Asthma in children

By Trish Weller

Asthma in children needs to be carefully monitored. Trish Weller of the National Asthma and Respiratory Training Centre looks at symptoms and treatments

If you’ve ever watched someone coping with a severe attack of asthma, you’ll know how distressing it can be. They fight for breath, wheeze and cough. If you could see inside the lungs you’d notice the muscles around the breathing tubes were tight, making the airways narrow and constricted. If the tightness is not treated, the inside of the airways become sore and swollen and clogged with phlegm. This can lead to permanent damage in the airways and loss of some lung function, if it is not treated.

We don’t know why, but asthma has increased dramatically over the last ten years and affects about 1 in 7 children. It is certainly more common if you suffer from eczema, hay fever or rhinitis and where there is a family history. The most common trigger of asthma in children is a viral infection such as the common cold.

Other asthma triggers are:
Temperature change
Exertion
Excitement especially laughter
Stress
Pollen – both grass and tree pollens
Moulds and spores
Animal allergy especially to cats or dogs
Dust
Tobacco smoke
Air pollution
Drugs such as beta blockers and aspirin type pain relievers
Some foods can trigger asthma but generally are not a major factor.

Wheezing infants

Some children under the age of one get wheezy when they have a cold. It is sometimes called viral wheezing, baby asthma, infantile asthma or even wheezy bronchitis, and is different to the asthma that occurs later on in childhood.

Asthma is more likely if the child has symptoms that persist, even when the cold is better and especially if they have eczema as well. It is difficult to diagnose asthma at this age, as there are no specific tests to confirm it.

Wheezing in infancy is difficult to treat because it does not always respond to asthma drugs. However, it is worth trying asthma medicines to see if they do work. These asthma drugs are normally given via inhalers because smaller doses can be used, reducing the risk of any side effects. Using an inhaler, they are also delivered straight to the lungs where they need to work. Giving asthma medicines to very young children is difficult, but there are special inhaler devices for infants and toddlers. Your asthma nurse or doctor will be able to show you how to use them.