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May 27, 2024

All About Childhood Asthma: Managing Symptoms of Asthma in Children

Asthma has been a cause of concern worldwide, due to a variety of causes. As per estimates, almost 9 million people in Malaysia suffer from asthma, 13% of whom are children. While the disease remains the same in children and adults, symptoms and management strategies for children are significantly different.

Today, we will deep dive into childhood asthma and understand various aspects associated with it. We will also discuss what you can do as a parent to provide relief to your child to fight this chronic disease.


What is Childhood Asthma?

Childhood asthma is diagnosed when the airways and lungs become easily inflamed when exposed to certain triggers such as catching colds, respiratory infections or inhaling pollen. It is a chronic long-term disease that can interfere with a child’s daily activities such as school, sleep and play. Unmanaged asthma in children can lead to severe attacks. In most cases, the disease is detected by the time a child turns 5. It is one of the leading causes of hospital emergency visits.

It is unfortunate that childhood asthma is mostly a non-curable disease, and can continue well into adulthood. However, with the right treatment and management strategies, the symptoms can be kept under control, thus preventing long-term damage to the lungs.


What are the Common Symptoms of Asthma in Children?

While the main issue faced during an asthma attack is difficulty in breathing, here are some of the other common symptoms:

  • Continuous coughing that can start anytime, especially during play, laughing, crying, when in contact with cold air or at night.
  • Tightness or pain in the chest
  • Shortness of breath
  • Rapid breathing
  • Feeling lethargic during play
  • Stopping to catch breath during day-to-day activities
  • Coughing can get worse during a viral infection such as the flu
  • Trouble sleeping due to breathing problems or coughing
  • Wheezing
  • Tightness in chest or neck muscles
  • Retractions in chest
  • Trouble eating (mostly seen in infants)

The symptoms vary from one child to another, and everyone may not experience all the symptoms. A child may have different symptoms during different asthma episodes. The symptoms can get better or worse over time. However, the symptoms usually follow a pattern, such as getting worse at night or coming and going within the same day.

At times it can be difficult to tell whether the symptoms are caused by asthma or other respiratory issues such as bronchitis. However, if your child experiences several episodes of bronchitis, then seeing an allergist or immunologist can be a good idea.


What are the Causes of Asthma in Children

Well, the exact causes of childhood asthma are unknown, although genetics and environment play a vital role. An asthma attack is caused by a trigger, which can start or worsen the flare-up.

Allergic asthma can be caused by allergens such as:

  • Dust mites
  • Pollen
  • Mould
  • Pets
  • Waste from pests such as mice or cockroaches

Non-allergic asthma can be caused by triggers such as:

  • Infections such as cold and flu
  • Breathing in cold air
  • Certain medications
  • Usage of chemicals in the house such as paint, disinfectants, etc.
  • Air pollution
  • Tobacco smoke

Asthma can also be induced through physical exercise, especially in dry weather.


When Should You See a Doctor?

Seeing your child suffer can be the worst experience as a parent. Meeting the right doctor at the right time can make all the difference. Early treatment not only helps control the symptoms, but it can also reduce the chances or severity of future attacks.

Seek a doctor’s advice if you notice that your child:

  • Is coughing constantly or intermittently or during physical activity
  • Produces whistling or wheezing sounds when they breathe
  • Experiences shortness of breath or rapid breathing
  • Complains about tightness in the chest
  • Suffering from repeated episodes of pneumonia or bronchitis.

Creating a treatment and management plan with your doctor can help in monitoring symptoms and providing relief to your child.


When to visit the emergency?

Take your child to the emergency if you see your child is having severe difficulty breathing, with his chest or sides pulling inward while breathing. The heartbeat might increase along with chest pain and sweating.

You may also need to visit the emergency if your child:

  • Uses abdominal muscles to breathe
  • Stops mid-sentence to take a breath
  • Is trying hard to breathe
  • The nostrils are widened while breathing in

Do not panic if your child shows the above symptoms. Proper medical attention can reduce the severity of attacks.


Risk Factors Leading to the Development of Childhood Asthma

Certain risk factors can increase the chances of a child suffering from this chronic disease. These include:

  • Exposure to tobacco smoke, even when the mother is pregnant with the child
  • Family history of allergies and asthma
  • Allergic reactions such as food allergies, skin reactions or hay fever
  • High pollution levels in the atmosphere
  • Childhood obesity
  • Respiratory conditions such as chronic stuffy or runny nose, pneumonia or inflamed sinuses
  • Gastroesophageal reflux disease (GERD)

How is Childhood Asthma Diagnosed?

Asthma in children can be difficult to diagnose, especially in younger children. The symptoms of asthma are often similar to symptoms of other paediatric diseases. Moreover, some children may not have asthma symptoms often, making it more difficult to diagnose the chronic condition.

Childhood asthma is usually diagnosed through:

  • Taking the medical history
  • Conducting a physical exam of the child
  • Chest x-ray
  • Lung function test which includes spirometry that tests the efficiency of the lungs.
  • Skin allergy or blood tests, if the child or parents have a history of allergies. Different allergens’ reactions to the immune system are checked through these tests.

Younger children are usually not able to tolerate these tests. In such cases, the healthcare provider may suggest a trial of asthma medicines which involves administering a medicine to your child for several weeks to see if the symptoms improve.


Management and Treatment

If your child is diagnosed with childhood asthma, your doctor will develop a care plan for managing and treating the symptoms. It will contain the list of medications, when and how to take them, what to do during an episode and the steps to take if an attack gets worse. It will also contain the details of conditions under which you should seek emergency care. This plan is crucial to your child’s well-being, hence make sure to clarify any questions that you may have with the doctor or the medical team.

This action plan is important, hence circulate it among all taking care of your child such as family members, nanny or even at the school. This will ensure your child gets the required care not only at home but also when they are away.

Two things are vital concerning the management of asthma in children:

1. Knowing the signs of an attack

Identifying your child is about to get an attack can make a huge difference. In most cases, warning signs appear a few hours or even a day before the attack actually starts. Your kid may look different, may have mood swings, their breathing structure may change or they may complain of feeling different. Giving the right kind of medicines even before an actual attack can lessen the severity of a flare-up.

2. Knowing what to do during an attack:

Another crucial aspect is the knowledge of how to react to an attack. The first thing is not to panic. Having asthma medicines readily available is essential to ensure you can help your child right when they need it. It’s also important to know when to take your child to the emergency department. The right attention at the right time can make all the difference.


Tips to Manage Symptoms of Childhood Asthma

As a parent, you are responsible for your child’s well-being. We know this is not an easy task, especially if your child suffers from a chronic disease such as childhood asthma. Here we share our top tips to ace the asthma management game:

  • Let’s start with the medication. It is essential to stick to what’s prescribed. There will be daily medicines that ease or prevent the inflammation of the airways. The doctor will also include certain medicines which are to be taken only when there’s an attack, to open the airways. Most medicines require an inhaler or nebulizer with a spacer to help the medicine get to the lungs. Some medicines can come in the form of pills or liquids as well. Understand from your doctor exactly how to administer the medicines to your child and the timing of administering them.
  • One of the most important things, apart from this action plan, is to keep your child away from the triggers. The first step is to find your child’s triggers to help your child as much as possible. Keep an eye out for things that make your child’s asthma worse. In general, avoid going to any place where your child might be exposed to allergens. Also, ensure not to use anything at home which may irritate your child.
  • Tobacco smoke is one of the most important triggers of childhood asthma, especially for infants. Ensure your child is not exposed to tobacco smoke.
  • Physical activity is a very important factor in children. Ensure your child stays active when there are no symptoms of asthma.
  • Maintaining a healthy weight is crucial. Excessive weight can worsen symptoms as well as increase the risk of other health issues.
  • Obtain treatment for acid reflux as it can worsen asthma symptoms in your child. If your child is experiencing acid reflux, speak to your child’s doctor about the medicines that can help ease it.
  • If your child is aged 6 months and above, ensure your child gets a yearly flu vaccine. Cold and flu can worsen asthma and can lead to more serious illnesses. Getting the vaccine can help prevent this.
  • Last, but not least, go for regular checkups. The asthma management plan will have details of the frequency of checkups required for your child. Sticking to it is crucial to keep the symptoms under control. Regular checkups can also help you avoid those traumatic visits to the hospital emergency.

Understanding is Key to Management of Childhood Asthma

Understanding the disease is half the battle won. Knowing when and how to react can make a world of difference to the quality of life you can gift to your child. We know living with a child who has chronic asthma is not easy. It is more difficult to see your child suffer day in and day out. But you are not in this alone. Seek support from friends and family members and form a support group.

It is also important to remember that as your child grows, the symptoms or their severity can change. The treatment plan needs to be modified accordingly. Educate your child about their disease as they grow so that they can help themselves. Form a team with family members and work together for the betterment of everyone.

Great things can be achieved together.


Frequently Asked Questions

What are the signs of asthma in a child?


The most common symptoms of asthma in a child are:
– Continuous coughing
– Coughing can get worse during a viral infection such as the flu
– Trouble sleeping due to breathing problems or coughing
– Rapid breathing
– Feeling lethargic during play
– Stopping to catch breath during day-to-day activities
– Tightness or pain in the chest
– Shortness of breath
– Wheezing
– Tightness in chest or neck muscles
– Retractions in the chest
– Trouble eating (mostly seen in infants)

At what age is asthma diagnosed?

Childhood asthma can start right from the infancy stage. However, most children suffer from colds and thus cough and wheeze. Hence, childhood asthma is diagnosed only if a child has recurrent episodes of cough and cold after the age of three.

Does child asthma go away?

Unfortunately, asthma is a lifelong disease with no cure. However, as a child grows, the symptoms of asthma might change. With proper techniques, asthma can also be managed to live a healthier life.


Require expert advice or specialized treatment? Please arrange an appointment with our specialist.

Dr Shariza Lukman
Consultant Paediatrician

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