Winter and childhood asthma

Winter and

childhood asthma

Winter can be a difficult time of the year for children living with asthma. Cold, dry air, sudden changes in the weather and fluctuations in temperatures can all irritate their already inflamed airways. When you add it all up, the impact of cold weather on breathing can be serious and the colder months a recipe for exacerbations or flare-ups.

Persistent inflammation

An asthmatic child has a degree of inflammation present in their airways at all times. This inflammation causes the bronchial tubes to narrow, making it harder for air to get to the lungs, even when they they’re not having a flare-up from a trigger like cold air. That being so, it points to reason that treatment goals should focus on reducing inflammation1 .

According to the Allergy Association of South Africa (ALLSA) chronic control relies on anti-inflammatory maintenance2. This is true whether your child has mild, moderate, or severe asthma.

The approach to treatment and management of asthma is almost identical and reducing inflammation is at the heart of it.3

ALLSA says the same applies for asthma attacks. Mild asthma doesn’t preclude children from having an asthma attack. The risk is equally high regardless of disease severity, adherence to treatment, or level of control.4, 5, 6 This is significant because mild asthmatic patients are regarded as the silent majority of asthmatics and in children, mild asthma is more frequent, symptomatic, and less controlled than in adults.7,8

Mild asthma doesn’t preclude children from having an asthma attack.

Break over-reliance on relievers

Inflammation of the lungs can be made worse when a child is continually overusing the short-acting beta2 agonists (SABA) or blue over-the-counter symptom reliever inhaler. Using a reliever inhaler three or more times a week is now considered over-reliant and increases a child’s risk of asthma attacks9 - 12 and asthma-related deaths.13-15

Patients often under-use their anti-inflammatory ‘preventer’ therapy and overrely on their SABA reliever, which can mask symptoms worsening10,16-19 and explain suboptimal control in children. Using a SABA inhaler alone does not address the underlying inflammation caused by asthma, leaving children at risk of an asthma flare up10,16-18 and potential exposure to frequent bursts of oral corticosteroids.16,19

Reducing asthma-induced airway inflammation with a combination maintenance inhaler has been shown to be more effective in controlling asthma symptoms and preventing attacks,1 according to ALLSA. This approach to treatment is in line with the latest Global Initiative for Asthma guidelines which have ushered in a new, more effective, and safer approach to asthma management.

Establishing control is key

The good news for parents concerned that their child may indeed be overusing the blue pump, is that over-reliance can easily be established, thanks to a free, first-of-its-kind digital assessment tool.

By answering five short questions the online Reliever Reliance Test will help parents quickly identify if their little ones are in fact over-reliant. The results are immediate and if your child is found to be over-using their SABA inhaler, it’s time to revisit their asthma management plan. By doing so, your child’s risk of increased asthma attacks should be reduced this winter.

Asthma attacks may be life threatening, require emergency room treatment or hospitalisation. They can be emotionally traumatising, and they keep kids from activities that matter, reducing their overall quality of life. Take the test and take control of your child’s asthma.

While there’s no cure for asthma, it’s important to work with your child’s doctor to treat it and prevent damage to their developing lungs. Controlled asthma in children is possible but it requires a solid asthma treatment plan that prioritises reducing inflammation safely. 

For more information about the Break OverReliance campaign and to take the Reliever Reliance Test, visit www.bit.ly/Yes2Breathe

References 1. Global strategy for Asthma Management and prevention. Global initiative for Asthma (GINA)2021. Available from https://ginasthma.org/wp-content uploads/2021/05/GINA-Main-

Report-2021-V2-WMS.pdf. Accessed August 2021. 2. P.M. O Byrne. How much is too much? The treatment of mild asthma. EUR RESPIR J. 2007(30):403-406. 3. Global Initiative for Asthma. Updated 2018. www.ginasthma.org. Accessed March 2019. 4. Papi A et al. J Allergy Clin Immunol Pract. 2018;6:1989-1998. 5. Price D et al. NPJ Prim Care Respir Med. 2014;24:14009. 6. Fitzgerald J, Branes J, Ghipps E, et al. The burden of exacerbations in mild asthma: a systematic review. ERJ Open Res. 2020;6:00359-2019. 7. Dusser D, Montani D, Chanez P, et al. Mild asthma: an expert review on epidemiology, clinical characteristics, and treatment recommendations. Allergy.2007;62:591–604. 8. O'Byrne. Daily inhaled corticosteroid treatment should be prescribed for mild persistent asthma. Am J Respir crit care med. 2005;172:410-416. 9. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2020 Update. Available at: https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020- report_20_06_04-1-wms.pdf Last accessed July 2020. 10. Rabe KF, Vermeire PA, Soriano JB, Maier WC. Clinical management of asthma in 1999: the asthma insights and reality in Europe (AIRE) study. Eur Respir J. 2000; 16: 802–807. 11. Asthma UK: Asthma Attacks. Available at: https://www.asthma.org.uk/advice/asthma-attacks/ Last accessed July 2020. 12. Asthma UK. Reducing prescribing errors in asthma care. Available at: https://www.asthma.org.uk/support-us/campaigns/publications/nrad-one-year-on/ Last accessed July 2020. 13. Suissa S, et al. Am J Respir Crit Care Med 1994;149:604–10. 14. Suissa S, et al. N Engl J Med 2000;343:332–6. 15. Buhl R, et al. Respir Res 2012;13:59. 16. Tattersfield AE, Postma DS, Barnes PJ, et al. on behalf of the FACET International Study Group. Exacerbations of asthma: a descriptive study of 425 severe exacerbations. Am J Respir Crit

Care Med. 1999; 160: 594–599. 17. Adams RJ, Fuhlbrigge A, Guilbert T, et al. Inadequate use of asthma medication in the United States: results of the asthma in America national population survey. J Allergy Clin Immunol. 2002; 110: 58–64. 18. Larsson, K., Kankaanranta, H., Janson, C. et al. Bringing asthma care into the twenty-first century. NPJ Prim. Care Respir. Med. 2020; 30, 25, 19. Price DB, Trudo F, Voorham J, et al. Adverse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy. 2018;11:193–204 20. Mosler G, Oyenuga V, Addo-Yobo E, et al. Achieving Control of Asthma in Children in Africa (ACACIA): protocol of an observational study of children’s lung health in six sub-Saharan

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