If your child’s asthma suddenly gets much worse (asthma attack), they will require urgent treatment. Signs of an asthma attack include:
Sometimes there is no obvious cause for your child’s asthma attack, but the most common triggers are viral infections (coughs, colds and chest infections), sudden changes in the weather and exposure to cigarette smoke.
If you are concerned about your child’s symptoms please see the table below.
Keep child in upright position and reassure them
Increase salbutamol (blue) reliever inhaler 6-10 puffs every 4 hours
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If your child starts to cough, wheeze or has a tight chest but can continue day to day activities; if this continues for more than 5 days contact your GP
Watch them closely for any change and monitor for any red or amber symptoms
At the start of cold symptoms (such as runny nose), begin your child on blue (salbutamol) reliever inhaler 2 puffs every 4 hours as needed. This can be increased to up to 10 puffs at a time if your child’s symptoms are still significant. If your child is requiring increasing amounts of blue inhaler you should seek medical advice according to the table above.
Signs of poorly controlled asthma include your child having a regular cough at night (nocturnal cough), being wheezy or more breathless than other children when they run around (exertional dyspnoea) or using their reliever inhaler more often than expected.
Arrange to see your GP or asthma nurse if they are experiencing such symptoms, discuss with your GP an asthma action plan.
To watch a video on encouraging children to use their inhalers effectively please.
Your child’s asthma will not be controlled if their medicines are not getting into their lungs.
Choose appropriate sized spacer with mask (or mouthpiece if they are older with good technique). Your child may need lots of positive encouragement when they first start to use the spacer. You may want to make it into a game or use a small reward to encourage them.
Sit your child in an upright position, as this will help them to breathe in the inhaler medication.
Shake the inhaler and push it into the port on the end of the spacer. Holder the spacer away from your child's face.
If you are using a spacer with a face mask you will need to fit this over your child's nose and mouth. You will need to make sure that there are no gaps, as these will let the inhaler gases escape before they can be breathed in. Some spacers come with a mouthpiece instead of a mask. These are usually for older children who can breathe in and out just through their mouth.
Press the top of the inhaler firmly and release, this will administer one puff into the spacer. Allow your child to breathe in and out with the spacer mask still on their face. You may have been taught to count 10 breaths per puff, but if this is difficult for your child when you are at home the recommendation is at least 5 breaths.
Remove the spacer mask from your child's face. Shake the spacer and attached inhaler to get it ready for the next dose.
Repeat the process until your child has had their prescribed amount of puffs
If the spacer makes a whistling noise, this means your child is breathing too quickly. Encourage them to take slower, deeper breaths to make sure they received a sufficient dose of their medicine
Plastic spacers should be washed before 1st use and every month as per manufacturer's guidelines.
For videos on using your child's inhaler and spacer correctly see asthmaandlung.org
See your practice nurse or doctor if you are not sure whether your child is using their inhaler properly.
Although it is extremely difficult to avoid your child getting a viral infection or experiencing changes in the weather, you can reduce exposure to common irritants such as cigarette smoke. Even where adults smoke away from their children, smoke on their clothes and hair is likely to make their child’s asthma worse. For smoking cessation advice, please discuss with your GP, or click here for local support to help you quit smoking.
Not only can flu trigger an asthma attack in your child, your child is more likely to experience severe influenza if they have asthma. Protect them by having them vaccinated every year. Click here for essential information on childhood vaccinations and immunisations.
The Beat Asthma website has a wide range of useful resources on asthma for children and families.
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Health visitors also provide advice, support and guidance in caring for your child, including:
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
You have a choice of service:
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, you can call 111 or use 111 online.
Please note that 111 online is for people aged 5 and over. Call 111 if you need help for a child under 5.
An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.