An estimated 2.5 million Australians have asthma. It’s a prevalent and often hereditary disease that affects more boys than girls during childhood, however it can be difficult to diagnose in very young children.

Breathing problems are a common reason for children to present to the RCH’s Emergency Department, but in many cases it’s not asthma – yet.

“Most children have what we call viral-induced wheeze,” said Joanne Grindlay, deputy director of emergency. “Some of those children go on to have asthma and lots of them don’t.”

So when is it asthma?

A proper diagnosis of asthma can only occur after a child presents with wheezing more than once, and, importantly, when they don’t have a virus.

“If they’re exercising or if they’re exposed to pollens or they’re doing other things and wheezing, then it’s probably asthma,” said Joanne. “They need to get it when they don’t have a cold, and it’s got to be recurrent.”

If your child has eczema or if there’s a history of asthma and allergies in the family, then they are more likely to have asthma.

Other triggers for asthma include:

• allergens like dust mites and mould spores
• tobacco smoke
• cold air
• some medicines.

Hay fever and thunderstorm asthma

Children who get hay fever also have a higher chance of suffering a sudden asthma attack. For these children, Joanne recommended having some reliever medication on hand, advice particularly applicable to people affected by Melbourne’s thunderstorm asthma event.

“Thunderstorm asthma will reoccur,” Joanne said.  “Thunderstorm asthma affects people who have hay fever and who may not have had asthma before, but suddenly get severe asthma.”

Reliever medication is available over the counter, but Joanne warned it was important to see a GP for review and to have a plan of what to do if your child gets asthma when they haven’t had it before.

Treating asthma

Having an up-to-date asthma management plan is the best way to manage diagnosed asthma in children. It was concerning, Joanne said, to see how often asthma sufferers had an inadequate asthma plan.  A combination of treatments is needed, including preventer and reliever medicine, administered with a spacer.

“Older children don’t bother using their spacers because they think they’re coordinated enough to not need them,” she said.

“Everyone always needs to use a spacer – it’s very hard to be coordinated enough to get the medicine to go down to the deep parts of the lung where you need it.

“If you’re using just an inhaler, you are just spraying into your mouth, with little effect.”

See a GP if you think your child has asthma, or to ensure you have an up-to-date asthma management plan. You can read more on asthma in our Kids Health Info fact sheet, http://www.rch.org.au/kidsinfo/fact_sheets/Asthma/.