If your child has a frequent cough, does he simply have a weak chest, or is he asthmatic?
It can be very hard for parents to tell, but as asthma is the most common long-term medical condition in children and it can kill, it’s important that mums and dads know the symptoms, says Asthma UK.
In the week of World Asthma Day, May 1, the charity is highlighting the fact that the condition kills three people every day in the UK, and around 40 children every year.
One in 11 UK children has asthma, and every 17 minutes a child is admitted to hospital because of the condition.
Asthma UK asthma nurse specialist Angela Jones says: “This is a condition that needs to be taken seriously - people die from it, yet people still tell us they didn’t realise it could be fatal.”
Asthma occurs when the airways - the small tubes that carry air in and out of the lungs - are irritated by an asthma ‘trigger’, which can be anything from pollen and pet hair to changes in temperature and viruses.
The irritation makes the airways become narrower, inflamed and swollen, and sometimes mucus builds up, which can further narrow the tubes. As a result of these reactions, it becomes difficult for sufferers to breathe.
The usual symptoms of asthma are coughing, wheezing, shortness of breath and tightness in the chest, but not everyone gets all the symptoms, and they vary widely in frequency and severity.
“Diagnosis of asthma is really looking at a pattern of symptoms that develop over time,” she explains.
Jones advises parents who suspect their child may have asthma to discuss it with their GP, so he/she can assess the likelihood of the child having the condition, based on family history, the child’s own medical history of conditions such as eczema and allergies, and their pattern of symptoms.
Family history is important because if one parent has asthma, the chance of their child developing the condition is double that of children whose parents aren’t asthmatic.
A family history of eczema or allergies also means a child is more likely to develop asthma.
Jones explains that the way a child reacts to an ordinary cough and cold may give some clues as to whether he/she has asthma.
“Usually when the cold subsides, the cough gets better, but children with asthma may get a cold and be left with a lingering cough for many weeks.
“Sometimes that may be a night-time cough, or they may be coughing when they’re exercising and not be able to tolerate exercise as much as other children who haven’t got the problem.”
She points out that some parents think their child can’t have asthma because he or she doesn’t wheeze.
“Some children just have a cough, and that’s their only asthma symptom,” she says.
Younger children with asthma may complain of tummy ache, when what they really mean is that their chest feels tight, but they haven’t got the vocabulary to explain it.
If a doctor thinks asthma is a possibility, they may put a child on a trial of asthma medicines, based on the premise that such medicines won’t help if the child hasn’t actually got asthma.
Initially a child would be prescribed a blue Ventolin inhaler to be used when they have asthma symptoms.
If the Ventolin relieves the symptoms, it adds to the possibility that the child does have asthma, and if they need to use it regularly - say more than three times a week - they may be prescribed a brown steroid preventer inhaler, to see whether, over a period of weeks, their symptoms disappear.
If they do, that adds more weight to an asthma diagnosis, and to be absolutely sure, the treatment may be withdrawn to see whether the symptoms return.
Diagnosis of children aged over five or six may also involve them being asked to do lung function tests using a peak flow meter which they blow into to measure the amount of air exhaled and its speed.
Children with narrowed airways because of asthma will blow out less air than normal, at a slower speed.
Jones says it’s very important that children with asthma symptoms are diagnosed, pointing out: “They’re not going to be sleeping so well, they’ll be tired and not learning properly, and they might not be able to join in with sport at school.
“And it’s important from a physiological point of view - if their lungs are permanently red and swollen, eventually that can lead to scarring, which can affect their future lung health.”
For more information and advice about asthma, visit the Asthma UK website at www.asthma.org.uk, or ring its advice line on 0800 121 6244.