Asthma (Common Childhood Illnesses)

Asthma affects about one in five children in Singapore. Learn more about asthma in children and asthma triggers.

What is Asthma?

Asthma is a condition in which the airways are inflamed and become more sensitive than usual. When sensitive airways are exposed to certain triggers, they overreact, become narrower, and breathing becomes difficult. Childhood asthma can interfere with a child’s daily life activities such as exercise, school, and sleep. If this condition is not managed well, it can lead to life-threatening asthma attacks. 

The Allergic March

Asthma is an atopic (i.e. allergic) condition. The term "Atopic March" or "Allergic March" was coined to describe the progression of allergy-related conditions in childhood, usually beginning with eczema and progressing to food allergy, allergic rhinitis (sensitive nose) and asthma.

This means that if your child develops eczema, he/she will have a higher risk of getting other atopic conditions, such as food allergy and asthma, in the future. In Singapore, the incidence of atopic conditions among children are increasing. These conditions may coexist in a child.

How Common is Asthma Among Children in Singapore?

Asthma affects about one in five children in Singapore. The good news is, if your child has asthma, he will most likely outgrow it. Up to half of the children with asthma are likely to be attack-free in their teens, while the remaining are likely to have milder and less frequent attacks. Only five percent of children continue to have asthma in adulthood.

What Causes an Asthma Attack?

The exact cause of sensitive airways and asthma attacks are unknown, but you can watch out for common triggers of asthma attacks. These include:
  • Viral infections, especially upper respiratory tract infections such as cold or flu
  • House dust mite allergy
  • Cigarette smoke
  • Pollution, including the haze
  • Exercise
  • Pollen (more common in temperate countries)
  • Pet allergens (uncommon)

Foods such as cold drinks, ice cream and chocolates are usually not asthma triggers.

What Are the Symptoms of Asthma?


Asthma symptoms and signs vary from child to child and might get better or worse over time. During an asthma attack, the airway lining becomes inflamed, the airway wall muscles contract and go into spasms. Thick mucus is also produced and clogs up the airways.

Asthma symptoms include the following:

  • Coughing – especially chronic cough and cough which usually happens at night or after exercising
  • Wheeze (whistling noise in the chest)
  • Shortness of breath
  • Tightness of the chest

If your child has wheezing, coughing or difficulty in breathing, it is important to talk to your doctor about the possibility of your child having asthma.

What is an asthma action plan?

An asthma action plan is a personalized written list of instructions that provides instructions for you to follow at home. You might have been given one if your child has been diagnosed with asthma by a healthcare provider. It includes instructions on:

  • What medicines your child should use at home each day
  • What warning symptoms to watch for (which suggest that asthma is getting worse)
  • What other medicines to give your child if the symptoms get worse
  • When to get help or call for an ambulance

You, your child, and their doctor will work together to make an asthma action plan for your child. This can be useful in clarifying the medication regimen, identifying declines in asthma control, guiding treatment adjustments in response to changes in symptoms and guidance when there is a severe attack.

What Can I Do If My Child Has an Asthma Attack?

  1. Stay calm.
  2. If your child has an asthma action plan in place, follow the action plan. If there is no action plan, and your child has been given an inhaler by his doctor, let your child use the inhaler to open up his narrowed airways for immediate relief. Repeat every 20 minutes, or as advised by his doctor.
  3. Keep your child comfortable, such as by loosening clothing around his neck, getting him to sit upright and letting fresh air into the room. 
  4. In a severe asthma attack, your child may be unable to speak, struggle to breathe and gasp for air. He/she may also develop chest pain, palpitations and blue lips or fingertips. He/she may not be getting better with the reliever inhalers. It can become life-threatening if not treated properly. Bring your child to the doctor immediately or call for an ambulance.

How Is Asthma Treated?

For a child diagnosed with asthma, their condition will require a long term management plan. This would depend on the severity and frequency of their asthma attacks. Successful treatment of asthma depends on the partnership between you, your child, and your doctor.
Here are some practical steps to help you and your child control their asthma:

1. Medications for Asthma

  • Take all medications prescribed by your child's doctor and follow up with your child's medical appointments regularly.
  • Understand the difference between a short-acting reliever (e.g. salbutamol) for short-term relief and a long-acting controller (e.g. flixotide, Seretide) for long-term control.
  • Learn how to use the inhaler correctly to administer medications and if you are unsure, check with your doctor.

2. Keep Yourself Educated

  • Understand the diagnosis of asthma and its long-term impact on your child's health, so that you will ensure your child is compliant to the inhalers.
  • Minimise your child's exposure to triggers of asthma.
  • Allow your child to exercise and participate in sports when his asthma is well-controlled.

3. Educate Your Child & Teachers

  • Teach your child to avoid certain triggers, especially in school.
  • Teach your child to recognise asthma symptoms such as breathlessness, wheezing, chest tightness and manage it accordingly with inhalers or seek help from people around him/her.
  • Inform your child's teachers and/or caregivers of his condition and educate them on managing an asthma attack. 
How Do We Avoid Asthma Triggers? 

• Reduce the risk of respiratory infections with regular vaccinations, good hand hygiene and avoiding contact with sick people.

• Reduce exposure to allergens

  • Remove carpets, curtains, and soft toys from your child's bedroom, and use anti-dust mite pillow/mattress covers to reduce the accumulation of house dust mites. Wash linens in 60 degrees Celsius water every 1-2 weeks.
  • Avoid foods that trigger an allergic reaction or asthma attack.
  • If you have a pet, try to relocate your pet, otherwise keep the pet out of your child's bedroom.
  • Ensure good pest control in your house to avoid cockroaches.

• Reduce exposure to irritants or air pollution

  • Avoid going to places near construction sites and keep windows closed during a haze. Wear a mask if needed.
  • Avoid exposing your child to cigarette smoke. If there is a family member who smokes, please do consider quitting. If not, please advise him/her to smoke outside the house and change his/her clothes after smoking.

• Only allow exercise when your child's asthma is well-controlled.

• If your child is facing a lot of stress or has high-riding emotions, do teach your child relaxation techniques to manage his/her mental state.

Disclaimer: The information provided in this article is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your health, physical fitness or medical condition.

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