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 (viruses), 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  

These changes cause narrowing of the airways. This leads to wheezing, cough and difficulty with breathing.

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 have 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 occurred 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 4 children in New Zealand will have asthma at some time during childhood. 

What are the signs and symptoms of asthma?

See external links and downloads below for an asthma action plan and other useful resources.

You should see your doctor and ask about asthma if your child:

• wheezes and coughs with a cold (virus)
• 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
• says they are out of breath or breathless
• complains they feel tired or ask you to carry them (depending on their age) when you go for a walk
• does not run around as much as children of the same age

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 life including 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 cold (virus). It is not always possible to know when an attack will occur.

Some common trigger factors for asthma

• colds (viruses)
• cigarette smoke
• changes in the weather
• house dust-mites
• mould
• pollens
• pets
• exercise
• emotions, such as being upset

Keep a symptom diary and note possible triggers

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.

Make sure your child's environment is smoke-free

Make sure your child's environment is smoke-free, wherever they happen to be. Asthma increases 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 free Quitline on 0800 778 778 or text 4006
• check out the Quitline/Me Mutu website [1]
• ask your health professional

After your child's asthma diagnosis

After your child has had a diagnosis of asthma:

• 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 
• 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.

What are signs of an asthma attack?

Signs of an asthma attack include:

• wheezing
• 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 collarbone with each breath

Your child may be more comfortable sitting up so do not make them lie down.

When should I seek urgent help for an asthma attack?

When to see a doctor urgently

Check out Signs that children are struggling to breathe [2].

You should see a doctor urgently (straightaway) 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

When to seek emergency medical help

In severe asthma it is usually better to dial 111 rather than drive your child in your own car to the hospital.

Dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for emergency 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 oxygen as an emergency.

Emergency services carry oxygen so your child gets treatment while they are on the way to hospital.

In severe asthma it is usually better to dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for emergency medical help, rather than drive your child in your own car to the hospital.

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.

Asthma checklist

Make sure you know the medicines:

• names
• what they are for
• when to give them
• how to give them
• how much to give

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 within New Zealand for medical help. See Emergencies - dialling 111 [3] on this website.

Asthma medicines

This information does not include details about asthma medicines. You do need to know about the medicines your family doctor prescribes for your child. You should ask your family doctor or asthma educator. 

Asthma inhaler devices

Photoboard of asthma inhaler devices [4] (Royal Children's Hospital, Melbourne). This photoboard is for an Australian audience - some of the devices pictured may not be available in New Zealand.