Asthma is a chronic disease in which the airways (breathing tubes or bronchi) are more sensitive and become narrowed due to inflammation. This makes it harder for air to get through and results in wheezing, coughing and difficulty in breathing. This can happen every week, during exercise, or occasionally, with the child appearing well in between episodes.
Asthma can appear at any age.
The most typical presentation of Asthma is an attack. The child experiences sudden wheezing, coughing and shortness of breath. These attacks can be mild or severe and may need emergency treatment.
Symptoms include cough, wheezing (whistling noise in the chest), shortness of breath, and tightness of the chest.
These symptoms of Asthma in children can appear suddenly (attacks) or be chronically present (persistent). Persistent symptoms tend to occur in the early hours of the morning and at night. They can also be triggered by exercise. Attacks can be triggered by the common cold, cold air and air pollutants such as pet dander and cigarette smoke.
The diagnosis of Asthma is based on family history and clinical examinations. Special tests may be needed to help in the further evaluation or management of your child's Asthma, such as:
Spirometry is a lung function test that measures airflow obstruction in Asthma. When the diagnosis is unclear, it can be used to support the diagnosis of Asthma. It also helps to assess severity, and your child's response to treatment. Children above 6 years old are usually able to perform this test reliably.
Oscillometry is a special lung function test that can be used for children between 2 and 6 years old.
Exhaled nitric oxide measurements are used to determine the severity of lung inflammation in Asthma and the dose of preventer medication required.
Allergy tests are useful in detecting the allergens that your child may be sensitive to. Skin prick tests and blood tests are commonly used to test for Asthma. Children of any age, including babies, can undergo allergy testing. Knowing and avoiding the allergens that trigger your child's Asthma will help in its control.
The goals of Asthma treatment are to control all Asthma symptoms, prevent Asthma attacks, and allow your child to lead a healthy and normal life. Asthma can be controlled in nearly all children with the right management such as:
These are used during an Asthma attack to provide relief. The most commonly used reliever is Salbutamol or Albuterol.
These are called bronchodilators and have the best effect when they are inhaled. They open the airways and relieve symptoms of Asthma.
These are useful when Asthma is persistent, and if attacks are frequent and/or severe. They help to prevent Asthma attacks from happening and are usually inhaled.
Some examples include:
Preventer medications have to be taken every day. Not all children need preventer medications. Ask your doctor if your child needs to use a preventer for his or her Asthma.
Your doctor will take a detailed history and discuss with you the avoidance of triggers that may be worsening your child's Asthma.
Exercise-induced Asthma is suspected when there is a history that suggests it. For instance, when there are symptoms of Asthma as described above upon exercise. It may be confirmed with an exercise challenge test. During the test, your child will run on a treadmill machine until at least 80% of his or her maximum heart rate is achieved, and maintained for more than 6 to 8 minutes. Your child's lung function will first be assessed before exercising and then at various intervals after he or she has started exercising. If the lung function parameter shows a decrease of at least 12% to 15%, it means that your child has exercise-induced Asthma. Children above 5 years old are usually able to perform this test reliably.
If your child has Asthma, the symptoms of exercise-induced Asthma can be reduced by managing his or her Asthma well. Taking additional medications such as a short-acting bronchodilator spray 15 minutes before exercising is also helpful.
If you do not hear any coughing or wheezing and your child is breathing comfortably, there is no need to wake your child from sleep for medications.
Many children improve as they get older. Once Asthma is properly controlled, your child should be encouraged to take part in all usual activities. There is no need to restrict activity. With the right medication and care, children with Asthma should be able to participate in sports and lead normal active lives. Many outstanding athletes have won Olympic medals despite having Asthma.
Please take your child to the Children's Emergency if:
Click here to access our Find A Doctor directory for a list of doctors treating this condition across our NUHS institutions.
