Asthma is a chronic inflammatory condition in which the airways narrow and swell, and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. One in five Singaporean children suffers from bronchial asthma.

 

Asthma is a chronic condition and cannot be cured, however its symptoms can be controlled. In many children, symptoms do improve with age. Frequency and intensity of asthma symptoms vary over time, so it is important to work with the doctor to track your child's signs and symptoms and adjust treatment where needed.

Asthma symptoms vary from child to child. Common symptoms include:

 

Very young children may present with seemingly harmless symptoms of tiredness, irritability, persistent crying or changes in mood.

Childhood asthma is caused by the interaction of a genetic tendency for asthma with the environment. A family history of any allergic diseases such as bronchial asthma, allergic rhinitis, food allergy, atopic dermatitis increases the risk of a child developing bronchial asthma. The following environmental factors may also contribute to this risk:

 

Triggers that result in asthma attacks may differ in each child. Some common triggers include:

 

Bronchial asthma is a chronic disease and long-term treatment and follow up is necessary for good symptom control and optimal lung function and health outcomes. In addition, several childhood conditions have similar symptoms, and it is important to confirm the diagnosis of bronchial asthma before starting treatment.

 

The following tests may be helpful in the evaluation of and to confirm the diagnosis of asthma:

 

Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking symptoms to make sure daily asthma medications are keeping symptoms under control. Long-term preventers or controller medication use are key in preventing asthma flare ups.

 

There are two main types of asthma medications:

 

Preventers/ Controllers: These work slowly to control the chronic inflammation, by making airways less sensitive to triggers. Use these medicines/inhalers daily unless instructed to stop by the doctor – this is important in the control of asthma. Examples of preventers include steroid inhalers, combination inhalers and oral anti-leukotrienes.

 

Relievers: These work rapidly to open the airway, providing quick relief of asthma symptoms. They should only be used when needed. Examples of relievers include Salbutamol inhalers and certain combination inhalers.

The written asthma action plan outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Follow your written asthma action plan and check in with the doctor when in doubt.

Signs of an asthma flare up include:

 

Consult the doctor if your child:

 

Though bronchial asthma is a chronic disease, symptoms can be controlled and most children achieve a normal quality of life. Understanding the disease, active participation in the care plan, compliance with the prescribed medications and regular review is key to successful treatment of the condition.

Many parents worry about their children falling ill with SARS-CoV-2 (the virus that causes COVID-19). This is especially a concern if the child has bronchial asthma. Current studies suggest that children with asthma are not at increased risk of catching COVID-19 infections nor at risk of more severe COVID-19 disease. Keeping asthma well controlled is important for the prevention of severe COVID-19 disease in asthma.

 

To reduce the risk of flare of asthma or COVID-19 disease in children, parents must ensure the following:

 

As the COVID-19 pandemic evolves and new information is rapidly made available, prevention and treatment recommendations may change. Please reach out to your doctor early for any questions or concerns.

 

This article was contributed by Dr Jenny Tang, AIA Preferred Provider, and Consultant Paediatrician with a special interest in Asthma, Lung, Sleep and Allergy.  To request an appointment with Dr Jenny Tang, please click here.