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Asthma in childhood

asthma; wheeze; bronchodilator; reliever; preventer; puffer; ;

Asthma in childhood is common and it can be serious. About 1 in 9 children and 1 in 10 adults in South Australia are affected by asthma.

You need to work out a plan for managing your child's asthma with your doctor.

Contents

There is information about asthma including asthma action plans in many languages on the website of Asthma Australia   
https://www.asthmaaustralia.org.au/ 

Asthma first aid

If a child is short of breath and wheezing from asthma, follow the child's Asthma Action Plan, or  Asthma First Aid published on the website of the National Asthma Council of Australia 
https://www.nationalasthma.org.au/ 

What is asthma?

  • People with asthma have sensitive or 'twitchy' airways (bronchi and bronchioles). When they are exposed to certain 'triggers' such as cigarette smoke or viruses, the airways become narrowed and this makes breathing difficult.
  • The main ways the airways become narrow are:
    • the lining inside the airways becomes red and swollen
    • the muscles around the airways tighten
    • extra mucus may be made.
  • Symptoms of an asthma attack include shortness of breath, wheeze (noisy breathing when breathing out), a dry cough (often at night, early morning and during exercise or play), chest tightness and shortness of breath.
  • Note: there are other causes for each of these symptoms - they do not always mean that the child has asthma but a child with these symptoms should be checked by a doctor.

What causes asthma?

  • It is not yet clear why some people get asthma, but asthma tends to run in families. A child is more likely to get asthma if a parent, brother or sister has asthma.
  • Eczema and hay fever are also linked to asthma. If someone in the family has eczema or hay fever, a child is more likely to get asthma.
  • Some research has shown that exposure to cigarette smoke before birth or soon after birth makes it more likely a child will develop asthma.
  • Children who have bronchiolitis in the first year of their life are more likely to develop asthma than other children, but it is not clear if the infection causes the asthma, or if the child develops bronchiolitis because he or she already is likely to develop asthma.
  • Asthma can occur for the first time at any age. 

Trigger factors for asthma

  • Colds and 'flu (viral infections) are the most common triggers of asthma attacks in young children (about 70% of attacks).
  • Exercise and play - see Asthma and exercise below.
  • Breathing in allergens is a trigger for some people with asthma, eg pollens, moulds, house dust mite droppings, animal hair and skin flakes, dust. 
  • Smoking or passive smoking - smoke irritates the airways. Children who live with smokers are more at risk of developing asthma at a younger age.
  • Chemical fumes and strong smells, eg household paint, sprays, perfumes.
  • Changes in air temperature, eg going out into cold night air.
  • Some foods, food additives and colourings, and some medications (eg aspirin). 
  • Emotional reactions, such as laughing.

Asthma may be triggered by several of these factors in one person, or the triggers may never be known.

More information about asthma triggers  can be found on the Asthma Australia website
http://www.asthmaaustralia.org.au/Triggers.aspx

Asthma and young children

It is often difficult to tell whether young children have asthma.

  • Young children have narrower airways anyway and have a lot of colds. For young children most asthma attacks are triggered by a 'cold'. But cough and wheezing is common in colds and chest infections in young children and may not mean the child has asthma
  • Some young children with asthma may not wheeze. A cough, especially at night, may be the only symptom of asthma.
  • About half of young children with mild asthma will "grow out" of it as they get older, but it is not possible to tell which children will. Children are more likely to go on having asthma if they have allergies, if other people in the family have asthma, or if their asthma is severe. 

Asthma and exercise

  • Breathing harder with play, exercise or sport may trigger an asthma attack - in fact this may be the only time some children have asthma attacks.
  • Children who cough, wheeze or become breathless with exercise should be seen by a doctor to check whether they have asthma.
  • Children with asthma, inlcuding those with asthma that is triggered by exercise, need to be encouraged to exercise or take part in sport, in order to strengthen their chest muscles.
  • Using reliever medication before exercise will reduce symptoms for most children who have asthma when they exercise.
  • It is important to teach children how they can prevent their exercise related asthma attacks by using their puffer.

Asthma management

  • The most important parts of asthma management are:
    • Learning as much about your child's asthma as you can.
    • Teaching your child how to manage her asthma.
    • Getting the right preventive medicine, and reliever medicine to use if the child has an attack.
    • Working out what triggers the asthma and avoiding triggers as much as possible.
    • Recognising asthma symptoms and treating them early.
    • Using asthma medications correctly.
  • An asthma action plan needs to be worked out specially for each child - the medications used and the way they are used depends on the age of the child, how bad the asthma is and how often the child gets an attack.
    • Preventers need to be taken daily even when the child is well. They may take a few weeks to work.
    • Relievers are used to treat attacks, as well as sometimes being useful to prevent symptoms, for example with exercise induced asthma.
      • If a child needs relievers more than about 3 to 4 times a week, the child needs to be checked by a doctor, and preventers may help control the asthma.
    • Other medications such as symptom controllers, combination therapy, and steriods during a severe attack, may be needed.
    • Using a spacer means that more of the medication gets down into the lungs.
    • Always discuss changes to your child's asthma action plan with your doctor.
    • Make sure that your child's caregivers or teachers know your child's asthma management plan, so that they are able to provide the best care for your child.
  • Puffers and spacers need to be used correctly and cleaned regularly. See the Royal Children's Hospital Fact sheet 'Asthma - use of spacers'.
    http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=9185
    There is also more information about asthma management in their fact sheet Asthma http://www.rch.org.au/kidsinfo/fact_sheets/Asthma/ 
  • Raising Children Network: Asthma treatment and management 
    http://raisingchildren.net.au/articles/asthma_treatment.html 

What parents can do

  • Find out and control or reduce trigger factors if possible
  • Keep your home and car smoke free.
  • Encourage your child to eat a balanced diet with lots of fruit and vegetables.
  • Watch for signs of asthma when your child has a cold and be ready to start the asthma management plan as soon as symptoms appear.
  • Check with the doctor whether management needs to be improved or changed if your child is unwell, tired and not full of energy.
  • Depending on your child's age, help your child to take as much responsibility as possible for understanding and managing his own asthma.

The topic 'Feeling sick' has suggestions for caring for a sick child.

Resources

Women's and Children's Hospital
'Asthma - parent and caregiver information'

Asthma Australia 
http://www.asthmaaustralia.org.au/ 

National Asthma Council (Australia)
http://www.nationalasthma.org.au/  

Online resources in other languages

Further reading

Asthma Australia - information and fact sheets
http://www.asthmaaustralia.org.au/resources.aspx  

Royal Children's Hospital 'Asthma - use of spacers'
http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=9185

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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