New analysis from Asthma + Lung UK reveals the number of children ending up in hospital with asthma has surged in the past 12 months, as the charity urges parents to manage their child’s asthma proactively and to know what to do in an emergency.
The advice comes ahead of World Asthma Day on Tuesday (2nd May) as NHS figures reveal that hospital asthma admissions for children increased by 149% in England1 and Wales2 between 2021 and 2022. A total of 19,506 children were admitted with asthma symptoms compared to 7,850 between 2020 and 2021.
This rise could be fuelled by increased mixing after the relaxation of COVID-19 lockdown restrictions, resulting in more exposure to colds and flu viruses, which are common triggers for asthma attacks. Disruptions due to the pandemic may too have meant that children missed vital routine checks of their medication and care, as two thirds of all people with asthma did not receive an annual asthma review at the height of the pandemic.3
Out of 15 countries in Europe, including Spain and France, the UK has the worst death rate for asthma in children and young people aged between 10 and 244 with far too many children ending up in hospital – and the charity has heard from parents whose children aren’t always receiving the right care and follow-up support.
Asthma is the most common long-term medical condition in children in the UK, affecting around one in 11 youngsters. Children with asthma have more sensitive, inflamed airways. This means they’re more likely to react to common asthma triggers like colds and viruses, pollen (tree and grass pollen can be a particular problem at this time of year), dust mites, pollution, pets, and stress, resulting in coughing, wheezing, feeling out of breath, and having a tight chest.
Sarah Woolnough, CEO at Asthma + Lung UK, said:
“Although hospital admissions for children with asthma haven’t returned to pre-Covid levels, they are bouncing back which is very worrying. Parents are the first-line defence in keeping their children safe and enabling them to lead normal lives, despite having asthma. There is often a ‘golden opportunity’ to get help before a child really starts to struggle with asthma symptoms.
“Common signs that a child might be at risk of an asthma attack include increased coughing, especially when doing activities, a lot of coughing at night, wheezing, and a tight chest. But symptoms vary, which is why it’s important that parents, carers, and teachers are all familiar with a child’s individual triggers and red flags. These can be shared in the asthma action plan.
“Most children with asthma can treat their symptoms with a reliever inhaler (usually blue) that helps to open the airways quickly, but long-term protection can only be provided by a preventer inhaler. Preventer inhalers contain low doses of steroid medication which keep down inflammation and swelling in the airways. This reduces the risk of symptoms and asthma attacks. It is crucial that children use preventer inhalers every day as prescribed.
“There is no such thing as mild asthma - as anyone with the condition could end up having a potentially life-threatening asthma attack. Even without an asthma diagnosis, if a parent is concerned about their child’s breathing, they should call their GP or 111, or if they are extremely worried, get urgent help by calling 999. Many hospital admissions occur in the under-fives when a child might not typically have a confirmed diagnosis.
“It is vital that parents are familiar with what to do in an emergency. Following these five steps if a child is having an asthma attack, could be lifesaving.
- Get your child to sit up, rather than lying them down, and keep them calm
- Help them to take one puff of their reliever inhaler (usually blue) with their spacer every 30 to 60 seconds, up to 10 puffs
- If you don’t have their reliever, it’s not helping, or you are worried at any time, call 999 for an ambulance
- If the ambulance has not arrived after 10 minutes, or the child’s symptoms aren’t improving, repeat step two
- If there’s no improvement, call 999 again immediately.
“With the right management, hospital admissions for asthma, which can be traumatic, are far less likely to occur. We know that life can be hectic for parents, and a child’s asthma might not be front of mind, especially if they rarely display symptoms. But asthma is not always predictable, which is why it is crucial that all children with asthma receive basic asthma care, which includes:
- Helping your child take a preventer inhaler every day
- Regular inhaler checks
- An asthma action plan (which can be downloaded from our website)
- An asthma review at least once a year
- A follow up by the child’s GP at least 48 hours after an asthma attack.
“Without this basic care, children are not only more vulnerable to having an asthma attack; poorly managed symptoms can also stop them enjoying things like running around with their friends and socialising. To help your child stay well and active, asthma needs to be managed every day. That is why it is crucial that parents can recognise their child’s triggers, and when their symptoms are worsening, and they know exactly what to do in the event of an asthma attack.
“Despite concerted NHS efforts, far too many children are ending up in hospital, struggling for breath, and this must change. Childhood is a window of opportunity for lung health, and people need to realise how dangerous lung conditions can be. We need more research to understand why so many children develop asthma, and the government needs to tackle poor air quality and the stark health inequalities that exist in the country, so that every child is given a fighting chance to breathe freely.”
Rebecca Grandison, 43, from Cheshire, knows how serious asthma can be as her eight-year-old son Wilf has been hospitalised 15 times since 2019.
She said: “Wilf has always suffered from terrible hay fever, but four years ago he became incredibly unwell. He started vomiting, became drowsy, and was struggling to breathe and so I called an ambulance.
“In hospital, the doctors initially thought he was suffering from sepsis. But a paediatrician suggested he was put on a nebuliser, and after a few minutes he really started to wheeze as his airways gradually opened. I was told then that Wilf was in respiratory distress, and although he was officially too young for an asthma diagnosis, he was having a severe asthma attack.
“I was stunned as Wilf didn’t wheeze, and wasn’t even coughing, but as I’ve since learned not every child will experience symptoms in the same way which is why it’s crucial to know the signs that your child needs urgent help. The trigger for that first attack was tree pollen, but Wilf, who has since been diagnosed with severe asthma, is vulnerable to viral infections too.
“In the last few years his hay fever and asthma have become so bad that I’ve had to give up work as his symptoms are so unpredictable, and when pollen levels are high, it can be too dangerous for him to leave the house. I never take any chances with Wilf’s asthma as I am all too aware that complacency can kill, and that his symptoms can get worse very quickly.
“We don’t go anywhere without his inhalers and asthma action plan, and I know when Wilf is starting to deteriorate as he gets very tired, struggles to sleep, and doesn’t want to play football. He is now under a hospital consultant, but when he was in primary care, I would push for regular reviews and follow-ups after hospital admissions, and I’d take him to the doctor at the first sign of things worsening, and I’ve been told repeatedly by medics that this is always the right thing to do. As a parent of a child with asthma, I know I need to be hyper-vigilant and a driving force to keep my son safe.”
For more information on caring for a child with asthma, visit our website. If you are worried about your child’s asthma, you can contact our helpline on 0300 222 5800. Asthma + Lung runs a monthly parental support group for parents of children with asthma. For more information on the next meeting on World Asthma Day, visit Parent Carer Network Events.
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Notes to Editors
1) NHS Digital – Statistical Hospital Admitted Patient Care Activity
2) Digital Health and Care Wales – A bespoke request for hospital admissions data
3) Annual Asthma Report 2020 - Annual Asthma Report
4) International comparisons of health and wellbeing in adolescence and early adulthood - Nuffield Trust Report 2019