Helping your child manage asthma effectively

Proper treatment with preventer medications can help avoid life-threatening acute asthma attacks and prevent asthma symptoms in the long run. — Positive Parenting

Asthma is the most common chronic respiratory illness among children.

More than 300 million people worldwide are affected by asthma, with the majority being children.

In this disease, the respiratory airways are inflamed and swollen, causing them to be narrowed and leading to the classical symptoms of cough, wheeze and shortness of breath.

These symptoms often disrupt sleep, appetite, exercise and many daily activities.

It can also result in school absenteeism and parents taking time off to care for the sick child.

If the symptoms are acute and severe, it can be a frightening experience for both parents and child, and often involves a visit to the emergency room and/or hospitalisation.

It is important to recognise the symptoms of asthma and provide proper and correct treatment.

Quick-relief medications like inhaled bronchodilators, are used to treat the acute symptoms of cough and wheeze.

However, the cornerstone of treatment is the regular use of long-term preventer medications, such as inhaled corticosteroids, to prevent the symptoms.

The over-reliance on quick-relief medications and non-compliance to preventer medication are associated with poor asthma control and permanent airway narrowing.

This is known as airway remodelling and is due to prolonged airway inflammation.

It can subsequently result in long-term loss of lung function.

Proper treatment with preventer medications will improve quality of life, prevent asthma symptoms and avoid life-threatening acute asthma attacks.

Taking action

Work with and follow your child’s doctor’s advice, and adopt these important measures:

> Set an asthma action plan

Work with the doctor to prepare a detailed plan for managing your child’s asthma.

It should provide clear directions on when to take which medicines, how to identify and avoid triggers, how to recognise and manage asthma attacks, and when to go to the emergency room.

Share the plan with your child’s caretakers and school staff.

> Identify and avoid triggers

A number of outdoor allergens and irritants can trigger asthma attacks, e.g. pet dander, ambient pollution (i.e. haze), mould, viral respiratory infections, tobacco smoke and so on.

Identifying your child’s allergen(s) can help you and your child avoid those triggers.

Keep your home free from pets, mould, dust and cigarette smoke, and do regular cleaning.

> Take medicines as prescribed

Your child’s compliance with treatment is vital for asthma control.

Follow the doctor’s instructions on which medicines he needs and how to take them.

Make sure to differentiate between preventer medicines for long-term use and quick-relief medicines for asthma attacks.

If he relies too much on a quick-relief inhaler, his condition is not under control and his treatment plan may need to be adjusted.

> Monitor and track

Keep an asthma diary to help track your child’s symptoms.

This is to help recognise her early warning signs, as well as to observe how well the treatment is working.

Use a peak flow meter to mea-sure her airway narrowing.

If the reading is lower than normal, it means the airways are getting narrow and she is at risk of an acute asthma attack.

> Know the symptoms

Early warning symptoms may manifest hours, or even a day, before an asthma attack.

Your child may look, act or breathe differently, or complain of feeling uncomfortable.

Take note of these signs and promptly administer the appropriate medicine to avoid a severe asthma attack.

Get medical attention if the condition does not improve.

> Get vaccinated

It is recommended that children with asthma get flu and pneumococcal vaccines to prevent respiratory infections, which can trigger asthma attacks.

> Recognising an emergency

It is important to recognise the symptoms and signs of a severe and potentially life-threatening asthma attack.

Call your child’s doctor or go to the emergency room immediately if he shows any of these symptoms and signs:

  • Constant wheezing and breathlessness, despite repeated use of quick-relief medicines
  • Persistent cough that does not respond to quick-relief medicines
  • Bluish or grey lips and fingernails
  • Retraction or tightening of the ribs, chest and neck muscles during inhalation
  • Trouble talking and can’t speak in full sentences
  • Drowsiness and looking tired

Recognition of asthma in your child and starting the proper medication will lead to good asthma control, thus allowing him to lead a normal active life.

The long-term prognosis of asthma is good, with the majority of child patients growing into fit young adults.

Dr Patrick Chan is a consultant paediatric respiratory physician. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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