Key points to remember about asthma
- asthma is a condition that leads to narrowing of the airways of the lungs
- symptoms include wheeze, cough and difficulty breathing
- common asthma triggers are colds, exercise, dust, pollens and cigarette smoke
- an asthma action plan can help you understand and manage your child's asthma
What is asthma?
Asthma is a common respiratory condition. It affects the small and medium-sized airways (also called breathing tubes or bronchi) in the lungs.
Symptoms of asthma can vary from mild to severe.
In asthma the airways are inflamed and there is:
- swelling of the airway wall
- an increase in mucus or phlegm
- tightening of the muscle in the airway wall
See Acknowledgements for this diagram.
These changes cause narrowing of the airways. This leads to difficulty with breathing and wheezing.
Wheezing is a musical, whistling sound with breathing, usually as you breathe out. It comes from the chest – not the nose or throat.
Why do some children have asthma?
We do not know why some children will have asthma when others do not.
We do know that:
- asthma often runs in families
- asthma is associated with other conditions such as eczema, hay fever and allergies
- if one or both parents has an allergic condition such as asthma, hay fever or eczema, their child is more likely to develop asthma
We think that modern Western lifestyle may play a part in the rise in asthma that has occured over the last few decades. Changes in housing, our diet and a more hygienic environment may be responsible – but we do not really know the cause of the increase in asthma.
We do know that:
- mother’s smoking during pregnancy increases the risk of asthma in her child
- outdoor environmental pollution may make asthma symptoms worse but it does not actually cause asthma
One in four children in New Zealand will have asthma at some time during childhood.
What are the signs and symptoms of asthma?
You should see your doctor and ask about asthma if your child:
- wheezes and coughs with a virus cold
- wheezes and coughs after exercise
- wheezes and coughs during the night
- cannot keep up when they are running around with children of the same age
- complains they feel tired or ask to be carried (depending on their age) when you go for a walk
- does not run around as much as children of the same age
- says they are out of breath or breathless
These are some of the symptoms of asthma in children. However, these symptoms may be due to other less common conditions. Your doctor will know.
There are very good asthma treatments available, so you can stop asthma interfering with your child’s enjoyment of sports and play.
Your doctor or asthma educator will develop a tailor-made asthma action plan for your child with you. This will help you to manage the day-to-day symptoms and tell you what to do in an asthma attack.
See the sample asthma action plans below.
What are the triggers for asthma?
Some children have asthma all year round; others may only have it in certain seasons or when they have a virus cold. It is not always possible to know when an attack will occur.
Some common trigger factors for asthma are:
- colds (viruses)
- changes in the weather
- house dust-mites
- cigarette smoke
- emotions, such as being upset
Asthma symptoms and triggers may differ from child to child and from time to time. It is useful to know your child's triggers. Keep a symptom diary and note possible triggers.
See the sample symptom diaries:
For more information about triggers and some tips for controlling them, see:
- Inhaled triggers: Dust mites, pollens and pets (Asthma New Zealand)
Make sure your child's environment is smoke-free. Asthma is increased in children whose parents smoke. Tobacco smoke also triggers asthma attacks and makes a child's asthma more severe than it would otherwise be. Many environmental factors contribute to asthma; cigarette smoke is one that you can avoid.
If you want to give up smoking:
- call the Quitline on 0800 778 778 for free
- check out the website Quit / Me Mutu
- ask your health professional
After your child is diagnosed with asthma
After the diagnosis of asthma has been made:
- talk to your doctor or asthma educator about how asthma affects your child
- ask your doctor for an asthma action plan - this is a personal written plan for your child. It lists their medicines and how and when to give them - see the sample asthma action plans below
- think of a way to remember to give your child their medicine every day - later on they will need to remember for themselves
Asthma can be well controlled in most children. Your child should be able to take part in all the normal activities of childhood, including energetic play and sports.
You can help your child by learning as much as you can about asthma.
Asthma action plans
- Child asthma plan (Asthma Foundation); image at right
- Asthma care plan for your child (Asthma NZ)
- Asthma management plan for young people (Asthma NZ)
- Asthma emergency action plan for children under five years of age (Asthma NZ)
What are signs of an asthma attack?
Signs of an asthma attack include:
- breathing faster than usual
- putting extra effort into breathing
- flaring of the nostrils
- sucking in of the spaces between the ribs with each breath
- sucking in of the spaces above the collar bone with each breath
Your child may be more comfortable sitting up so do not make them lie down.
When should I seek help?
You should see a doctor urgently if your child:
- is breathing fast, wheezing and having to use extra effort to breathe
- is breathless at rest
- looks unwell
- looks pale and is beginning to get tired
gets worse after beginning to get better
- has trouble completing a sentence because of difficulty breathing
- you are worried
Dial 111 and ask for urgent medical help if your child:
- has severe difficulty breathing
- is too breathless to talk
- is floppy and very tired
- is becoming less responsive
- has blue lips and tongue
- has periods of stopping breathing
Asthma affects your child’s breathing. In severe asthma it may be hard for them to get enough oxygen. Signs of not getting enough oxygen may include any of the following:
- looking very pale
- going blue in the tongue and lips
- becoming very sleepy and not easy to rouse
If your child has any of these signs, they will need to be given oxygen.
Oxygen is carried by emergency services – your child gets treatment while they are on the way to hospital.
In severe asthma it is usually better to dial 111 and ask for emergency medical help than drive your child in your own car to the hospital. See Emergencies - dialling 111 on this website.
Will my child grow out of asthma?
Asthma is a long-term condition. The majority of children with asthma have less troublesome asthma as teenagers. Symptoms can appear again in adulthood. If your child has severe asthma, it is more likely to continue or return in later life.
Your child should learn about asthma and gradually take over responsibility for its management, as they become a teenager, with support from you.
Make sure you know the medicines (see Asthma medications below):
- what they are for
- how to give them
- when to give them
Make sure that you can recognise your child’s:
- asthma symptoms
- asthma triggers
- signs of an asthma attack
Learn when you need to see a doctor urgently.
Learn when you need to dial 111 for medical help. See Emergencies - dialling 111 on this website.
Use this checklist as a guide when you talk to your GP (general practitioner) or asthma educator.
This fact sheet does not go into details about the medicines that are used in asthma. You do need to know about the medicines your GP (general practitioner) prescribes for your child. You should ask your GP or asthma educator.
The following resources about asthma medications are available at other websites:
- Asthma Foundation booklet What is asthma?
This has a section on medications, which includes the following information:
- how do preventer medicines work?
- steroid tablets
- how do reliever medicines work?
- how do symptom controllers work?
- what is a combination inhaler?
- can you reduce your medicines?
- complementary therapies
- Asthma Foundation booklet Understanding your inhaler
- Asthma New Zealand website resources:
- What's in the medicine cabinet?
- All about spacers
- Corticosteroids & asthma
- Royal Children's Hospital, Melbourne, Photoboard of asthma inhaler devices (this photoboard is designed for an Australian audience; some of the devices pictured may not be available in NZ)
Where to go for more information about asthma
Asthma Foundation NZ www.asthmafoundation.org.nz
The Asthma Foundation, based in Wellington, produces a range of information about asthma. See their resources, which includes the booklet Children and asthma (at right).
The Asthma Foundation also has resources available for Maori, including a book for younger children with asthma, What Maui Learnt about Asthma. In this book, Maui the mighty takes control of his asthma with the help of his tupuna – Papatuanuku and Ranginui.
Phone: 64 4 499 4592
Fax: 64 4 499 4594
Asthma New Zealand - The Lung Association www.asthma-nz.org.nz
Asthma New Zealand - The :ung Association, based in Auckland, works with others to provide training, education and support to people with asthma (and their families) so that they can lead as normal a lifestyle as possible.
A number of resources are available on their website, including:
- Asthma care plan for your child
- Asthma management plan for young people
- Asthma emergency action plan for children under five years of age
- Children's asthma symptoms diary
Phone: 64 9 623 0236
Fax: 64 9 623 0774
Space to Breathe (Pharmac) www.spacetobreathe.co.nz
Space to Breathe is a programme that provides education and best practice support to caregivers of children with asthma, including health professionals. The Space to Breathe website provides access to a range of resources, including:
- Best Practice Journal - Childhood Asthma (special edition)
- Space to Breathe Asthma Flip Chart
Children's Hospital at Westmead, Sydney kidshealth.schn.health.nsw.gov.au/fact-sheets
The website of the Children's Hospital at Westmead, Sydney provides access to a range of fact sheets on asthma, including the following:
- What is asthma?
- Helpful asthma management tips in managing your child's asthma
- Asthma trigger factors
- Passive smoking
- Children's asthma resource pack for parents and carers
Royal Children’s Hospital, Melbourne www.rch.org.au/kidsinfo/factsheets.cfm
The Royal Children’s Hospital website provides the following fact sheets:
The diagram of the airways has been reproduced from the NHLBI (National Heart Lung and Blood Institute) website; Disease and Conditions Index, disease topic, Asthma. NHLBI is a part of the NIH (National Institutes of Health) and the Department of Health and Human Services, United States. (These images are in the public domain; reproduction permitted). NHLBI cannot be held responsible for any other content in this fact sheet.
http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/ [Image accessed 9/7/2007]
© Paediatric Society of New Zealand and Starship Foundation 2005 – 2013
Printed on 19 June 2013. Content is regularly updated so please refer to www.kidshealth.org.nz for the most up-to-date version