What Is Asthma?
Asthma is a chronic respiratory condition that leads to episodes of wheezing, coughing, breathlessness, and chest tightness. In children aged 0–5, symptoms can be particularly challenging to identify as they may resemble other common respiratory infections such as coughs, colds and flu. However, whilst these are temporary conditions caused by infecting bacteria or viruses, asthma is a chronic condition that can have several causes including genetic and environmental factors such as:
- Genetics – children with a family history of asthma or allergies are at increased risk of developing the condition
- Exposure to allergens such as dust mites, pet dander, pollen, and mould
- Recurring respiratory infections, especially during early childhood
- Exposure to air pollution, including tobacco smoke, vehicle exhaust fumes, and industrial emissions
- Environmental factors such as living in homes with poor ventilation/mould
Triggers And Symptoms
People with asthma often have no symptoms until they experience an asthma attack, often brought on by ‘triggers’. Triggers for attacks include allergens (such as dust mites, pollen, and pet dander), colds and flu, smoke, air pollution, exercise, and even emotional stress. It’s important to identify and manage these triggers to help control symptoms and improve the children’s quality of life. However, since many young children are still developing speech and language capabilities, this is not always easy in this age group. Symptoms of an attack include severe wheezing, excessive coughing, difficulty speaking in full sentences, and noticeable distress. In severe cases, emergency medical help should be sought immediately by calling 999.
Asthma In The UK
Around 1 in 11 children in the UK have asthma, making it one of the most common long-term medical conditions in childhood. It accounts for numerous hospital admissions each year, with young children particularly vulnerable to severe attacks. In early years settings, it can affect a child’s ability to engage in physical play, concentrate on everyday activities, and maintain their attendance. Children with asthma may need medication to help deal with symptoms and to tackle the underlying disease.
Diagnosis
Diagnosing asthma in very young children is complex because their lungs are still developing, and other respiratory infections can mimic symptoms. Diagnosis is often based on identifying a pattern of recurring symptoms and response to medication rather than definitive tests. Since early years children are still developing their language skills, they cannot always talk about their symptoms clearly, so it’s important that practitioners recognise and record signs such as persistent coughing (especially after exercise), wheezing sounds when breathing, and visible difficulty in breathing.
Treatment
While there is no cure, it can be effectively managed with medication. Treating asthma in children under 5 typically involves a combination of medications and lifestyle adjustments. Common treatments include:
- Reliever inhalers (e.g., Salbutamol/Ventolin): These are quick-acting inhalers usually coloured blue that help open the airways during an episode, allowing the child to breathe more easily (bronchodilators)
- Preventer inhalers (e.g., Corticosteroids such as beclomethasone): These are taken daily to reduce airway inflammation and prevent symptoms and are usually brown or red/orange
- Combination inhalers (e.g., combination of corticosteroids and long-acting bronchodilators, e.g., fluticasone/salmeterol): These are usually purple
Since young children may struggle to use an inhaler properly, spacer devices can help deliver the medication more effectively by allowing children to breathe it in over several breaths.
Lifestyle changes can help reduce symptoms. These include avoiding triggers, maintaining high standards of hygiene, ensuring good ventilation, and using hypoallergenic bedding.
Practical Ways To Support Children With Asthma
There are several ways that settings can support children. It is crucial that each child with asthma has an Asthma Support Plan individual to them. This should include a risk assessment for the child, their emergency contact details, doctor contact details, diagnosis, medication details, and an emergency protocol. This should be given to all appropriate staff so they are aware of the child’s condition and understand what to do in the event of an emergency. You should also regularly review the plan since asthma can change over time.
Other ways you can support children include:
Create an friendly environment
- Reduce exposure to common triggers by maintaining good indoor air quality, keeping the setting well-ventilated, and avoiding strong scents (e.g., perfumes, cleaning products and aerosols)
- Enforce a strict smoke-free policy
- Make sure that children are dressed appropriately in cold weather, as cold air can trigger symptoms
- Educate other children so they understand what is happening and what to do if they witness someone having an asthma attack
Recognise and manage symptoms
- Train your staff to recognise the early signs of asthma symptoms and act promptly and calmly
- Encourage children to tell you if they feel unwell or experience difficulty breathing
- Have a clear protocol in place for handling asthma attacks, including when to seek emergency help. All staff and volunteers should be made aware of what they need to do and when
Support children with their medication
- Be familiar with each child’s asthma support plan and medication needs
- Ensure all medication is easily accessible and stored properly, out of the reach of other children
- Check inhalers regularly to ensure they are in date
- Train staff how to give and supervise medications, recording all details in a logbook
Encourage safe physical activity
- Encourage children with asthma to join in with physical activities but ensure they use their reliever inhaler before exercise if recommended by a healthcare professional
- Be aware that environmental conditions such as cold air or high pollen levels can trigger asthma attacks, and adapt the activities for children accordingly
Communicate with parents/carers and healthcare professionals
- Asthma can change over time so report any asthma symptoms or attacks that occur in the setting to parents/carers immediately
- Communicate with healthcare professionals and seek advice on how to implement the most up-to-date care plans
Asthma management in early years settings is crucial for ensuring children’s safety and well-being. By providing proper care and support, you can help children to thrive and participate fully in their early years education.
