What is Asthma?

Asthma is a common condition that affects about one in seven children in the UK. Most of the time asthma can be controlled but sometimes children can have attacks that can be frightening and distressing.

Asthma affects the airways – the small tubes that carry air in and out of the lungs. Children with asthma have airways that are extra sensitive. When they come into contact with something that irritates their airway (a “trigger”) the airway will narrow making it more difficult to breathe. The muscle layer around the airway tightens, the sensitive lining becomes inflamed, and more mucus than usual is produced. This results in it being harder for the child to breathe and is often described as “trying to breath through a straw”.

Asthma triggers

Everyone’s asthma is different and therefore triggered by different things. You may be able to identify what triggers your child’s asthma and it may be useful to make a note of anything you feel may have contributed to your child’s symptoms.

Common asthma triggers include:

• viral infections (common cold)
• allergies (e.g. to pollen, animals, dust)
• irritants (e.g. cold air, smoke, chemical fumes)
• exercise

Your child may have a blood test or skin prick test in our clinic to confirm allergies.

Why do people get asthma?

It is difficult to say what causes asthma. We do know that it is not infectious and that it often runs in families.

• If close family members have allergic conditions such as asthma or hay fever or eczema – then asthma is more likely.
• Smoking during pregnancy increases the chance of a child developing asthma.
• Environmental pollutions are known to make asthma symptoms worse but there is no evidence that they cause asthma.
• Changes in lifestyles over the years such as diet, housing, and hygiene may have also contributed to the rise in asthma in the last decades.
• Some children may grow out of asthma and about two thirds will have fewer symptoms as teenagers but it can return in adulthood.

How will it affect everyday life?

Most children with asthma can lead a normal life if they take their medications correctly and attend regular reviews. For most children, the symptoms associated with asthma can be easily controlled with medication.

As asthma is a common condition amongst children, schools are now more aware of how to deal with it. It is important that you inform your child’s school that your child has asthma and what triggers symptoms. Provide the school with an inhaler for your child to use when needed in line with the school asthma policy.

Exercise can trigger asthma symptoms but if medications are taken regularly and correctly your child should be able to participate in exercise along with their peers.

What medicines are needed?

There are two main types of asthma treatments called relievers and preventers. Everybody with a diagnosis of asthma should have a reliever inhaler. They are usually blue and should be used to relieve asthma symptoms quickly. They open up the airways by relaxing the muscles that have tightened around the airway making it easier to breathe. They usually work quickly - within 5-10 minutes.

They are very safe to use and have few side effects. High doses of reliever inhalers can make you shake a little or raise the heartbeat, but these effects are harmless and will wear off quickly.

Preventer inhalers are usually brown and contain steroids in small doses. They protect the lining of the airway and help to control the swelling and inflammation. They can also stop the airway being so sensitive to asthma triggers. The benefit of using a preventer inhaler will build up and it takes about two weeks to have an effect. This is why it is important that they are taken everyday even if you are well. They will not help to relieve sudden symptoms.

As the preventer inhalers contain steroids, it is recommended that they be always taken through a spacer device and to clean your teeth, gargle or rinse your mouth after use. This helps to reduce the side effects of mouth infections, soreness and hoarseness that can sometimes occur although the risk is small. Steroid tablets are sometimes used in addition to inhalers if your child has an asthma attack and needs to use their reliever inhaler a lot. Usually a short course of three to five days is needed to help reduce the inflammation in the airways and control their symptoms. You may be given a course of steroids to keep at home by your doctor, which will be included in your child’s management plan.

How will it feel?

Your child may:

• Cough or wheeze (a noise when breathing out) particularly at night, after exercise or with a cold. Not all children with asthma wheeze but most will at some time.
• Have a cough that will not go away or keeps coming back.
• Feel breathless or have difficultly breathing.
• Complain of a tight chest or sore tummy (younger children may not understand the difference between their chest and tummy).
• Be lethargic, feel tired, may not be able to run around like their friends or need to be carried a lot.

How will I know what is an asthma attack?

Sometimes you can’t avoid having an asthma attack even if you are really careful taking asthma treatments. Symptoms may gradually get worse over a few days or can worsen suddenly. Look out for: 

• Shortness of breath
• Cough/wheeze
• Chest tightness (sore tummy in younger children)
• Usual reliever medications not working
• Using ‘accessory’ muscles to breath – look at the neck for sucking in and also the ribs
• Unable to eat / feed or talk in sentences
• Agitation

The last three symptoms would be a sign that symptoms are becoming severe and medical advice should be sought.

You do to help your child?

• Try and be calm, reassuring and confident (even if you don’t feel like it) as anxiety could increase symptoms
• Ensure that a reliever inhaler and spacer are always accessible
• Administer two to four puffs of reliever inhaler through a spacer as taught
• You should see some improvement within five minutes. If there is no improvement repeat
• You can give up to ten puffs but should seek medical advice if there is little or no response or if symptoms return within four hours
• The patient will have been given an asthma management plan that is specific to their needs

Who do I contact if I need help or more advice?

We hope this information sheet has been helpful to you but is by no means a replacement for talking to either the doctor or nurse. If you have further questions, please contact one of the respiratory nurses below who will be able to help you.

Sally Hails, the Respiratory Nurse Specialist for Children
(Monday and Wednesday 8.30am to 5.00pm)

Telephone:  (0191) 282 0315 (answer phone) or 282 9721

Ann Kirk, the Respiratory Nurse Specialist for Children
(Monday to Friday 9.00am to 5.00pm)

Telephone:  (0191) 213 7243 or 214 8337