:

Cigarette smoke

Even when adults smoke away from their children, the smoke left on their hair and clothes can make their child's asthma worse.

House-dust mites

These are tiny creatures which lives in mattresses and other fabrics around the home. If your child is allergic to them, it may make symptoms worse.

Colds and coughs

These will cause breathlessness and will increase the symptoms of asthma.

Moulds and pollens

These will aggravate asthma especially in the hay fever season.


Any activity which causes breathlessness will obviously make the symptoms of asthma worse, as the narrowed airways will struggle to meet the increased demand of oxygen which the lungs require. It is, however, worth noting that sport and exercise is actually good for your child's asthma and therefore should be encouraged. Make sure that your child's teacher is aware of the diagnosis. Exercise-induced  asthma often represents under treated asthma and should this occur, it is important to contact your local GP at an early stage, in order to step up the usual preventer treatment taken.

Certain pillows and mattresses

Be careful when buying new bedding as feathers can aggravate asthma as can the chemicals in some memory foam pillows and mattress toppers.


Asthma has been known to be triggered by stress for example, around exam time in teenagers.

Animal allergies

Most asthmatics are allergic to animals - especially cats, dog and horses.

What symptoms should I look out for?

The more narrow the airways become, the more apparent the symptoms of asthma, which are:

  • Wheeze
  • Cough
  • Breathlessness
  • Chest tightness - speaking from first hand experience, it felt like somebody was sat on my chest and preventing my rib cage from expanding.
  • Sleep disturbance ( due to breathlessness or anxiety ) - personally I was always scared to fall asleep when I had a wheeze, incase I stopped breathing.

The severity and frequency of these symptoms varies enormously, from the child who has infrequent attacks once or twice a year to the child who is rarely free of these symptoms at all.

It is therefore extremely important that your child's asthma is managed meticulously not only by your GP, but by yourself and your child as they grow older.


Most children with asthma are treated with an inhaler, which is a device which can deliver a small dose of drug directly into the airways. The dose is enough to open up the airways, however only a small amount of the drug is absorbed into your child's system, thus avoiding most side effects.

Many children fail to gain the benefit of their treatment because they can not use the inhaler they are given. Spacer devices are recommended for children under the age of 5. These act as a reservoir for the drug ( once it is dispensed by the inhaler), which is only released through a valve at the mouthpiece when your child breathes in.

There are a variety of different kind of inhalers available and it is important to choose the right one for your child. The two main types of inhaler used are:

Reliever inhaler - 'the blue one'

This is taken when needed to relieve the symptoms. The drug released by this inhaler relaxes the muscle in the airways and opens them wider.

If your child only has symptoms every now and again and so only occasionally uses the inhaler for relief, this may be all they need, however if they use this inhaler 3 times a week or more then an additional preventer inhaler will be advised.

Preventer inhaler - 'the brown one'

This may be needed if the symptoms are not controlled by the reliever inhaler. The drug most commonly used in these inhalers is a steroid. These inhalers work by reducing the inflammation in the airways, but once the inflammation has gone, the airways are much less likely to narrow and cause symptoms in the future.

Steroid inhalers are usually taken twice per day. The steroid takes 7 - 14 days to take effect and up to 6 weeks to see it's maximum benefit. Your little one would need to continue to take this inhaler daily in order to prevent the symptoms from coming back. They should not need to use the reliever inhaler very often, if at all.

A common mistake that many parents make is, they avoid giving their child the steroid inhaler as they are worried that it will stunt their growth. This means that the child doesn't get the adequate treatment for their degree of asthma and as a result, it increases the risk of them having an asthma attack.

It is important to remember that only a very small and dilute dose of steroid manages to enter the body via the lungs, which means that it shouldn't take effect on your child's growth at all. If, however, they are prescribed at length and at high dose, there is a small risk that enough steroid will enter the body to delay growth. Consequently their growth will need to be monitored closely.

To conclude

Speaking from experience as an asthmatic child myself back in the 1980s, I would say that we have come a very long way in the management of asthma in children. Above all, parents need education, support and guidance on how to manage their child's condition. This should be readily available from your GP, practice nurse, specialist asthma nurse, health visitor and school nurse.

Remember that exercise is good for asthmatics  so do not get into the bad habit of writing sick notes for your child in order to excuse them from gym class. I may have got away with this back in the eighties, but it doesn't mean your little one should do now.

Last but not least, if you have apprehensions about the use of a steroid inhaler, please do not withdraw the inhaler from your child, without consulting your doctor first as this could do more harm then good in the long run.

If you or your child are asthmatic or suffer from hay fever, make sure you are stocked up on your inhalers, nasal sprays and anti histamines.

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