ASK THE EXPERT! Dr Helen Brough talks about Asthma in children

London Mums have talked to Dr Helen Brough, Consultant in Paediatric Allergy and Immunology, about Asthma in children.

How does asthma in children differ from asthma in adults?

Asthma in children is mostly allergic asthma, which means that it is driven by a type of cell in the lungs called the eosinophil and is usually associated with triggers from environmental allergens, such as house dust mite or grass pollen. This form of the condition is usually responsive to the standard treatments we prescribe for asthma including:

  • inhaled steroids which prevent exacerbations or attacks
  • reliever inhalers (usually blue) which help to relax the muscles in the airways to provide relief from symptoms

In adults, asthma could be related to obesity, for example.


What are the most common symptoms of asthma in children?
The most common symptom of asthma in children is wheezing, which is a high pitched, whistling sound. Wheezing is most often heard when the child breathes out and is usually triggered by sudden exposure to cold weather, exercise, or if the child is having an asthma exacerbation.

Further to this, a persistent cough may be associated with uncontrolled asthma. This is most often a dry cough, often but not always, at night. There are, however, many causes of a cough and therefore it’s important to go through a systematic approach to understanding the cause behind a chronic cough. For example, certain types of coughs, such as habit coughs, never occur at night, so that the timing as well as the characteristic of the cough are very important.

If a child is having an asthma attack, they can experience not only coughing and wheezing, but they can also develop difficulty breathing. In this situation, it’s important that the child has a personalised asthma action plan so that the family know how to deal with the asthma attack.


How is asthma in children diagnosed?

Asthma is mostly diagnosed after the age of five, because from this age up, the child has the necessary motor skills to perform sophisticated breathing tests.

Although these tests form part of the standard diagnosis of asthma in children from five years and up, a medical history is also vitally important and this can be taken from a very early age, meaning a diagnosis can be given at any time. Ruling out other conditions also forms part of the diagnostic process. This may include a chest infection or post-nasal drip due to house dust mite allergy, for example, which can lead to a wet cough.

Many children get recurrent viral infections and consequently can develop viral induced wheeze. In this case, the child only wheezes/coughs when they have a cold, but they don’t have any asthma symptoms in between colds.

Based on a clinical history and an examination, we can establish if asthma is likely.

Even during this diagnostic stage, it’s very important to provide inhaler device training along with a prescription for a reliever inhaler in case the child has an asthma exacerbation.


To book an appointment with Dr Brough email: 

This article featured in the Summer / Autumn 2022 issue of the London Mums magazine.



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