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Childhood Illnesses

Asthma & Wheezing

What is Asthma?

Asthma is a condition that affects the lungs. It affects the airways – the tubes that carry air in and out of the body. The airways get inflamed and produce mucus. This makes the airways tight and narrow. Asthma causes;

  • Wheezing
  • Shortness of breath
  • Tight feeling in chest
  • Coughing that happens overnight or early morning
  • A cough that keeps coming back
  • A cough during or after exercise and activity.

Asthma sufferers will often find symptoms are made worse by different triggers. This might be smoke, allergies, viruses or cold air.

People with asthma may have times when their symptoms are under control, but a trigger may cause a flare up. Asthma can have other symptoms too, so it is not always easy to diagnose.

What is a Wheeze?

A wheeze is a whistling or squeaking noise mostly heard on an outward breath. It is a sign that, for some reason, the airways are inflamed and narrower than usual.

A wheeze is one of the symptoms of asthma – but a wheeze does not always mean asthma. Most often wheeze goes away after a person recovers from a short term illness.

A wheeze is often heard when we have a bad cold and cough. This is known as a ‘viral wheeze’. Some children will get a wheeze every time they have a cold but in between times breathe easily.

Sometimes children may be prescribed inhalers to help with the wheeze, but will not need to use them when they are otherwise well.

When children have asthma, the wheeze may be present at other times. This might be when they are exercising or when they come across a ‘trigger’ for their asthma symptoms – like an allergy.

Dive Deeper

How is Asthma Diagnosed?

If you have any worries that your child has symptoms similar to asthma you should discuss this with a doctor. Doctors need to decide if your child has asthma or if they have symptoms such as a wheeze for other reasons. It is not always possible to decide this straight away and a definite diagnosis of asthma can take a while. Your child will be treated for their symptoms in the meantime.

The doctor will want to know about the symptoms and see what the risks are for your child having asthma. There are some things that increase the risk of asthma;

  • Being born early (before 37 weeks of pregnancy)
  • Being born at a low weight
  • Parents smoked during pregnancy
  • Living with smokers
  • They or others in the family have eczema, allergies or hay fever
  • Living in a polluted area – like on a main road
  • Damp or mould in the home
  • They have had bronchiolitis or croup in the past

There is not a definite way of being sure a young baby or child has asthma and before the age of five it is not possible to give a definite diagnosis. Doctors will want to be sure the symptoms are not caused by something else. They will check if a baby or child has ongoing symptoms of asthma, as well as if they have any of the risk factors above.

The health team are likely to try asthma treatments to see if they help and if they do, they will be prescribed for your child.

About 40% of children who wheeze and have other symptoms when they are little, will eventually be diagnosed with asthma – others will grow out of it.

Asthma Attacks

Asthma attacks can happen for a number of reasons. They can be caused because of contact with a ‘trigger’ like pollen or animal fur. It may be because of a viral illness, like a cold making it worse. Or it could be because asthma treatment plans haven’t been followed.

Often there will have been a change in asthma symptoms on the run up to an attack. If you notice this seeing your GP or nurse may help to stop a bad attack happening.

If you are worried that your child's symptoms are getting worse, you may notice that;

  • The reliever inhaler (usually blue) isn't working
  • They are complaining that their tummy or chest hurts
  • Their breathing is getting faster or doesn't sound like it normally does
  • They are too breathless to speak, eat, play or sleep.

What to Do

You should first;

  • Sit your child in an upright position
  • Try and keep your child calm – reassure and speak gently to them
  • Encourage them to take slow, steady breaths
  • Take 1 puff of their reliever inhaler (usually blue) through their spacer every 30 to 60 seconds. For each puff try and count to ten breaths. Do this up to a maximum of ten puffs.

If things don’t get better, or you feel worried at any time, you can ring 111 for advice. 

When to Get More Help?

Call 999 for an ambulance if;

  • You don't have access to an inhaler and symptoms are getting worse
  • They have used their inhaler but things are not getting any better
  • They are using a lot of their body to ‘get breath in’. You might notice their tummy pulling in, ribs standing out or ‘sucking in’ at front of throat
  • You can see your child’s colour change – they look pale, grey or blue
  • They are getting less able to respond to you.

Never be frightened of asking for help in an emergency

If Your Child is Being Treated for Asthma

Having a child with asthma is a worry for parents, and as children get older they may worry about their own health too.

Asthma is a common condition. It can be serious if not properly looked after. It is important that you follow the advice and treatment given to you by health professionals to keep it as well controlled as possible.

Many people live with asthma with few problems most of the time. 

Living with Asthma

If your child has been diagnosed with asthma you may be worried about how this might impact on their day to day life. There are ways you can help keep asthma symptoms under control as much as possible;

Inhalers and Spacers

  • Make sure your child uses their preventer inhaler every day, even when they are well.
  • Your child should always use a spacer when taking their inhaler. If you do not have a spacer; speak to your GP or asthma nurse.
  • Wash spacers at least monthly –this helps your child get more medicine through it.
  • Order new inhalers with plenty of time to spare. Set a reminder on your phone or on your calendar to remind yourself. Running out can be dangerous.
  • Follow your child's personal asthma plan between regular appointments.

Check Ups

  • Your child should have regular asthma reviews with their GP or asthma nurse at least once a year. This is a chance to review personal asthma plans too.
  • If you notice that your child seems to be needing their inhaler more, make an appointment to discuss with the asthma team at your GP practice.
  • Ensure your child has their yearly flu vaccine.

Environment

  • Do not smoke, or let others smoke, around your child. This will make asthma symptoms much worse.
  • Where possible avoid things that trigger your child's symptoms, or that make their asthma worse.
  • When your child’s asthma is well controlled exercise is very good for them. It helps create healthy habits for life.

Using an Inhaler

Babies and children do get used to using inhalers but there will be times when they are not keen, for all sorts of reasons. It is so important that they take their ‘preventer inhaler, as instructed, every day.

When they have symptoms they need to use their ‘reliever inhaler’ to help them breathe easily again. Hopefully giving them their inhalers will not be a battle but on occasion it may be – it is still important you continue to try.

If using the inhaler is a regular problem, seek advice from your doctor or asthma nurse.

 Using a Spacer

  • Take the cap off the inhaler. Check there is nothing inside the mouthpiece.
  • Shake the inhaler.
  • Place the inhaler in the end of the spacer.
  • Help your child to put the mask over their nose and mouth.
  • Make a good seal so no medicine can escape.
  • Press the top of the canister once so that one puff of medicine goes into the spacer.
  • Count to 10 slowly (say ‘One, and two, and three,’ to get the timing right).
  • Repeat the above steps for each puff you give. Remember to take the inhaler out of the spacer, to shake between each puff.

Other Things to Remember

  • Wait 30 seconds between each puff.
  • Wipe your child’s face afterwards, this removes medicine that might have landed on their skin, which could cause redness or irritation

Watch a helpful video about using a spacer

Talk to School

Nursery or School need to know if your child is given a diagnosis of asthma. This will allow them to act quickly if your child has symptoms at school

  • Share your child's asthma care plan with their school. It is important for school to know what will help your child in an emergency.
  • If your child does not have an asthma care plan - talk to the school about what they would need to do to help your child.
  • Ensure school have all of your child's medications, and a spacer and that they are in date.
  • Talk to your child and about how they must let a grown up know if they are struggling with their asthma.

 If Your Child Has a Wheeze

If your child seems wheezy with their cough or cold, but are usually well, you can help them feel better at home.

  • Having you close by will make them feel safe, maybe you could snuggle up together.
  • Reassure them. Noisy breathing can make children feel panicky.
  • Keep calm yourself. Remember if you do feel worried things are getting worse, you can get help.
  • Offer frequent drinks. Little and often is easier when you have a cold and warm drinks can be comforting.
  • Give paracetamol if they seem to be feeling poorly. Follow the instructions on the medicine bottle.
  • Keep away from smoky places and do not smoke near your child or allow anyone else to smoke near them.

MySpira App for 6 - 13 Year Olds

The MySpira app is designed to support children and young people with diagnosed asthma to understand all the things they need to know about their condition and encourage good inhaler technique.

It is best suited for 6 - 13 year olds and includes 8 fun modules. The app combines augmented reality and gameplay to offer the very best asthma education.

The app is validated and safe, and has been developed with close assistance from asthma specialists.

How to Download

  1. Download MySpira from your mobile device's app store
  2. Type in the following code when prompted: 62025117b8df4
  3. Follow the modules to complete the training
  4. Complete the asthma plan and enjoy the bonus AR asthma game!

Asthma Care Plans

Child Asthma Action Plan

This colourful ‘My Asthma Plan’ is designed especially for children age from six to 11.

Fill it in with their GP or asthma nurse. It lists the medicines your child needs to take every day to stay well, what to do if their asthma gets worse, and what to do in an asthma attack.

Older Child (12+) Asthma Action Plan

This plan is designed for adults and children age 12 and over.

Fill it in with your GP or asthma nurse. It lists the medicines you need to take every day to stay well, what to do if your asthma gets worse, and what to do in an asthma attack.

Download

Managing Asthma and Wheezing

Download

Child Asthma Action Plan

Download

Older Child (12+) Asthma Action Plan

Download

Who can Help?

You can contact the Healthy Child Programme by calling Just One Number on 0300 300 0123 or texting Parentline on 07520 631590. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays) and 9am-1pm on Saturdays.

If you are 11-19 you can text ChatHealth on 07480 635060 for confidential advice from one of our team.

Boloh - Are you are a Black, Asian or Minority Ethnic parent wanting to know more about chest infections? The Boloh helpline can help provide you with advice and guidance on what to do if your child has a chest infection.

Call 0800 151 2605 or visit https://helpline.barnardos.org.uk

They can provide a service in English, Punjabi, Mirpuri, Polish, Luganda, Ruyankole, Rukiga, Rutooro and Kinyarwanda. Interpreters can also be provided for other languages. 

If you have decided to keep smoke free around your child - which is especially important for children with Asthma. You can contact Smokefree Norfolk for help and advice.

The Lullaby Trust - Baby Check App- This app has simple checks that you can do if your baby is ill and helps you think about whether they need to see a doctor or health professional.

You can speak to other Norfolk parents and carers by clicking our online community forum below.


iHASCO Asthma Training

A free online course about asthma for parents/carers of children and young people with diagnosed asthma. The course covers;

  • How asthma affects our lungs
  • Triggers that may cause an attack
  • Symptoms leading up to an attack
  • What to do when an attack occurs.
  • Correct technique for the various types of inhaler and spacer.

There is a little test at the end, which people may or may not wish to take – anyone who does will be rewarded with a certificate.

Start the course

The course can be translated into 36 different languages and the video has subtitles and the translated text underneath. Language can be selected during registration.

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