Asthma treatments for children

If you have read our treatment section you will know that there are two types of drugs: relievers and preventers. The first type - relievers - open the airway and treat the attack, bringing relief. The second type of drug - preventers - help to reduce attacks by reducing inflammation in the airways. Preventer treatment has to be taken regularly, whether the asthma is there or not. It is not designed to treat an actual asthma attack. There are two types of preventer - steroid and non-steroid.

If your child needs a reliever medicine more than 3 - 4 times a week, you should ask your doctor for some kind of preventer treatment. Usually a non-steroid preventer is prescribed. However if this doesn’t stop the attacks then inhaled corticosteroids are usually the next step. Steroid medication is unproved to be safe or effective on children under five years of age so ask about other alternatives such as the non-steroid preventers available.

Taking Medications

There are a number of delivery mechanisms for asthma medication. The choices are between aerosol, powder inhalers, tablet, syrup medication and nebulised. It is important to find one that best suits your child’s needs. Some people fail to get their asthma under control because they are not using their inhalers properly. Tell your doctor if your child is having difficulty or for some reason doesn’t feel happy with the device.

Metered Dose Inhalers

The most common way of treating asthma is by a Metered Dose Inhaler or MDI for short. By using an MDI you inhale the medication straight into your lungs, unlike tablets which have to be digested and absorbed through the bloodstream.

The MDI is generally considered the best way to take asthma medication because:

you get faster, targeted relief
a minimal dose can be prescribed
there is less risk of side-effects, particularly if the medication is a steroid

However, MDI’s are difficult for young children to use properly, because they require co-ordination in ejecting the drug and inhaling at the correct time. If your child uses an MDI it is recommended they use it with a “spacer” which will ensure more medication is received by the lungs. Basically, a spacer is a plastic apparatus with a space for the MDI at one end and a mouthpiece at the other. A puff of the drug is puffed into the spacer and remains there until it is inhaled through the mouth piece. Spacers with masks are available for very small children.

If you do not feel that your child is getting her medication because of administering difficulties, talk to your doctor. It may mean using tablets or syrup or a Nebuliser until the child can master an inhaler.

Powder Inhalers:

Powder Inhalers dispense the medication in dry powder form. They are quite useful for children, as you simply breathe in to activate these devices, thus eliminating the need for co-ordination.

Tablet and syrups:

Very young children are often prescribed reliever drugs Salbutamol and Terbutaline) in syrup form. Tablet and syrup medications need to be absorbed into the bloodstream to reach the lungs, and this has two effects: they are slower to work and they need to be given in higher doses, thus increasing the risk of side-effects. As a result, doctors will encourage your child to use inhalers as soon as they are able.

Nebulisers:

A nebuliser is a machine that breaks down the medicine into a liquid solution that is then inhaled via a face mask or mouthpiece. Nebulisers are not better than metered dose inhalers, they simply deliver a larger dose of medication which is why they seem to work better.

Many health professionals have concerns about the use of nebulisers for the following reasons:

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