The start of the school year is often a busy time for children’s airways. Viruses begin circulating again among classmates, classrooms have been closed all summer and the mornings turn cooler. In a child with asthma, these changes can bring back symptoms that had stayed quiet during the holidays. Yet when asthma is well understood and well followed, the great majority of children lead an entirely ordinary life at school, on the sports field and at home.
What asthma is, in simple words
Asthma is a condition of the airways, the small tubes that carry air down to the lungs. In a child with asthma, these airways are more sensitive than usual. When they meet certain triggers, they become irritated, their lining swells, mucus builds up and the passage for air narrows. That narrowing is what makes breathing hard work and sometimes makes it whistle.
Asthma is a long-term condition that comes and goes. Between flare-ups, a child may feel nothing at all. That is exactly why follow-up matters: the aim is not only to settle an attack when it happens, but to make attacks rare.
The signs parents notice
Asthma does not always show itself through dramatic attacks. More often it appears in small everyday details, which are worth writing down to discuss with the doctor:
- a dry cough that comes back at night or early in the morning
- coughing or breathlessness while running, playing or doing sport
- a whistling sound, called wheezing, when the child breathes out
- a tight feeling in the chest, which older children can describe
- a cold that seems to settle on the chest and lasts longer than in other children
- a child who stops playing earlier than their friends
None of these signs is enough on its own to make a diagnosis. Only a doctor can do that, after an examination and sometimes breathing tests.
What can set symptoms off
Every child has their own triggers, and recognising them helps a great deal. The most common are viral infections such as colds, house dust and the mites that live in it, mould in damp rooms, pollen in spring, cold morning air and strong smells from some cleaning products or perfumes.
Tobacco smoke deserves a special mention. It irritates the airways over the long term, even when someone smokes in another room or by the window. Not smoking around children, at home or in the car, is one of the most useful things a family can do. Airing the home every day, keeping damp down and avoiding dust traps in the bedroom complete these precautions.
At school: plan ahead rather than react
It is best to tell the teacher in the first days of term. The doctor can provide a written plan summarising the usual treatment, the signs to watch for and what to do if the child struggles to breathe. A copy left with the school allows whichever adult is present to act calmly instead of improvising.
Sport is not the enemy of a child with asthma. With the doctor’s agreement, it is usually possible and even encouraged: it builds stamina, confidence and friendships. The doctor can explain how to prepare for exercise and what to do if breathlessness appears.
The inhaler, the spacer and follow-up
The treatment prescribed by the doctor is most often inhaled, so that it works directly in the airways. For children it is usually used with a spacer, a small tube that helps the treatment travel down to the lungs.
Technique matters as much as the treatment itself. The paediatrician explains it, demonstrates it and checks it at every visit, because habits slip quickly and children grow. Bring the inhaler and spacer to each appointment and ask to go through the steps together. Never change a treatment without talking to the doctor first.
Follow-up still matters when all is well, because a child who has stopped coughing is not necessarily a child whose asthma is settled. Follow-up visits make it possible to adjust treatment to the season, to growth and to the child’s daily life, to check inhaler technique and to answer the family’s questions. At Clinique Sakina, a paediatric consultation can be booked to take stock before or during the school year.
When to seek urgent care
Some signs should not wait for an appointment. Go to the emergency department or call the emergency services if your child:
- is breathing very fast or with great effort, with the skin pulling in at the neck or below the ribs
- cannot speak, cannot finish a sentence or, in a baby, cannot feed
- has lips or fingertips turning blue
- is not getting better, or is getting worse, despite the reliever treatment prescribed by the doctor
In these moments, staying calm and reassuring your child also helps their breathing. Take the written plan and the usual treatment with you.
Remember
This article offers general information about asthma in children. It does not replace a consultation and cannot take your child’s particular situation into account. For any question about their diagnosis or treatment, talk to your doctor.
General information: it does not replace your doctor’s advice.
