Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness in approximately one in ten children.
About half of all children who develop asthma will eventually grow out of it but left untreated asthma can cause permanent damage to the airways. In very rare, extreme cases, a severe asthma attack can be fatal.

What is Asthma?
Asthma is a condition where the airways become irritated and inflamed and as a result they become narrower as well as produce extra mucus. This makes it more difficult for air to flow into and out of the lungs and causes the symptoms of asthma.

What are the Symptoms?
The symptoms of asthma may be mild, moderate or severe. They may include coughing, wheezing, shortness of breath and tightness in the chest. These symptoms tend to be variable and may stop and start. They are usually worse at night.

What Causes Asthma?
The exact cause of asthma isn’t fully understood. Sometimes, the symptoms flare up for no obvious reason, but you may notice certain triggers that set off your child’s asthma attack or make their symptoms worse. These triggers irritate the airways in your child’s lungs and can include infections such as colds and flu, irritants such as dust, cigarette smoke, fumes and chemicals, allergies to pollen, medicines, animals, house dust mite or certain foods.
Exercise can also trigger off symptoms especially in cold, dry weather.

Are Some Children More at Risk?
Factors thought to increase a child’s risk of developing asthma include the following;

Asthma often runs in families and children can inherit the tendency to get inflamed bronchial tubes. Children can also inherit the tendency to have allergies which increases the risk of developing asthma.
Boys are more likely than girls to get asthma as a child but girls are more likely than boys to have asthma as adults.

If you smoke when pregnant your baby is more likely to get asthma. Children with parents that smoke around them are also more likely to get asthma.

Diagnosis?
If you think your child has asthma, consult your GP. He or she will ask about your child’s symptoms and if you have noticed any factors that trigger the symptoms. Your GP will carry out a physical examination.
Your doctor may also do one or more of the tests listed below;

Depending on the age of your child, your doctor may use a device called a peak flow meter to help diagnose asthma. A peak flow meter measures how much, and how fast, air can be expelled from your
child’s lungs. This device can also be used to monitor whether or not a treatment is effective.

A spirometry test can also measure how well your child’s lungs are functioning but provides a much more detailed analysis than the peak flow meter.

Less commonly other tests such as test x-rays may be done to make sure no other breathing problems are present.

An allergy skin test may be done to determine whether or not your child is allergic to other certain substances.

Treatment
Unfortunately asthma cannot be cured although treatments aim to reduce the frequency, severity and length of asthma attacks. Because a lot of different factors are involved in asthma, each treatment plan will be individual, combining medicines and asthma management in the way that works best for your child.

Inhalers
Inhalers, also sometimes referred to as ‘puffers’ contain a gas that propels the correct dose of medication when the top is pressed down. This is inhaled into the airways. Inhalers need to be used correctly to work properly and your doctor will be able to advise you further.

There are two types of inhalers - ‘relievers’ which treat the symptoms and ‘preventers’ which prevent symptoms.

Preventers are used every day - even if your child does not have symptoms. They help to keep symptoms from occurring. Preventers usually contain a steroid medicine, such as Beclometasone (Becotide) or Fluticasone (Flixotide) that works to reduce the inflammation of the airways. Side effects are unusual at normal doses (although they can sometimes cause a sore mouth or throat). It can take up to six weeks for the full effect of preventer medicines to build up, but once they have, the reliever inhaler may not be needed at all.

Other Medicines
Severe asthma attacks are sometimes treated with a course of steroid tablets, such as Prednisolone. In this case, steroids are used as a reliever therapy. If they are taken for approximately a week, there are few side effects. Side effects of steroids are usually associated with taking them for several months or at high doses.

Several other medicines are available as tablets and inhalers, if the standard treatments are not suitable for your child (this could be because of side effects) or if asthma is still not adequately controlled. These include tablets of Montelukast (Singulair), Zafirlukast (Accolate) or theophylline (e.g. Sio-Phyllin).

Nebulisers
Nebulisers make a mist of water and asthma medicine that is breathed in. They can deliver more of the drug to exactly where it’s needed than conventional inhalers can. This is particularly critical in the event of a moderate or severe asthma attack.
Nebulisers are often used in hospital, but occasionally people may buy them to use at home. They’re also sometimes used at home instead of an inhaler to treat children under two.
Nebulisers are not available on the NHS in England and Wales but you can purchase one – most manufacturers sell them by mail order.

Asthma Attacks - What You Need To Know
In the event of an asthma attack you should:

Give your child their reliever immediately.

Sit your child down (don’t lie them down) and try to relax them

Wait 5-10 minutes – if the symptoms disappear you do not need to do anything

If the symptoms persist then you should call a doctor or an ambulance

Continue giving your child their reliever, preferably with a spacer, every few minutes until help arrives

If you go to hospital, take details of your child’s treatments with you.

Visit your GP after your child is discharged from hospital so that you can review their treatment.

Asthma Management
Medicines are only a part of the treatment for asthma. Asthma also needs to be managed by dealing with the things that make it worse. Identifying and avoiding the things that trigger your child’s asthma are an essential part of their overall treatment plan.

Keeping a diary to record anything that triggers your child’s asthma can help you to discover a pattern.
The older your child, the more he or she will be able to understand and participate in their own asthma management. With good preventive measures and appropriate treatment, most children with asthma lead completely normal lives.