Childhood asthma

Asthma is the most common chronic disease in children, affecting many families in one way or another. In Finland, up to one in five preschool-aged children suffer from recurrent respiratory symptoms, which may indicate asthma. Although the symptoms can cause concern, it is a common and treatable disease.

Asthma can develop at any age, but often the first symptoms appear in early childhood. When symptoms are identified and treatment is started early, a child can usually live a normal, active childhood – playing and moving like other children. Parents do not have to face their concerns alone, as help and support are readily available.

The symptoms of childhood asthma can manifest in various ways in daily life and vary from child to child. Symptoms can be intermittent or worsen, for example, with a cold, exercise, or cold air. Common asthma symptoms in children include:

• wheezing or whistling when breathing.
• breathing difficulties, especially during play or physical activity.
• prolonged or recurrent cough, which is more pronounced at night or after exertion.
• recurrent respiratory tract infections or colds that linger.

If a child's respiratory symptoms recur, persist, or begin to affect daily life, the situation should be investigated at a physician's practice. A parent's concern is always a sufficient reason to seek examinations – especially if the child coughs frequently, gets out of breath more easily than usual, or repeatedly experiences symptoms in connection with colds.

Asthma symptoms can sometimes be very mild and only appear in certain situations, which is why they are not always easy to identify. The sooner the background of the symptoms can be investigated, the faster the child can get relief and support for a good, active daily life.

The diagnosis of childhood asthma always begins with a thorough physician's appointment, where the nature, frequency, and possible aggravating factors of the child's symptoms are clarified. At this stage, allergies and other illnesses that may affect respiratory symptoms are also taken into account. An accurate diagnosis is paramount for initiating the correct treatment. Several examinations are utilized in the diagnosis of asthma, which are selected according to the child's age and symptoms. The physician or nurse always provides more detailed preparation instructions for the examinations.

Impulsoscillometry

Impulsoscillometry is a lung function test particularly suitable for preschool-aged children, starting from 3–4 years of age. The examination is easy and pleasant for the child, as it does not require forceful exhalations. The child breathes calmly through a small mouthpiece, and the device measures lung function. A bronchodilation test can also be performed during the examination, where a bronchodilator is administered, and its effect is monitored. The entire examination lasts approximately 45 minutes to an hour.

Exercise Impulsoscillometry

If the child's symptoms appear particularly during physical activity, exercise impulsoscillometry can be performed. In this, after an initial measurement, the child performs an exercise portion of about six minutes, for example, by running or jumping on a trampoline. After exercise, respiratory function is monitored with an oscillometry device. This examination lasts approximately 1.5 hours and requires appropriate clothing and shoes for running.

Spirometry

For school-aged children and older who can exhale forcefully enough, a spirometry examination is usually performed. This breath test measures lung volume and airflow in the bronchi, providing more detailed information about lung function. A bronchodilation test can also be combined with spirometry. The examination lasts approximately 45 minutes to an hour.

Prick skin tests and blood tests

These tests determine whether the child has allergies that can trigger or worsen asthma symptoms. In practice, the examination can be performed either as a Prick test on the skin or as specific IgE antibodies measured from a blood sample. The choice of method is influenced by factors such as the child's possible antihistamine medication and skin condition.

The treatment of childhood asthma is always planned individually according to the child's symptoms and daily needs. The goal is for the child to live as normal and active a life as possible without respiratory symptoms limiting play, exercise, or hobbies.

Key aspects of asthma treatment include:

• Medication: Asthma is often treated with inhaled medications that alleviate symptoms and calm airway inflammation. The family always receives guidance on the safe and correct use of medications.
• Identification of aggravating factors: Asthma symptoms can be exacerbated by, for example, pollen, animal dander, tobacco smoke, strong odors, or respiratory tract infections. Once the factors causing symptoms are identified, daily life can be made smoother.
• Regular follow-up: The child's well-being and the effectiveness of the treatment are monitored together with the physician. If necessary, home PEF measurements, for example, can be used as an aid.

Although asthma cannot be fully cured, its symptoms can be effectively managed. With the right lifestyle and treatment, a child can live a full life. When the family receives sufficient information and support, everyday life often feels considerably easier and safer.

In everyday life, asthma management is supported by, for example:

• Regular medication: Medications are used according to the physician's instructions, even if there are no continuous symptoms. Good treatment balance prevents symptoms from worsening.
• Exercise and active daily life: Moving is good for a child with asthma too. Appropriate warm-up and, if necessary, medication taken before exercise can alleviate symptoms.
• Avoiding tobacco smoke and irritants: Tobacco smoke, strong odors, and other irritants can worsen symptoms.
• Considering allergies: If the child has allergies, good management of them can also alleviate asthma symptoms.
• Cooperation with daycare, school, and hobbies: When the child's close circle knows about asthma and possible symptoms, the child feels more comfortable participating in daily life and hobbies.
• Child's own understanding of symptoms: Depending on their age, children can be taught to recognize their own symptoms and report them to adults. This increases the sense of security and supports the child's independence.

Even small everyday actions can often significantly alleviate symptoms and help the child feel better.

An asthma attack can feel frightening, but with the right instructions, it's possible to react calmly and effectively. During an attack, a child's breathing may become heavier, faster, or wheezing than usual, and the child may become easily breathless or appear tired. Speaking may be difficult.

Parents should learn to identify their child's typical symptoms and possible warning signs. For some children, symptoms worsen quickly, for example, with a cold, exertion, or allergy symptoms, while for others, attacks occur less frequently.

How to act during an asthma attack:

1. Calm the child and help them sit down.
2. Administer bronchodilator medication as instructed by the physician.
3. Monitor the child's breathing and condition for 15–30 minutes.
4. If symptoms do not ease or worsen, seek emergency care.

If symptoms do not ease despite medication, breathing rapidly becomes difficult, or the child cannot speak normally, emergency care should be sought. The emergency number 112 should be called immediately if the child's breathing is clearly labored, lips turn bluish, or condition rapidly deteriorates.

Although attacks can cause concern, most situations can be managed well when the family has a clear action plan and the necessary support in daily life.