On the Coast – Families Issue 98 I February/March 2019 | Page 8

Asthma
in Children
By Dr Georgia Page
A
sthma is a common lung
condition in which the
airways become narrow making
it hard to breath leading to
wheeze, cough and shortness of
breath. Approximately 1 in 10
children have asthma and it is
one of the most common reasons
that children present to the
hospital or doctors.
Having a child with asthma can be
daunting but by recognising the signs of
asthma, being on the correct medication
and having an asthma action plan,
symptoms can be well controlled.
What causes Asthma?
Asthma occurs when, in response to
certain triggers, the muscles around the
airways tighten, become swollen and
produce more mucous. This makes the
airways narrow and it harder to breath.
Triggers can include;
ƒ ƒ Viral infections (colds and flu’s)
ƒ ƒ Allergens such as dust mites, pollen,
mould, and animals.
ƒ ƒ Inhaled irritants such as pollution, and
cigarette smoke.
ƒ ƒ Weather conditions – such as cold or
dry air.
ƒ ƒ Exercise
ƒ ƒ Some medicines (such as aspirin,
non-steroidal anti-inflammatories
like ibuprofen)
Not every child has the same trigger
and some children have more than one.
8
KI DZ O N T H E C OA S T
Knowing and minimising exposure
to triggers can help you manage your
child’s asthma.
Children are more at risk of developing
asthma if it runs in the family or if they
have a history of eczema or hayfever.
Unfortunately we can’t change genetics!
What are the Symptoms of Asthma?
Common symptoms of asthma include;
ƒ ƒ Cough
ƒ ƒ Wheeze
ƒ ƒ Shortness of breath
ƒ ƒ Chest tightness
Symptoms are often worse at night,
early in the morning, and in response to
triggers such as viruses and exercise.
Diagnosing Asthma
Diagnosing asthma can be tricky in
children, especially in those under 5
years of age. This is because there are a
lot of other conditions that can cause
wheeze in young children such as viral
infections (colds and flu). A lung
function test called spirometry can be
used to help diagnose asthma however
most children under 5 are unable to
perform this test. Diagnosis is therefore
based on the presence of recurrent
symptoms, their response to asthma
medications and if there is a family
history of asthma. This requires regular
assessment by the child’s doctor. A large
proportion of kids under 5 will ‘grow out’
of their asthma and have no symptoms
later in life.
Treatment of Asthma
The goal of treating asthma is to control
symptoms and to reduce the number of
flare ups.
This can be done by avoiding or
reducing triggers where possible and by
the use of asthma medications. The most
common way for children to take asthma
medication is by breathing it into the
lungs via an inhaler or puffer.
Treatment depends on how severe
the child’s symptoms are. The most
commonly used medication are divided
into two groups:
ƒ ƒ Relievers – are used to treat asthma
when symptoms occurs. They relax the
smooth muscle around the airways
causing them to open up. They work
quickly and usually last 4 hrs. The most
commonly used reliever is the ‘’blue
puffer’’ Salbutamol (Ventolin) and is
usually given via a spacer in children.
ƒ ƒ Preventers – are used when children
are getting frequent symptoms and
need to use their reliever treatment
often. They work by reducing the
swelling and mucous production in the
airways and make them less sensitive
to triggers. They do not work straight
away like relievers and can take up to a
few weeks before symptoms improve.
Preventatives need to be given every
day and are either steroid based
inhaler’s (e.g flixotide, pulmicort) or
non-steroid based (e.g Montelukast/
singulair tablets) depending on your
child’s needs. Not all children with