Asthma in Children

Asthma is a chronic inflammatory condition of the airways characterised by recurrent episodes of wheezing, breathlessness, chest tightness and coughing. It is the most common chronic respiratory disease in the Republic of Ireland affecting people of all ages. Ireland has the fourth highest prevalence of Asthma worldwide, and current estimates from the HSE suggest that there are approximately 450,000 people with doctor-diagnosed asthma in Ireland. The prevalence is even higher in children with about 21% of children affected.

Symptoms of Asthma:

• Coughing
• Wheezing or noisy breathing
• Tightness in the chest
• Shortness of breath
• Soreness in the tummy
• Tiredness
• Difficulty speaking

Asthma Triggers

• Infections
• Allergies
• Exercise
• Pollution
• Cold air

Children With Asthma and Cold Weather

• They should always carry their reliever inhaler and keep taking the regular preventer inhaler as prescribed
• If your child need to use their inhaler more than usual, speak to your doctor about reviewing their treatment
• Keep them warm and dry – have them wear gloves, a scarf, and a hat, and carry an umbrella
• Wrap a scarf loosely over their nose and mouth – this will help them warm up the air before breathing it in
• They should try breathing in through their nose instead of their mouth – their nose warms the air as they breathe

Testing for Asthma:

1. FeNO test – you breathe into a machine that measures the level of nitric oxide in your breath, which is a sign of inflammation in your lungs
2. Spirometry – you blow into a machine that measures how fast you can breathe out and how much air you can hold in your lungs.
3. Peak flow test – you blow into a handheld device that measures how fast you can breathe out, and this may be done several times over a few weeks to see if it changes over time

Treatment for Asthma:

1. Reliever Inhalers: Reliever inhalers relax the muscles around the breathing tubes during an asthma attack. This allows airways to open, making it easier to breathe.
2. Preventer Inhalers: These inhalers prevent your child’s symptoms from appearing and reduce the risk of long-term problems. Most use a small dose of steroids.
3. Preventer inhalers work gradually over time. They won't relieve sudden attacks.
4. Your child should use their preventer inhaler every day for it to have the optimum impact.
5. Face Masks & Spacer Devices: Most young children will be prescribed a face mask which attaches to their inhaler. Older children will be prescribed a 'spacer device'. A spacer device is a plastic or metal container with a mouthpiece and a hole for the inhaler. If your child has been prescribed a face mask or a spacer device, it is important to always use these. Face masks and spacers are the best way of making sure that your child gets the correct dose of medication right to their lungs.

What is an Asthma Attack?

An asthma attack occurs when the airways of the lung become narrowed causing an obstruction to the flow of air. During an asthma attack the muscle wall contracts and the lining of the airways becomes swollen and inflamed. These changes cause a narrowing of the airways which is further aggravated by an increase in secretions from the mucus membrane, which may block the smaller airways. All these give rise to an obstruction to airflow. This leads to a significant increase in the effort needed to move air in and out of the lungs, giving rise to wheezing and breathlessness.

What to do if your Child has an asthma attack?

• Sit them up straight and try to keep them calm
• Ask them to take slow breaths
• Give them a puff of their inhaler every minute. Children under the age of 6 can have 6 puffs in a 10-minute period. Children over the age of 6 can take 10 puffs over 10 minutes.
• If they feel worse at any point, or they do not feel better after 10 puffs, call 999 for an ambulance.
• Try to take the details of their medicines with you for the hospital if possible.
• If their symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP

Mis-managed asthma can cause problems such as:

• Feeling tired all the time
• Missing school or not doing well in school
• Stress, anxiety, or depression
• Lung infections (pneumonia)
• Delays in growth or puberty

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References
Asthma in babies and children - HSE.ie
Your lungs - an asthma attack - HSE
Asthma - HSE.ie
asthma-guidelines.pdf (hse.ie)
Asthma - Diagnosis - NHS (www.nhs.uk)