Understanding Asthma in Children with Paediatric Respiratory Specialist, Dr Noor Zehan
10 December 2024
Asthma is more than an occasional breathing problem. It’s a common chronic respiratory disease that affects children, with nearly half a million of children aged 6 to 17 years old who are diagnosed with it, according to the National Health and Morbidity Survey 2023.
Early recognition and proper management are essential not only to enhance the child’s quality of life but also to preserve their long-term lung function. In this regard, parents play a critical role.
Dr Noor Zehan Binti Abdul Rahim, our Consultant Paediatrician and Paediatric Respiratory Specialist, shares valuable insights about asthma and essential information every parent should know to effectively manage their child’s condition. With the right care, children with asthma can thrive and lead healthy, active lives.
What Exactly Is Asthma in Children and What Do the Symptoms Look Like?
Asthma in children occurs when the lungs and airways become inflamed and narrow in response to exposure to specific triggers, causing difficulty in breathing.
However, according to Dr Noor Zehan, parents may not always recognise asthma symptoms, particularly in younger children who may not be able to fully express their discomfort.
“It’s very hard to diagnose before they’re five years of age, as their airways are often not mature yet at that time,” explains the doctor.
What signs should parents look out for? Dr Noor Zehan highlights the following symptoms that may indicate asthma:
- Frequent coughing, especially at night or after physical activity
- Shortness of breath, rapid breathing or complaints of “feeling tight in the chest”
- Producing a whistling sound when breathing (wheezing)
- Frequent colds that take longer to recover from
- Irritability or fatigue due to disrupted sleep from coughing or difficulty breathing
- Gets tired more easily compared to other children
What Are Common Triggers of Asthma in Children?
Dr Noor Zehan explains that symptoms of asthma are brought on by certain triggers.
“For allergic asthma, the most common (inhaled allergens) would be like house dust mites and also cockroaches because of the spores they produce, which can cause inflammation in the body and trigger asthma,” reveals Dr Noor Zehan.
Other most common asthma triggers include:
- Allergens (e.g., dust mites, pet dander, mold, pollen)
- Respiratory infections (e.g., colds, flu)
- Physical activity (exercise-induced asthma)
- Air pollution and tobacco smoke
- Weather changes, especially cold air
- Strong odors or fumes (e.g., cleaning products, perfumes)
- Emotional stress or laughing too hard
- Certain food allergies or sensitivities
What Should Parents Know About Managing Asthma in Children?
Dr Noor Zehan emphasises that effective asthma control goes beyond just medication; education is equally important.
“It is essential for both the patient and their caregivers to have a clear understanding of what asthma is, how it affects the body, and how asthma medications work. This empowers them to manage asthma better and recognise early warning signs before symptoms escalate,” explains Dr Noor Zehan.
She recounts the story of a 7-year-old patient who experienced recurrent asthma exacerbations. Upon conducting a detailed history and examination, Dr Noor Zehan discovered that the child and their parents lacked a proper understanding of asthma, leading to non-compliance with treatment. Additionally, the child was exposed to dampness and mold at home, which triggered their symptoms.
“After taking steps like providing asthma education which includes monitoring technique of using the inhaler as well as lung function test readings, coupled with modification of the home environment, the patient improved significantly,” she shared.
Dr Noor Zehan also warns against the long-term use of oral steroids in children to treat their asthma, as it can lead to side effects such as stunted growth, weakened bones and other developmental issues.
“The risk of growth delay with inhaled steroids is much less than with oral steroids. The key is ensuring the child receives the right dose and is regularly monitored by their doctor to adjust treatment as necessary,” says Dr Noor Zehan.
This is why the role of a Paediatric Respiratory Specialist is invaluable. They ensure that children receive accurate diagnoses, effective treatment, and proper guidance to manage their asthma based on detailed history-taking and specialised tests, including peak flow measurements, lung function tests, nitric oxide tests, and other assessments to rule out additional conditions.
How Do I Know If My Child’s Asthma Is Getting Worse?
Asthma symptoms can sometimes flare up. Dr Noor Zehan advises parents to seek medical advice if they notice these signs:
- Frequent asthma symptoms (almost daily)
- Not participating in physical activity in school due to being tired all the time
- Not able to sleep at night due to frequent coughing
She warns that if the child exhibits the below symptoms, immediate emergency treatment at the hospital is necessary:
- Fast breathing
- Not being able to lie flat on bed
- Not being able to speak in full sentence
What Should I Do If My Child Gets an Asthma Attack?
It can be hard to predict when an asthma attack happens. In the event it occurs, Dr Noor Zehan advises parents to remain calm, follow the steps in the asthma action plan provided by their paediatrician and administer reliever medicine (e.g., Ventolin) every 10 to 15 minutes.
What If an Attack Happens at School or Away From Home?
To be prepared for the possibility of asthma attacks outside the home, Dr Noor Zehan recommends that parents provide school staff and caregivers with a written asthma action plan, which should include the following:
- Signs of an asthma attack
- Instructions for using the asthma inhaler or medication
- Contact information of child’s doctor or emergency services
Parents should also make sure that the child’s caregivers or teachers are trained on how to recognise an asthma attack and how to use asthma inhalers or nebulisers properly.
“Most importantly, parents should make sure the child always carries their asthma inhaler or has access to it,” emphasises the doctor.
Ultimately, asthma affects every child differently. Some children may have mild asthma symptoms, while others may experience more severe reactions. Treatment plans should be tailored to the child’s specific triggers, symptoms, and lifestyle.
If you suspect that your child has asthma, or need guidance on managing their condition, schedule an appointment with our Consultant Paediatrician and Paediatric Respiratory Specialist today. Click to make an appointment here.
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