Managing asthma in children
In children, initial treatment after making the diagnosis of asthma is guided by the pattern and severity of asthma symptoms. The aims of asthma management are to ensure that the child’s asthma has been correctly diagnosed, and to enable the child to maintain a normal quality of life without interference from asthma or the side effects of asthma treatment.
For children already taking regular preventer treatment, adjustments to the treatment regimen are based on finding the lowest dose of medicines that will maintain good control of symptoms and prevent flare-ups.
The management of asthma and wheezing disorders in children is based on:
- Confirming the diagnosis
- Assessing the pattern of symptoms (including frequency of episodes and pattern of symptoms between episodes)
- Assessing triggers
- Discussing the goals of management with the child’s parents and the child (depending on age)
- Choosing initial treatment based on the child’s age and pattern of symptoms
- Reviewing and adjusting treatment periodically based on recent asthma symptom control and risk factors (see Figure: Stepped approach to adjusting asthma medication in children)
- Managing co-morbid conditions that affect asthma (e.g. allergic rhinitis)
- Providing parents and children with information and skills to manage their asthma, including:
- a written asthma action plan
- information about avoiding triggers, where appropriate
- training in correct use of medicines, including inhaler technique
- information and support to maximize adherence
- Managing flare-ups when they occur
- Providing advice about avoidance of tobacco smoke, healthy eating, physical activity, healthy weight and immunization.
The good news for most kids with asthma is that it can be controlled — sometimes so well that flare-ups are rare.
The learning process can be the hardest part of controlling asthma. Between diagnosis and good control, there’s much to learn and a lot to do.
Don’t be surprised or discouraged if your child has flare-ups while learning to control asthma. Asthma control can take a little time and energy to master, but is worth the effort!
How long it takes to get asthma under control depends on a child’s age, the severity of symptoms, how often flare-ups happen, and how willing and able the family is to follow a doctor’s treatment plan.
All kids need a doctor-prescribed asthma action plan to control symptoms and flare-ups.