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• Give enough reliever – salbutamol (e.g.ventolin) to your child when it is needed, but do not give it to them as a routine when they are well.
• Always use the spacer device if you have been given one, it helps get the drugs into the lungs. Do not use the puffer (metered dose inhaler) straight into the child’s mouth, that way only 5% of the medicine gets into the lungs.
• Do give them all their inhalers as prescribed, especially the preventers (e.g. inhaled steroids). Check they have taken their inhalers every day, children forget so easily. It is best to watch them actually do it.
• Montelukast (Singulair) granules should be mixed into cold food e.g. yoghurt, fruit puree, and not into hot food or drinks. When children are old enough they can have the chewable tablet form. Some children get disturbed sleep or bad dreams with it, in which case stop using it and let your doctor know. It works within 4 hours so can sometimes be used at the start of colds or symptoms until they are better e.g. for a few days to a week or so.
• Do not run out of inhalers, especially the relievers (salbutamol). It always happens on bank holidays when you can’t get to your GP. Order one from your GP when you get the last one out of its box to start it.
• Do not start inhaled steroids and give them only when your child is unwell, it takes 4-6 weeks for them to have full effect, so, your child will get none of the benefits but possibly some side effects.
• There is no need to double the dose of inhaled steroids when your child has a cold or is a bit wheezy, as there is no evidence it helps.
• Take all inhalers in hand luggage when you are going on holiday, especially on an airplane.
• Take your child to your GP or nearest Accident & Emergency if you are worried – especially at night.
• If things are out of control – lots of admissions or courses of prednisolone (oral steroids), get them seen by your specialist to see if the preventers can be adjusted to improve things.
• Do not smoke anywhere near them, especially in your home or car. You exhale toxins for a few hours after a cigarette so having one outside in the garden only helps a little. You know it is best to give up totally.
• Think seriously about furry pets (especially cats), if your child is known to be allergic to them. The allergy causes constant irritation in the airways, so if the child then gets a cold their airways are bound to tighten significantly. Certainly don’t let the pets into your child’s bedroom, and try washing the cat every week.
• If your child is allergic to house dust mite, don’t let them be surrounded by loads of teddy bears at night, and put their favourite one in the freezer overnight every month to kill off the mites.
• Consider if the stresses of life are making your child more anxious and worsening their asthma – seek help if you think there might be a problem.
• Give enough reliever – salbutamol (e.g.ventolin) to your child when it is needed, but do not give it to them as a routine when they are well.
• Always use the spacer device if you have been given one, it helps get the drugs into the lungs. Do not use the puffer (metered dose inhaler) straight into the child’s mouth, that way only 5% of the medicine gets into the lungs.
• Do give them all their inhalers as prescribed, especially the preventers (e.g. inhaled steroids). Check they have taken their inhalers every day, children forget so easily. It is best to watch them actually do it.
• Montelukast (Singulair) granules should be mixed into cold food e.g. yoghurt, fruit puree, and not into hot food or drinks. When children are old enough they can have the chewable tablet form. Some children get disturbed sleep or bad dreams with it, in which case stop using it and let your doctor know. It works within 4 hours so can sometimes be used at the start of colds or symptoms until they are better e.g. for a few days to a week or so.
• Do not run out of inhalers, especially the relievers (salbutamol). It always happens on bank holidays when you can’t get to your GP. Order one from your GP when you get the last one out of its box to start it.
• Do not start inhaled steroids and give them only when your child is unwell, it takes 4-6 weeks for them to have full effect, so, your child will get none of the benefits but possibly some side effects.
• There is no need to double the dose of inhaled steroids when your child has a cold or is a bit wheezy, as there is no evidence it helps.
• Take all inhalers in hand luggage when you are going on holiday, especially on an airplane.
• Take your child to your GP or nearest Accident & Emergency if you are worried – especially at night.
• If things are out of control – lots of admissions or courses of prednisolone (oral steroids), get them seen by your specialist to see if the preventers can be adjusted to improve things.
• Do not smoke anywhere near them, especially in your home or car. You exhale toxins for a few hours after a cigarette so having one outside in the garden only helps a little. You know it is best to give up totally.
• Think seriously about furry pets (especially cats), if your child is known to be allergic to them. The allergy causes constant irritation in the airways, so if the child then gets a cold their airways are bound to tighten significantly. Certainly don’t let the pets into your child’s bedroom, and try washing the cat every week.
• If your child is allergic to house dust mite, don’t let them be surrounded by loads of teddy bears at night, and put their favourite one in the freezer overnight every month to kill off the mites.
• Consider if the stresses of life are making your child more anxious and worsening their asthma – seek help if you think there might be a problem.
© Dr. Ian Balfour-Lynn
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