What is asthma?
Asthma is a condition that affects the airways and can make it difficult to breathe. It is one of the most common health problems that children can have. Adults can have it too. Asthma can run in the family.

A child with asthma can experience one or more of the following problems:
• Coughing that occurs more at night or early in the morning.
• This is a course, whistling sound produced in the airways during breathing.
• A feeling of tightness or pain in the chest.
• Shortness of breath.

What is an asthma attack?
Symptoms of asthma are not present all the time. The problems occur periodically or when something triggers them. When they occur, it is called an “asthma attack” or a “flare up” of asthma.

The airways are tubes that carry air to the lungs. During an asthma attack, the walls of the airways in the lungs swell and become narrow. More mucous is produced which clogs up the airways. The muscles around the airways also get tight. Less air gets in and out of the lungs making breathing difficult.

What causes an asthma attack?
Asthma symptoms can be caused when one is exposed to asthma triggers. What triggers problems in one person is not always the same as what triggers them in another. It is important to identify the triggers in your child and learn how to minimize exposure to them. Here are some of the common triggers:
• Smoke from cigarettes, burning wood or fuel,
• Weather changes: when it’s cold, very hot or very windy. Environmental temperatures are lowest at night or early in the morning.
• Infections like the common cold
• Strong smells or fragrances like burning incense, perfumes, exhaust fumes, air fresheners
• Allergens like molds, cockroach droppings, furry pets, dust mites, pollen and grasses.
• Intense emotions like laughing and crying
• Some children will suffer symptoms when the run or play a lot.

How can I tell if my child has asthma?
It can be hard to tell if your child has asthma especially if he or she is younger than 5 years. This is because symptoms like cough, chest tightness, wheezing or trouble breathing can occur in illnesses other than asthma. You will need to visit the doctor with your child if you notice asthma-like problems.
During the clinic visit the doctor will ask you questions about the problems your child is experiencing. You will be asked if your child has allergic tendencies that may be related to asthma; these include conditions like eczema and allergies of the nose. The doctor will ask you if a family member (e.g a parent or sibling) of the child has been diagnosed with asthma or has had similar problems. The doctor will help you pick out possible triggers of the symptoms and seek to determine how intense or frequent the complaints are. A physical examination will be performed, and tests may be done if further information is required.

Is there a test for asthma?
Most of the time the doctor will be able to tell that one has asthma from the set of questions he asks and what he finds on physical examination. Sometimes the picture may not be clear, and tests may be done to determine if asthma is indeed present or if other problems may be causing the symptoms.
A simple breathing test called spirometry can be done to measure how much and how fast one can blow air out of one’s lungs. This helps the doctor know how clear or blocked/obstructed your child`s air passages are. Many children older than 6 years should be able to complete this test.
Sometimes this test is repeated after the child inhales a bronchodilator (this is medicine that opens up the airways). This test is called a postbronchodilator or bronchodilator response test. It is done to see if the child’s breathing improves after inhaling the medicine.
If the history, physical exam and the breathing test do not clearly establish a diagnosis of asthma a methacholine challenge test may be done. Methacholine is medicine that may narrow the airways when inhaled. First the baseline lung function will be tested; next methacholine with be administered using a nebulizer and the breathing test repeated; finally, the child will be given a bronchodilator (this is medicine that opens up the airways) using either an inhaler or a nebuliser.
The breathing test will be done again to determine if any change has occurred following the bronchodilator inhalation.
Allergy tests can be done to determine if one is allergic to specific foods or environmental particles.
A chest X-ray may be done in some children to make sure nothing else is causing the asthma symptoms.
Other tests may be done to rule out presence of conditions like Gastroesophageal reflux disease and sinusitis that may exist together with asthma and contribute to the symptoms.

How is asthma treated?
Different types of medicines are used to treat asthma. These include inhalers, syrups, powder or pills. The medicine the doctor prescribes will depend on the child’s age and how frequent or severe the symptoms are.
Quick-relief medicines are inhaled bronchodilators ( medicines that are breathed in and open the airway immediately) that work by opening up the airways to relieve symptoms. They should only be used when asthma symptoms are present.

Long-term controller medicines control asthma and prevent future symptoms. If your child has frequent symptoms or suffers multiple severe asthma attacks, then she may have to take these medications every day.They may come in the form of inhalers, syrups or tablets.

Most children who are prescribed an inhaler will need to use it with a device called a “spacer”. Your health care provider will instruct you on how to use the inhaler and spacer correctly.

It is very important that you give your child the medicines as prescribed. Leaving asthma untreated has much bigger dangers that the adverse effects the medicines might have. Asthma that is not treated with the right medicines can prevent children from doing normal activities, make the miss school, or even damage the lungs.

What is an asthma action plan?
An asthma action plan is a written list of instructions that tell you:
• What medicines to give your child at home and when to give them
• What symptoms to watch out for
• What to do when symptoms are getting worse
• When to visit your healthcare provider or call for help
• It also gives you a list of possible triggers
You, your child, and your doctor will work together to develop an asthma action plan.
It will be important to share the plan with all the child’s caregivers (at home, at school or in hospital)
The plan should be reviewed with your doctor at agreed intervals of time to keep it current

When should I take my child with asthma to the hospital?
Seek emergency treatment if:
• Asthma symptoms are rapidly getting worse
• Your child’s symptoms don’t improve despite using quick-relief medicines
• Symptoms affecting even minimal daily activities of the child.
See your doctor:
• If your child has frequent coughing or wheezing or any other asthma-related problem.
• To partner with the doctor in monitoring your child’s symptoms.
• If your child’s symptoms don’t get better despite using the quick-relief medication.
• If you have to give the quick-relief medications more frequently to ease your child’s symptoms.
• To discuss your child’s symptoms and make any required treatment adjustment.