What should you know about asthma in children?

Asthma symptoms vary. Some children cough mainly at night or during exercise, while others wheeze with colds, smoke exposure, dust, pollen or cold air. The airway muscles tighten and the lining becomes inflamed, so air moves less easily. A child may pause during play, avoid activity, or use the muscles around the ribs and neck to breathe. A clinician may use the symptom pattern, examination and age-appropriate breathing tests to assess asthma. Wheeze in a young child does not by itself establish the diagnosis, so repeated or troublesome episodes merit review.

Keep a written action plan where caregivers and school staff can find it. Make sure the child knows how and when to use the reliever inhaler, with a spacer if prescribed, and check technique regularly. Controller treatment must be taken as directed even when symptoms are quiet; never change it without medical advice. Reduce smoke and vaping exposure, identify personal triggers, and support normal activity with the agreed plan. Keep inhalers within their expiry date and arrange review if the child needs the reliever more often, wakes with cough, or limits play.

Use the child’s action plan during an attack. Seek emergency help if breathing remains difficult after the prescribed reliever, the child cannot speak or drink normally, becomes exhausted or confused, has blue or grey lips, or the skin between the ribs pulls in strongly. A silent chest, severe drowsiness or rapidly worsening breathing is especially concerning. Sit the child upright, stay with them and follow the prescribed emergency instructions while help is coming.

Ask how asthma will be confirmed, which inhaler is for relief and which is for control, and how to use a spacer. Ask when to repeat review, whether exercise needs preparation, and what the school action plan should say.