One million and counting

In this country, more than 1.1 million children have asthma, a disease that often starts in childhood. If you’re a parent with a child who has asthma, here are some of the things you should be aware of.

Nearly five and a half million people in the UK are currently receiving treatment for asthma, 1.1 million of whom are children. That means one in 11 children has asthma – an average of two children in every UK classroom – making it the most common long-term childhood condition.

Asthma affects the airways that carry air in and out of the lungs. But in someone who has asthma, these airways are more sensitive than normal. So when a child is exposed to something that irritates their airways, it sets off a chain of events that can cause wheezing, coughing, shortness of breath and tightness in the chest.

Nobody really knows exactly what causes asthma, but it can run in families. It’s also related to eczema and hay fever, which means children with asthma may have or develop the other two conditions.

Common asthma symptom triggers

A child (or indeed an adult) who has asthma may be affected by one or more symptom triggers, such as the following:

  • Upper respiratory tract infection (a cold or flu, for example)
  • Exercising, particularly in cold weather
  • Allergic reaction to pollen, house dust mites, animal fur or certain foods
  • Air pollution, including tobacco smoke and chemical fumes
  • Medicines including ibuprofen and aspirin (children under 16 should not be given aspirin)
  • Stress and other emotions, including laughing
  • Sulphites – substances that are found in certain foods and drinks (ready meals may include a high level of sulphites, for instance, or fruit juice, jam and prawns)
  • Changes in temperature and other weather parameters such as humidity

However, if you can pin down your child’s asthma triggers, you can help reduce their symptoms by taking steps to avoid them.

Asthma medicines

Avoiding asthma symptom triggers is just part of managing your child’s asthma. When your child is initially diagnosed with asthma, you’ll both be encouraged to follow a personal asthma action given to you by your GP or asthma nurse. This will include details about your child’s asthma medicines, which will help to keep their asthma under control. These are usually inhalers called reliever and preventer.

Reliever inhalers – usually blue in colour – contain a medicine that relieves the symptoms of asthma quickly by relaxing the muscles in the airways, making it easier for your child to breathe.

Preventer inhalers are usually brown and help to prevent or reduce symptoms by reducing inflammation in the airways. They’re usually recommended if your child has ongoing asthma symptoms or needs to use their reliever inhaler more than twice a week.

If your child is given a preventer inhaler (some children with mild asthma are only given a reliever), they should use it every day, even when they aren’t having any symptoms. That’s because using a preventer inhaler regularly – usually every morning and evening – helps to keep your child’s asthma under control.

It’s also a good idea to make sure your child knows all about their asthma and how to manage it, so that they gradually learn how to control it themselves. This is particularly important when they’re old enough to start spending time away from home.

Ways your pharmacist can help

It’s important that your child uses their inhaler correctly, so ask your pharmacist to show you how your child can improve their inhaler technique. They may also offer advice such as always taking one puff at a time and leaving 30 seconds between puffs for the inhaler to recharge.

If your child is having difficulties with their inhaler, your pharmacist can recommend a device called a spacer to make breathing in the medicine easier. They can also supply you with a peak flow meter to monitor your child’s symptoms, as well as discuss your child’s treatment and suggest ways of avoiding their asthma symptom triggers (ask at your local pharmacy for details).

Safe at school

If your child has just been diagnosed with asthma, you may worry about them being safe while they’re at school. However, there’s no reason why children with asthma can’t enjoy their school life fully as well as take part in activities and exercise classes.

According to Asthma UK, it’s important to work in partnership with your child’s school if they have asthma. The first thing you should do is inform the school about your child’s condition as well as any medicines they may need during school hours or while taking part in out-of-school hours activities.

You should also give the school a spare reliever inhaler labelled with your child’s name, and make sure the inhaler they take to school is marked with their name too. And if there is any change in your child’s condition, let the school know.

Meanwhile it’s important that your child gets at least 60 minutes of aerobic activity every day. If they experience asthma symptoms during or after exercise, tell their GP or asthma nurse, as they may be advised to use their reliever inhaler 10-15 minutes before they exercise and again after two hours of non-stop exercise or when they finish.

For more information about exercising with asthma, speak to your GP or asthma nurse, or ask your pharmacist for advice.

What to do in an attack

Your child’s personal asthma action plan will include the following information about what you should do if they have an asthma attack, as outlined by Asthma UK:

Help them sit up straight and keep calm.

Help them take one puff of their reliever inhaler (usually blue) every 30-60 seconds, up to a maximum of 10 puffs.

Call 999 for an ambulance if:

  • Their symptoms get worse while they’re using their inhaler – this could be a cough, breathlessness, wheeze, tight chest or sometimes a child will say the have a tummy ache
  • They don’t feel better after 10 puffs
  • You’re worried at any time

You can repeat step 2 if the ambulance is taking longer than 15 minutes.

Note: This asthma attack information is not designed for children using a SMART or MART regime. If they do not have a reliever inhaler, call an ambulance. Then speak to their GP or asthma nurse to get the correct asthma information for the future.

 

Asthma UK also provides resources for parents and children, including a My Asthma pack. This is designed to help children to understand more about their asthma and their asthma medicines. Two of the components of the pack – the My Asthma Child Action Plan and a booklet called Asthma and My Child – can be downloaded from Asthma UK’s website. Or full the full pack – which also includes a calendar and stickers – call 0300 222 5800 and choose option 2.

Flu protection

Some children with long-term conditions such as asthma are advised to have an annual vaccination to protect against flu, as well as a one-off anti-pneumococcal vaccination.

However, this winter a nasal spray flu vaccine is available for all children aged from two to four years as part of the NHS childhood vaccination programme, with older children offered the vaccine in selected parts of the country. In time, all children between the ages of two and 16 will be offered the nasal spray flu vaccine every year.

Since the nasal spray vaccine is more effective than the injection, all children between the ages of two and 16 who have asthma are now being offered the nasal spray (but those aged between six months and two years will still be offered the injectable vaccine).