When a wheeze is cause for alarm
Around one in seven New Zealand children will have asthma. These rates are even higher for Ma¯ ori and Pacific Island children, who get more severe symptoms and are more likely to be hospitalised as a result.
Winter can be a particularly problematic time for kids with asthma, as the drop in temperature, as well as the number of colds and flus going round, can have a massive effect on their symptoms.
So if you have a child who tends to spend the winter wheezing and feeling miserable, here is a quick list of things you can do to make sure this season is as healthy as it can be:
Make sure you have a proper diagnosis of asthma
This sounds simple, but making a diagnosis of asthma in children isn’t always easy. With some children asthma is obvious – these tend to be the kids in families where asthma, hayfever or eczema (known collectively as ‘‘atopy’’) are common, and the children exhibit the classic symptoms of intermittent wheezing, shortness of breath and cough.
‘‘Asthma’’ symptoms however can be caused by lots of other things in childhood, especially in children under two.
If you’re unsure whether your child could be asthmatic, or you don’t think they are responding to their asthma treatment as they should be, please book an appointment to see your GP or local asthma nurse.
If asthma is the cause, they will be able to give you a good management plan for winter, and if it isn’t, they will be able to advise what other treatment might help.
Know your child’s triggers
For some people with asthma, attacks will come ‘‘out of the blue’’ with no obvious reason. However, for other people, triggers will be easy to spot.
In children, this is commonly a concurrent cold or upper respiratory tract infection, exercise (especially in cold weather), sudden drops in temperature, or exposure to allergens, including pets, house dust mite, grasses, moulds and pollens.
Smoking around children is also a big factor, so ensuring your child’s room is entirely smoke-free, and if possible the whole house, will make a massive difference.
Once you have identified the factors that make their asthma worse, try to modify them.
Keeping an oil heater on a low thermostat in their bedrooms, or giving them some of their inhaler before they exercise can make a big difference.
Unfortunately it isn’t so easy to avoid colds and flus at this time of year, but I would strongly recommend you vaccinate all children with asthma against flu. It should be funded if they use a preventer inhaler, and if not it is pretty affordable at around $25 per child.
Make sure you have plenty of in-date medication
Asthma inhalers don’t last forever, and it’s worth checking the expiry date on yours.
Make sure you have plenty in stock – if your child gets an asthma attack, and you are using their reliever medication every hour or so, it is easy to get through a new inhaler in a matter of days.
Try to have separate supplies of inhalers for school and home, so your child isn’t caught short.
Follow an asthma plan
Medication won’t work if you don’t take it as prescribed.
‘‘Reliever’’ medications for asthma (most commonly salbutamol or terbutaline, the ‘‘blue’’ inhaler) have a rapid, temporary effect of widening the airway, enabling your child to breathe more
If your children appear distressed, wheezy, are coughing persistently or their breathing looks laboured, you need to get medical help immediately.
easily. If your child has moderate or severe asthma, they should also be prescribed a ‘‘preventer’’ medication.
This works differently by reducing the responsiveness of your child’s airways and minimising the risk of an asthma attack.
‘‘Preventers’’ only work if used regularly, normally twice every day, so making sure this is part of your daily routine, especially over winter months, is essential for maintaining good asthma control.
All medications are best given through a spacer
This device is easy for parents and older children to use and enables the drug to be delivered
directly to the lungs and airways, where it is needed.
Take action promptly if you are concerned
Every year, children die from asthma attacks, so don’t under-estimate the symptoms.
Young children especially may not be able to tell you how they are feeling, but if they appear distressed, wheezy, are coughing persistently or their breathing looks laboured, you need to get medical help immediately. Call an ambulance if you have to. It is better to over-react than wait until they are seriously unwell.
For more information, visit healthnavigator or talk to your GP or practice nurse.