Childhood Asthma
What is Asthma?
Asthma is a long-term condition that affects the airways in the lungs. It usually causes symptoms of coughing, wheezing and breathlessness. Symptoms get worse with exposure to triggers, and this can lead to asthma attacks.
A person with asthma has sensitive airways that are inflamed and ready to react to things that irritate them – triggers. When someone with asthma comes into contact with a trigger, the muscles in the airways tighten, and the airways may swell and produce sticky phlegm (mucus). This is called an asthma attack. It is important to know what to do in an asthma attack – this is on your asthma action plan.
An asthma trigger is anything that sets off asthma symptoms. Common triggers include colds, viruses, pets, cigarette smoke, cold weather and pollens. Everyone with asthma has their own set of triggers. It’s helpful to know what they are and record this in your asthma plan.
In the UK, around one in every 11 children have asthma. It is the most common long term condition of childhood. Asthma is usually a lifelong condition. For children, asthma may improve or disappear as they get older, particularly if the asthma was mild. If there are allergies which cause asthma, it is less likely to get better.
Can Asthma be treated?
Although there is not a cure for asthma, the good news is that regular treatment with a steroid ‘preventer’ inhaler is effective. This medicine reduces the swelling in the airways. However, it only works if taken every day, even when you are feeling well. It can take a few weeks to become fully effective. It is important not to stop this treatment unless discussed with your health professional.
Only a very small number of children, less than 5%, have severe asthma that needs more specialist assessment and treatment.
Your asthma action plan
It is essential that your health professional has given you an asthma action plan. This explains your medicines, when to use them, and how to manage an acute episode of asthma. If you have not been given one, contact your health professional to arrange this. For more information on plans, visit the Asthma UK website.
After an attack/ going home:
- Your child should now be feeling better
- You/your child should not need the reliever inhaler as much
- Use the preventer inhaler every day according to your asthma UK action plan. Don’t stop unless directed by a health professional.
- Take the blue reliever inhaler (2 to 6 puffs) as needed to treat symptoms (these include wheeze, chest tightness, shortness of breath, cough and difficulty breathing). The effects should last for at least 4 hours.
- If you need to use the reliever inhaler more than every four hours, you are having an acute asthma attack. Seek urgent help either from your doctor, 111 or 999. Follow your asthma UK action plan.
- If you still need to use the reliever inhaler regularly after 48 hours from discharge you have not fully recovered. Arrange an urgent medical review.
- You should have a post-attack review with either your GP or asthma nurse within two working days. This is to make sure you/ your child is improving. Please contact your GP surgery to arrange this.
- You should also have a follow up appointment with your GP or the asthma clinic within the next 4 weeks for a full asthma review. Please book this.
Asthma Medicines
Preventer inhalers: These are usually brown (beclomethasone/Clenil) or orange (fluticasone/Flixotide). They contain a small amount of steroid that reduces inflammation in the lungs and prevents asthma. They must be taken every day even if you/your child is OK.
Combination preventer inhalers: These are usually red (Symbicort) or purple (Seretide) and contain a small amount of steroid plus a long-acting reliever medication to help keep the airways open for longer. They must be taken every day even you/your child is OK.
Reliever inhalers: These are blue (salbutamol/Ventolin; terbutaline/Bricanyl) and work by relaxing the airways which opens them up, relieving symptoms. They work within minutes.
- To help you remember to take your preventer, use it at the same time each day. For example, before brushing teeth in the morning and evening
- Try setting an alarm on your phone as a reminder
- Always directly supervise your child, especially when they get older!
- Make sure medications don’t run out – get repeat prescriptions on time
- If your medication is not shown visit Asthma UK: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/
How to use your medicine
First choice is always via a spacer – it makes the inhaler more effective by increasing the amount of medicine that gets into the lungs.
- Remove the inhaler cap, shake and attach the inhaler to the end of the spacer
- Place the mask over your child’s face, covering the nose and mouth to make a good seal
- Press the inhaler once and encourage your child to breathe slow and steady whilst you count for 10 seconds
- Repeat all steps for each puff
Spacer and mouthpiece for 4 years + (including teenagers and adults):
- Remove the inhaler cap, shake and attach the inhaler to the end of the spacer
- Place the mouthpiece between the teeth and close lips around it so there are no gaps
- Hold the spacer level so that it does not tip up or hang down
- Press the inhaler once and take five slow and steady breaths
- Repeat all steps for each puff
Other devices:
There are lots of other medicines you may have been prescribed. Asthma UK has a full range of videos on how to use every device: https://www.asthma.org.uk/advice/inhaler-videos/
General advice
- Rinse the mouth after using a steroid inhaler
- Spacers should be washed at least monthly with warm soapy water, and allowed to air dry – do not rinse or put in the dishwasher
Measuring Peak Flow
You may have been given a peak flow device to take home. For information on how to use this, see: Peak flow test | Asthma UK
Checklist
Make sure you know the answer to all these questions. If you are unsure, ask your health professional.
My Plan:
- ☐ I know which medication to take
- ☐ I know the doses of my medication
- ☐ I know when and for how long I will take my medication
- ☐ I know how to use my inhalers, and my technique has been checked
- ☐ I have an asthma UK asthma action plan
Trigger factors
- ☐ I know what could make my asthma worse
My Plan
- ☐ If I have been given a peak flow meter, I know how to use it
My follow up
- ☐ I will arrange an appointment with my GP within 2 working days
- ☐ If I have been offered a follow up appointment, I know the details
Contact details:
Paediatric Emergency department CWH 0203 315 8600
Starlight Ward 0208 321 6172 / PSSU 0208 321 5210
Please see your asthma action plan for specific advice on your medications and what to do in an emergency.
For urgent advice contact 111 - In an emergency call 999
Where to get more information: