When wheezing and coughing prevail

Steroid tablets are only given if a serious asthma attack occurs, or if the asthma is not responding to the usual treatment. They are given for a few days and are very effective in treating asthma that is out of control.

Possible side effects will only occur if long term oral steroids are used regularly. However local side effects are more common and these include:

• Oral thrush (a fungal infection) if high doses of inhaled steroid treatment are used. It can be treated easily.
• Hoarse voice. Using a spacer device to deliver the steroid medication and then rinsing the mouth out after use, usually resolves these local side effects.

Asthma attacks can develop quickly. Signs that the asthma is worsening are:

• Increased cough, wheeze, breathlessness – often worse at night
• Wakening at night with coughing, wheezing or breathing difficulties
• Reliever inhaler (salbutamol or terbutaline) less effective and not lasting as long
• More salbutamol or terbutaline required than usual
• Increased symptoms when exercising

Occasionally a nebuliser is used in the surgery or at hospital to treat acute asthma. This is an electrical machine which can deliver high doses of asthma medication (salbutamol or terbutaline), to relax the tight breathing tubes. If a nebuliser is used in an asthma attack, the amount of medicine delivered is the equivalent of 25-50 puffs salbutamol or terbutaline given via an inhaler.

Does asthma go away?

It’s difficult to predict but this is a likely pattern to asthma in childhood:

• Early viral wheezing with no eczema or family history of asthma, is likely to disappear by the time your child gets to school-age
• Viral wheezing, with eczema, a family history of asthma but the child is well in-between the virus infection – this is likely to improve by around 7-10 years

While asthma may disappear, it is important to remember that it can sometimes return after many years of being symptom free with no treatment.

Smoking
Smoke irritates the breathing tubes. In children who already have sensitive breathing tubes, smoke will make things worse. Another reason to give up for good.

Restrictions on lifestyle
Naturally you’re concerned if your child has asthma, but it is important not to restrict their activities once the asthma is under control. A child with asthma is like any other child; the only difference is that they need to use inhaler medicines.

For more information see the National Asthma Campaign website.

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