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Could it be asthma by Sarah Purcell

Does your child cough and wheeze each time he gets a cold? If so, you might be wondering if he has asthma, especially when you read stories about the rising number of children who have the disease. However, while it is something you should talk to your GP about, in many cases wheezing is something children grow out of by school age.

At least one in seven children will have wheezing at some point during their first five years, often after a virus, and many of these won't be asthmatic. Some young children have softer cartilage in their windpipe, which means this airway moves around more, making breathing sound noisy. This will normally correct itself by the age of two.

However, asthma is a serious and potentially fatal condition so it's important to see your doctor for a proper diagnosis. If your child does have asthma he'll need treatment to control his symptoms and you'll need to learn how to prevent and manage his asthma attacks.

What is Asthma?

Asthma is a condition affecting the airways, the tiny tubes that carry air in and out of our lungs. People with asthma have airways that are sensitive and inflamed. When a child with asthma comes in contact with an asthma trigger, such as an infection, dust mites or cold air, the muscles around his airways tighten and the airway linings swell and produce sticky mucus. It's harder to breathe with narrowed airways and it is this that causes the typical asthma symptoms such as shortness of breath and coughing.

What Causes Asthma?

In up to half of cases, asthma is inherited, so if you or your partner suffers, your child's risk of developing asthma is doubled. Boys are more likely to suffer than girls, although by adulthood more women than men are asthmatic. The good news is that one in three children grow out of asthma by their teens and two-thirds of asthma sufferers will see symptoms much improved by this age, according to Asthma UK.

Asthma is usually an allergic condition, and is closely linked with eczema and hayfever. Up to half of children with eczema also develop asthma. Other factors that increase your child's risk of developing asthma include being born premature and being exposed to cigarette smoke - children of smokers are 1.5 times more likely to be asthmatic.

Outdoor pollution can make symptoms worse in an already asthmatic child and recent studies have found that children living next to a main road are also more likely to develop asthma.

The rise in conditions like asthma has been linked to our obsession with cleanliness. Children need to be exposed to a wide range of bacteria and bugs to develop a strong immune system and many experts believe that if they aren't allowed to do this they become more susceptible to allergic conditions.

Our homes harbour millions of dust mites, thanks to the warm, sealed environment created by double glazing and central heating. An allergy to dust mites can trigger the development of asthma.

Signs to watch for

An asthmatic child will have some (probably not all) of these symptoms:

  • Coughing. If your child has a dry cough that wakes him at night, or if he coughs even when he doesn't have a cold and gets worse after he's been running around, this could be a warning sign of asthma.
  • Noisy breathing and wheeziness. Lots of things can cause wheezing in young children, so it's unlikely your doctor will diagnose asthma from just this one symptom. An asthmatic will wheeze more at night and after exercise.
  • A tight chest or sore tummy. If your child says his chest or tummy feels tight or sore this could be a sign of narrowed airways not allowing enough air through to his lungs.
  • Out of breath. If your child is reluctant to run around as much as his friends and gets out of breath after just a short burst of exercise, this could also be a sign.
  • You may notice a worsening in your child's symptoms after he's been in contact with pets, smoke or a new environment..

What will my GP look for?

  • Your doctor will probably ask you to keep a diary of your child's symptoms and anything which seems to trigger his asthma.
  • You'll be asked about a family history of asthma or other allergic diseases like eczema or hay fever.
  • If your child is over five, your doctor can measure how well his lungs are working with a peak flow metre.
  • In younger children it's hard to diagnose asthma and your doctor will look at family history and his pattern of symptoms.

How it's treated

Relievers are inhalers that help to make breathing easier during an asthma attack. They work by relaxing the muscles surrounding the airways, making it easier to breathe. Children with asthma should always have one with them. They can also be used before exercise, an outing to the park or a party to help prevent an attack.

Preventers help to control asthma by stopping inflammation of the airways when they come into contact with asthma triggers like pet fur. If your child needs to use their reliever inhaler more than once a day or 3-4 times a week, they probably need a preventer inhaler too. These normally contain low-dose corticosteroids that help to reduce the chances of a severe asthma attack, but need to be taken daily, even when your child is feeling well.

If your child has suffered a severe asthma attack, he may need a short course of steroid tablets to bring it under control.

Masks and inhalers

You'll need these special devices to give asthma medicine to your child.
Babies and toddlers will need to use a mask to make sure they inhale the medicine properly. The mask is fitted to a device called a spacer, a plastic container with a mouthpiece at one end and a hole for the inhaler at the other. You simply press the inhaler to deliver a dose of medicine into the spacer and your child inhales it through the mask. Once your child is three he'll be able to use the spacer without the mask and just inhale using the mouthpiece.

Is it an asthma attack?

A survey by Asthma UK found that while 93% of us know an asthma attack can be fatal, only half know what to do if someone is having an attack.

Signs of an attack:

  • His coughing and wheezing get worse.
  • Your child's usual reliever inhaler has no effect.
  • His chest is very tight and his ribs 'suck in' when he breathes.
  • His lips turn blue. This means not enough oxygen is getting through and is an emergency situation.
  • He's too out of breath to speak or eat.

What to do:

  • Give his reliever inhaler immediately.
  • Stay calm and reassure your child - an asthma attack is frightening but if he panics it'll make things worse.
  • Help your child to sit up straight and breathe slowly.
  • Loosen any tight clothing.
  • After about 5-10 minutes his breathing should return to normal, but if it doesn't, call an ambulance.
  • Call an ambulance if your child is distressed or unable to talk or is getting exhausted. Continue giving him his reliever inhaler while you wait - two puffs initially then one per minute for five minutes.
  • Take your child's medicines with you to hospital.

Common Asthma triggers

If you can work out what triggers your child's asthma this will help to avoid attacks. Here are the most common ones:

  • Dust mites: These tiny creatures live in our beds, carpets, soft toys and furnishings and it's their faeces that cause allergic reactions.
  • Colds and viruses: These are very common asthma triggers in children.
  • Cigarette smoke: This irritates the airways and is a common asthma trigger. It also increases your child's chances of developing a reaction to dust mites and pets.
  • Pet fur: It's the tiny pieces of fur and skin that animals shed daily that can trigger asthma.
  • Cold air: This can cause the airways to narrow and trigger wheezing and shortness of breath.
  • Exercise: This is one of the commonest triggers of childhood asthma. When you exercise your heart rate increases and your lungs need more oxygen. In children with asthma, the airways narrow instead of widen in response and cause wheezing, chest and stomach pain.
  • Excitement: Getting over-excited can trigger asthma.

Top tips for parents

  • If dust mites trigger his asthma, minimise soft furnishings in his room and swap carpets for hard flooring if possible. Damp dust and vacuum regularly, air his room daily and turn down the heating.
  • Don't smoke in your house, or allow anyone to smoke near your child.
  • Think carefully about getting a pet if there's a family history of allergy. If you already have one, keep it out of his bedroom and bath it regularly.
  • See your doctor regularly to review your child's treatment.
  • To minimise your baby's chances of developing asthma, exclusive breast feeding for the first six months is recommended.

For more information

Asthma UK -

The British Lung Foundation -


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