Childhood asthma is one of the most common long-term conditions affecting children. Dr Ramnik Mathur, a Consultant Paediatrician in West London, explains the symptoms, diagnosis and treatment of childhood asthma.
Asthma is one of the most prevalent chronic diseases among children. According to the National Institute for Health and Care Excellence, approximately 160,000 people in the UK are diagnosed with asthma each year.
With proper treatment and management, most children with asthma can live normal, active lives.
If your child has asthma, you can book an appointment to see me in clinic.
Asthma is a respiratory condition marked by spasms and inflammation in the bronchial airways, which causes intermittent wheezing, coughing, chest tightness and shortness of breath.
During an asthma flare-up, the airways become swollen and inflamed, and the muscles around them constrict. This narrows the airways and reduces airflow into and out of the lungs. The lining of the airways also produces more mucus than normal, which can further block airflow. These attacks can range from mild to severe, and sometimes can be life-threatening. With proper treatment, most childhood asthma is controllable.
The most common symptoms of asthma in children include:
- Wheezing: High-pitched whistling sound when breathing out
- Coughing: Chronic, dry cough or cough that gets worse at night
- Shortness of breath: Feeling like they can’t get enough air
- Chest tightness or pain: Feeling like someone is squeezing their chest
- Trouble sleeping: Coughing or wheezing disrupts their sleep
- Fatigue: Feeling tired due to poor sleep and breathing difficulties
The exact causes of asthma are unknown. However, researchers believe it develops from a combination of genetic and environmental factors. Common triggers that can set off asthma attacks in children include:
- Allergens: Dust mites, pollen, mould, pet dander or hair
- Irritants: Cigarette smoke, air pollution, chemicals with strong odours
- Respiratory infections: Colds, ‘flu, sinus infections, bronchitis
- Exercise: Increased breathing when active
- Weather: Cold, dry air or sudden temperature changes
- Emotions: Anxiety, stress, laughter
To diagnose asthma in children, I will usually review the child’s symptoms and take a medical history. I will also perform various tests which may include:
- Physical exam: Listen to breathing with stethoscope, check for allergies
- Challenge testing: Monitoring symptoms after exercising or inhaling Salbutamol.
- Allergy testing: Skin prick test or blood test to identify allergies
- Chest x-ray: Helps rule out other lung conditions
While there is no cure for asthma, there are several effective treatments to control symptoms and prevent attacks:
- Inhaled corticosteroids: Prevent inflammation and control daily symptoms
- Bronchodilators: Quick-relief inhalers – see Asthma + Lung UK for more information
- Allergy medications: Antihistamines, nasal sprays, allergy shots to control allergic asthma
- Biologics: New injectable drugs for severe asthma unresponsive to other medications
- Nebulizer therapy: Delivers asthma drugs via mask/mouthpiece for acute attacks
- Avoiding triggers: Eliminating exposure to known triggers whenever possible
In addition to medication, good asthma control requires educating children and families about the condition, creating an asthma action plan, monitoring symptoms, and adjusting treatment as needed.
The following lifestyle modifications and coping tips can also help children manage their asthma:
- Learn proper inhaler technique to effectively deliver asthma meds
- Use a spacer or valved holding chamber with inhalers
- Stick to a consistent daily routine for taking medications
- Keep bedrooms dust-mite free by encasing mattresses and washing bedding weekly in hot water
- Use HEPA air filters and vacuums to reduce allergens and irritants
- Limit strenuous outdoor activity when air pollution or pollen counts are high
- Drink lots of water to keep mucus thin
- Learn breathing exercises to expand and relax airways
- Identify and avoid personal asthma triggers whenever possible
- Carry rescue inhaler at all times in case of an asthma attack
- Create an asthma action plan with steps to take when symptoms worsen
Looking after a child with asthma can be challenging, but you are not alone. Reach out to these organisations for education, tools for managing asthma, and connections with other families impacted by childhood asthma:
Here are answers to some common questions about childhood asthma:
Asthma is one of the most common chronic conditions affecting children today. With a proper diagnosis, avoidance of triggers, adherence to treatment plans, and support from family and physicians, children with asthma can live full lives.
I work closely with you and your child to find the best treatments and coping strategies for you both.
