Dr Mark Rosenthal

MD MB ChB FRCP FRCPCH BSc

Consultant in Paediatric Respiratory Medicine

also specialist in Food Allergies & Disorders of Sleep

A | A | A

T: 0207 351 8832

E: s.harvey@rbht.nhs.uk

A:The Royal Brompton Hospital, London, SW3 6NP

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Keeping Track of Your Child’s Asthma Symptoms in Winter

Winter can be a difficult time of year for children with asthma. Many children experience worse or more frequent symptoms because they are susceptible to certain triggers that occur at this time of year. Identifying your child’s asthma triggers is the first step to eliminating them, but it can be difficult to tell what is causing the problem if you’re not tracking your child’s symptoms. Keeping an asthma diary is a simple way to spot the patterns when and where the symptoms appear. If your child’s asthma always gets worse when the weather is freezing or after you’ve been using the wood burner then this could tell you what’s causing the problem.

Asthama

Winter Asthma Triggers

Asthma in children can get worse during the colder months. Winter weather and changes in our lifestyles can trigger asthma symptoms for some children. However, the triggers can be different for everyone so it can be difficult to tell which factors you need to change in order to protect your child.

Common winter triggers for asthma in children include:

  • Cold weather, especially when children are breathing in cold air while outside
  • Dry indoor air due to central heating
  • Smoke and air pollution from open fires or wood burning stoves indoors
  • Damp and mould, which often thrive during colder, wetter weather
  • Dust mites, pet dander and other indoor allergens can cause more problems when we’re spending longer at home or reducing ventilation by keeping windows closed
  • olds, flu or chest infections, which can exacerbate asthma symptoms by narrowing the airways

How to Keep an Asthma Diary

Consistency is the key to keeping an asthma diary for your child so it’s important to find an approach that works for you. Some people find it easier to keep notes on their phone while others prefer a notebook or use a calendar or wall chart. You should decide what information you want to record and make sure that everyone involved understands what is required. You may need to include grandparents, teachers, and your child in the process in order to ensure every detail is recorded.

Useful details to include in your child’s asthma diary include:

  • the date of each entry
  • a description of any symptoms your child experienced
  • what your child was doing and where they were when the symptoms happened – this information will help identifying any asthma triggers so include details such as the weather or temperature
  • what medication your child used or other actions taken to relive the symptoms
  • peak flow measurements if you have a peak flow metre

Filling in your child’s asthma diary should become part of your normal routine. You could set aside some time to do this every evening or make a note immediately after your child experiences symptoms. It’s also helpful to take time to look back over the diary regularly to look for any gradual changes or patterns in when symptoms occurred. You’ll also be able to provide more accurate details to your doctor, which can help them to provide the best treatment for asthma in children.

How to Deal with Asthma During COVID-19 Lockdown

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The COVID-19 pandemic and lockdown restrictions have had a dramatic impact on all of us. By this time we’re all familiar with the guidance on washing hands, wearing masks and social distancing to prevent the spread of COVID-19 but coping with lockdown can still be tough, especially if your child has a respiratory condition like asthma. However COVID-19 has not so far been a trigger for asthma in children.

asthma

Coping with Anxiety

Both parents and children have endured a lot of stress and anxiety over the last year. We’ve worried about catching COVID-19 and dealt with enormous changes in our daily lives, especially during lockdowns. Stress can sometimes trigger or worsen asthma symptoms so it is important to find ways to manage it. Explaining the situation to your child in an age-appropriate manner is vital as half-heard news stories and rumours from school could make things sound a lot worse. You should also set aside time to ask your child how they’re doing and listen to their questions or concerns. Planning some fun or relaxing activities together can also help you all to de-stress.

Exercise During Lockdown

Exercise can be a trigger for asthma in children, but it is still an essential part of keeping healthy. You should encourage your child to stay active during lockdown as long as their asthma is under control. Getting regular exercise can help to improve lung function as well as boosting your child’s mood and giving them something fun to do. Joining an online PE class is a great way to stay active at home, but other activities such as dancing, skipping, ball games, or building obstacle courses in the garden can all be enjoyed during lockdown. If you’re able to take your daily exercise outdoors then you could go for a walk or bike ride together. The best place to exercise will be a nearby green area. It’s best to avoid areas with lots of people where you can’t keep your distance. You should also try to exercise away from busy roads or traffic as air pollution can trigger asthma in children. If your child’s asthma is severe or symptoms are triggered by exercise then you should talk to your doctor about how to do it safely.

Get Help When You Need It

Sticking to your child’s asthma action plan and continuing to take any medication your doctor has prescribed can help keep the symptoms under control. However, if anything does change or the symptoms become severe, it is vital to seek help. You can arrange an online consultation with your respiratory specialist to discuss your child’s asthma. You can also access emergency services at A&E or by calling 999 if your child has an asthma attack. Although many parents feel reluctant about going to hospital during lockdown, asthma attacks can be very serious or even life-threatening. Don’t delay seeking help because you’re worried about COVID-19. All possible precautions are being taken by healthcare workers to prevent infections and the risks of delaying seeking help for an asthma attack are much greater.

Keeping Track of Your Child’s Asthma Symptoms in Winter

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Winter can be a difficult time of year for children with asthma. Many children experience worse or more frequent symptoms because they are susceptible to certain triggers that occur at this time of year. Identifying your child’s asthma triggers is the first step to eliminating them, but it can be difficult to tell what is causing the problem if you’re not tracking your child’s symptoms. Keeping an asthma diary is a simple way to spot the patterns when and where the symptoms appear. If your child’s asthma always gets worse when the weather is freezing or after you’ve been using the wood burner then this could tell you what’s causing the problem.

Asthama

Winter Asthma Triggers

Asthma in children can get worse during the colder months. Winter weather and changes in our lifestyles can trigger Asthma symptoms for some children. However, the triggers can be different for everyone so it can be difficult to tell which factors you need to change in order to protect your child.

Common winter triggers for Asthma in children include:

  • Cold weather, especially when children are breathing in cold air while outside
  • Dry indoor air due to central heating
  • Smoke and air pollution from open fires or wood burning stoves indoors
  • Damp and mould, which often thrive during colder, wetter weather
  • Dust mites, pet dander and other indoor allergens can cause more problems when we’re spending longer at home or reducing ventilation by keeping windows closed
  • olds, flu or chest infections, which can exacerbate asthma symptoms by narrowing the airways

How to Keep an Asthma Diary

Consistency is the key to keeping an asthma diary for your child so it’s important to find an approach that works for you. Some people find it easier to keep notes on their phone while others prefer a notebook or use a calendar or wall chart. You should decide what information you want to record and make sure that everyone involved understands what is required. You may need to include grandparents, teachers, and your child in the process in order to ensure every detail is recorded.

Useful details to include in your child’s asthma diary include:

  • the date of each entry
  • a description of any symptoms your child experienced
  • what your child was doing and where they were when the symptoms happened – this information will help identifying any asthma triggers so include details such as the weather or temperature
  • what medication your child used or other actions taken to relive the symptoms
  • peak flow measurements if you have a peak flow metre

Filling in your child’s asthma diary should become part of your normal routine. You could set aside some time to do this every evening or make a note immediately after your child experiences symptoms. It’s also helpful to take time to look back over the diary regularly to look for any gradual changes or patterns in when symptoms occurred. You’ll also be able to provide more accurate details to your doctor, which can help them to provide the best treatment for asthma in children.

What is Psychogenic Cough in Children?

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Coughing is a common symptom in children, but it usually occurs along with other signs of a cold or infection, such as a runny nose or fever. If your child has been coughing for a while, without having these other symptoms, then something else might be going on. One of the possible causes is a psychogenic cough, but this term can be unfamiliar to many parents. Keep reading to find out what your doctor means by this diagnosis and what other possible causes of persistent coughing in children may need to be ruled out.

girl-coughing

Psychogenic Coughing in Children

Psychogenic coughs are also known as habit coughs. Psychogenic or habit coughs are usually seen in children or teenagers, although adults can develop them too. The cough usually begins as part of a cold or respiratory infection, alongside other symptoms. It is common for coughs to last a little longer than the other symptoms, but a habit cough can last for more than a few weeks. Habit coughs are also different than coughs caused by infections because they disappear when your child is asleep or when they are distracted, for example when playing. Unlike other coughs, habit coughs won’t be triggered or made worse by exercise. However, it may appear or get worse when your child is feeling stressed or anxious.

What makes a habit cough so different from other coughs is that there is not a physical cause. Psychogenic coughs usually develop after your child has been coughing for another reason (such as a cold or chest infection). The cough can become a habit, so that they keep coughing even though there is no need to do so.

It’s important to be aware that habit coughs are not intentional and your child isn’t coughing on purpose. The best way to get rid of a psychogenic cough is to be patient and help your child to resist the urge to cough. Starting from just five or ten minutes, the length of time that you child holds back their cough can be gradually increased until the habit disappears completely.

Other Possible Causes of Coughing in Children

Although a persistent cough could be psychogenic, there are some other possible causes that your doctor will want to rule out. Coughing can be a sign of asthma in children, especially if it often happens after exercising or if your child also has other symptoms such as wheezing. Another possible cause of coughing can be sleep apnoea in children. However, sleep apnoea in children can easily be differentiated from other causes such as psychogenic coughing. A psychogenic cough only happens when your child is awake, while coughing caused by sleep apnoea in children will only occur when they are sleeping.

Finding out what is causing your child’s cough is the first step towards treating it. Psychogenic coughs can usually be eliminated with the right approach, while conditions such as asthma and sleep apnoea in children can be managed with medication or other treatments.

Can You Snore without Tonsils and Adenoids?

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Snoring in children is often caused by enlarged tonsils or adenoids at the back of the throat, so it should go away once they have been removed. However, there can be other reasons for snoring so it is still possible for your child to snore without their tonsils or adenoids, especially if they also have sleep apnoea that is affecting their breathing at night.

little boy snoring

Common Causes of Snoring in Children

Snoring happens when there is some kind of blockage making it harder for air to exit through the nose as we breathe out. A stuffy nose can often cause snoring because it is temporarily narrowing or blocking the nostrils. If your child snores regularly then it is more likely to be caused by a permanent blockage, such as large tonsils or adenoids at the back of the throat. Snoring can be a sign of sleep apnoea in children, which can also cause pauses in breathing. Sleep apnoea happens when the throat relaxes during sleep, becoming narrower, and restricting airflow. Sometimes it is a combination of these two issues that is responsible for snoring in children. However, there can also be other reasons for snoring, such as a deviated septum, enlarged turbinates (bony parts of the nose) or other blockages in the nose. Recurring snoring can also be a sign of allergies in some children, as these can narrow the airways in a similar way to a cold.

Tonsillectomy or Adenoidectomy for Snoring

When snoring is linked to enlarged tonsils or adenoids, surgery may be recommended to remove them. Removing the tonsils or adenoids is a relatively straightforward procedure and it can be very effective at treating snoring. Surgery can be particularly beneficial when the problem goes beyond snoring and is associated with breathing problems. Sleep apnoea in children can reduce the quality of sleep, leading to behavioural and educational problems during the day. Interrupted breathing can also have serious consequences if it isn’t treated. However, if your child’s breathing is not affected then it can be better to wait and see if they grow out of snoring as they get older. As the throat grows larger, the tonsils or adenoids may not cause blockages any more.

What If My Child Still Snores After Surgery?

If your child has surgery for snoring then it should help them to breathe easier and sleep more quietly. In most cases, the problem will be solved once your child has fully recovered from the operation. It can take about a month for the full effects to be felt. However, children can still snore for other reasons, for example if they have a cold or are affected by allergies. It is also possible for sleep apnoea in children to causing snoring and breathing problems even without the tonsils or adenoids as the throat can still close up during sleep. If your child continues to snore after a tonsillectomy or adenoidectomy then it is important to talk to your doctor as they may need more treatment for sleep apnoea.

Understanding the Risks of Viral Infections in Children

Coughs, colds, and infections are very common in children. Most children will have at least 8 colds every year as they build up immunity to these common infections.

Why Are Children More Likely to Catch Viral Infections?

  • Children often mix in large groups in schools, nurseries, playgrounds and other spaces – some come in contact with more people than their parents do!
  • When children are together, they are more likely to come in closer contact as they hug or play together.
  • Young children haven’t learned how to practice proper hygiene by wiping runny noses, covering up coughs and sneezes, and washing their hands regularly.
  • Toys are often shared between children, so they can easily spread germs.
  • Young children often put toys or other objects in their mouths, as well as their own fingers.
  • Children have less developed immune systems so are more likely to be susceptible to the germs they encounter.

understanding the risks of viral infections in children infographics

Why Can Viral Infections in Children Be More Serious?

  • Children’s developing immune systems can’t respond as quickly or strongly to infections, which means they are more likely to develop ear infections, chest infections, or other complications
  • Smaller lungs and airways can be more severely affected by respiratory infections that make them even narrower due to inflammation or mucus, so children are more likely to experience breathing difficulties
  • Children aren’t always aware when they start feeling ill or able to tell their caregivers what is wrong, which means they don’t always rest or drink enough fluids when they are unwell, which can lead to complications such as dehydration

understanding the risks of viral infections in children

Viral infections in children are more likely to be serious in:

  • Babies are at highest risk of developing complications
  • Children under 5 are also at increased risk of complications
  • Children with underlying health conditions, especially if their respiratory system or immune system is affected

How to Talk About COVID-19 with Children

how-to-talk-about-covid-19-with-children
The COVID-19 pandemic has had a dramatic influence on all our lives. It can be particularly confusing and upsetting for children, especially those who are at higher risk due to a respiratory condition. Here are some tips to help your child to understand what’s going on.

Finding Time to Talk

  • Set aside some quiet time to sit down with your child to explain the facts on COVID-19 in a clear, calm way
  • Don’t feel as if you have to say everything in one go as you can follow up with smaller, more casual conversations
  • Chatting over dinner or a shared activity can make it easier for children to open up
  • Make time every day to chat openly with your child so they have a chance to raise any questions or concerns about anything
  • Some children may find it easier to write down their worries or to express themselves in other ways
  • Talking to friends can make a big difference, so make sure your child has a safe way to socialize by phone, online, or even by sending a letter

Giving Children the Facts on COVID-19

  • Keep it simple for young children: there’s a nasty illness and we need to take care to stop it spreading
  • Older children will need more detail and you can point them to trustworthy resources such as the WHO or reputable news sources where they can learn more
  • Don’t feel pressured to have all the answers, but do suggest looking up more information together if your child has questions
  • Make sure children know what they can do to protect themselves and others through handwashing and social distancing
  • Activities such as creating rainbow drawings, raising money for charity or helping a neighbor can help children feel more in control
  • Reassure your child that the risks are low and that everyone is working hard to protect each other