There isn’t a quick, easy test to find out if your child has asthma. Getting an asthma diagnosis can be a tricky business and tends to take time.
This page will cover:
- Suspected asthma
- What your GP will do if your child has suspected asthma
- What you can do if your child has suspected asthma
- Explaining suspected asthma to other people
Been to see your child’s GP?
If you’ve already been to see your child’s GP because you think your child might have asthma, they may say your child has ‘suspected asthma’.
Not been to see your child’s GP?
If you haven’t yet been to see your child’s GP and you think your child might have asthma, there are some things you can do to prepare for this first appointment.
If you’ve been to your GP to talk about whether your child might have asthma, and your doctor thinks it could be the case, you will work together to go through a process to confirm a diagnosis or rule one out.
At this stage, your child may be described as having ‘suspected’ asthma, which means your GP thinks asthma is a strong possibility, but can’t give a definite diagnosis. This is because asthma symptoms can come and go, and because there are lots of other reasons why children cough and wheeze, including colds and viral infections. In other words, cough and wheeze might mean asthma, but they might not.
Parents often tell us they feel confused or frustrated when they’re told their child has ‘suspected asthma’ and wonder why the GP can’t just say it’s asthma.
“We were in and out of hospital when Oliver was a baby and when they said they didn’t know if it was asthma, I felt like I wasn’t being listened to or taken seriously. I was also really scared that he might have something a lot worse, something that isn’t manageable. If only the doctors had explained it wasn’t possible to diagnose asthma in such a young child, and that it’s a long process, it would have saved me a lot of stress.” - Alexa Keatley, mum to Oliver, 11.
Rest assured, though, that your child’s GP, and hospital consultants if they’re involved, are following a recommended process to make sure your child gets the right diagnosis.
And it’s worth remembering that being told your child has suspected asthma usually means you’re further along the road in terms of getting a diagnosis, and hopefully closer to getting the right treatments to help your child with their symptoms.
If your child’s under five
If your child is very young, it’s difficult to measure how well their lungs are working because the tests that can do this aren’t suitable for small children.
This means your GP may say your child has ‘suspected asthma’ for months, or even years, before they can confirm or rule out a diagnosis of asthma.
If your child’s five or older
If your child’s five or older, their lungs, co-ordination and understanding are probably well developed enough for them to take tests to measure how well their lungs are working. These may include peak flow and/or spirometry.
Depending on the results of these tests, your GP may be able to diagnose or rule out asthma in a few weeks.
Watch and wait
If your child’s GP thinks your child has suspected asthma, it’s common for them to use a ‘watch and wait’ approach. You’ll probably have lots of appointments during this time. Although it may feel like you’re in limbo, it’s actually a very useful stage because:
- it allows time to see the pattern of your child’s symptoms – when they are worse, what triggers them and what helps them. All this information will help your child get the best care.
- your child might be referred to an asthma nurse to give you more specialist support within your local surgery.
Depending on your child’s symptoms during this time, the GP or asthma nurse may then prescribe what’s called a ‘trial of treatment’.
Trial of treatment
A ‘trial of treatment’ is where one or more asthma medicines are prescribed to see if they ease your child’s symptoms. This might involve your child being given an inhaler and spacer to use, or tablets to take.
“Gabriel developed a night-time cough when he was 18 months old. Although he wasn’t given an official diagnosis of asthma at that point, he was given a blue Ventolin inhaler.” - Anna Bonnett, mum to Gabriel, 10.
At this stage, your child’s GP or asthma nurse will regularly review how your child is getting on with the treatment(s) they’ve been prescribed. If the medicines are making a difference to your child’s asthma symptoms this suggests they probably do have asthma.
Some parents worry about giving their child asthma medicines before they have a diagnosis of asthma. If you’re worried, it might help you to focus on the positives:
- UK medical guidelines recommend a trial of treatment before diagnosis to help find out whether or not a child has asthma
- Even though you don’t have a clear diagnosis yet, you DO have a clear plan of action which means your child is on the way to a definite diagnosis one way or another
- if your child has asthma and needs to carry on taking asthma medicines, there’s plenty of evidence to show the benefits of treatment far outweigh the risk of potential side effects. Think about how much better it will be for them to have fewer symptoms waking them up at night and leaving them feeling under the weather, and how much more they will be able to enjoy life.
- Even if it turns out your child doesn’t have asthma, the doses of medicines prescribed are very unlikely to cause side effects. All healthcare professionals treating asthma or suspected asthma aim to use the lowest dose of medicines possible to help a child stay symptom-free.
What you can do if your child has suspected asthma
If your child is going through a ‘watch and wait’ period or a ‘trial of treatment’, there’s a lot you can do to help your GP reach a diagnosis and ease your child’s symptoms:
- Track your child’s symptoms – and when they get worse or better. Asthma symptoms can come and go, so tracking them will help your child’s GP or asthma nurse build up a good picture, spot any patterns and work out what’s normal for your child and what’s not. Why not:
- Keep a symptom diary with the dates and times you notice symptoms.
- If you have a younger child, you might want to order a My Asthma calendar with a set of stickers.
- Make a note of what your child’s been doing when symptoms happen as this may help pinpoint triggers, such as pets or exercise.
- Video your child’s symptoms on your phone to play back to your GP.
- Use and share an asthma action plan. Using a child asthma action plan is useful even if your child doesn’t have a diagnosis of asthma yet. Your child’s GP or asthma nurse will fill it out with you so you’ll have all the information about your child’s suspected asthma in one place. It gives you step-by-step instructions on which medicines to take each day and what to do if you notice your child’s symptoms are getting any worse or if they have an asthma attack. You can also help everyone who cares for your child feel confident by giving them copies of the asthma action plan. Either give out paper copies or forward a photo from your phone.
- Give your child the medicines exactly as prescribed. The outcome of your child’s trial of treatment will be much more accurate if they’ve taken the right dose of treatment at the right times every day. Plus if your child does have asthma, the medicines will help ease your child’s symptoms so you can both get on with enjoying your usual playgroups, park outings, play dates and going to nursery or school. If you skip doses or forget, it will take longer for your GP or asthma nurse to reach a diagnosis and your child’s symptoms will continue.
Getting into a new routine can take a bit of practice before it starts to feel like a normal part of your day. So it’s worth making a plan of how and when you can fit your child’s medicines into your daily routine before you start – research shows this makes it more likely you’ll be able to get into a routine and stick to it. Why not:
- Stick a reminder note in your diary, on the calendar or next to the front door.
- Use a reminder app on your phone.
- Link taking your child’s inhalers with something else they already do every day – such as cleaning teeth, bed time stories or after-school snack.
- Ask other members of the family to remind you while you’re still getting used to the new routine.
- Make sure your child knows how to use their inhalers and spacers properly. Your child will only get the full benefits of the medicines they’ve been given if they use the inhaler and spacer in the right way. Get your child’s GP or asthma nurse, or a pharmacist to show you both the correct technique. Even a small tweak to the way your child takes their inhaler can make a difference to how much medicine gets down into their lungs where they need it.
- Attend all your child’s asthma appointments. Keeping in regular contact with your child’s GP or asthma nurse means you can talk about how your child’s been and the GP or asthma nurse can review the medicines they’re taking and make sure they’re on the lowest dose possible to keep them well. Talking to your child’s GP or asthma nurse helps them build a full picture of your child’s symptoms – and makes a clear diagnosis more possible. Don’t forget to write down any questions before you go so you can really make the most of your appointment.
- Don’t allow anyone to smoke around your child. Cigarette smoke can trigger symptoms and an asthma attack. It’s also known to be one of the causes of childhood asthma.
- Keep a peak flow diary. If your child’s old enough, your GP or asthma nurse may ask you to keep a peak flow diary to see how well their lungs are working over a period of time. Getting a clear result over time does depend on how well your child can use the peak flow meter, and if they're blowing into it with the same amount of effort every time, so it's not always reliable. Also, a normal result doesn’t necessarily mean it’s not asthma and clinical history is very important.
- Try to be patient. It can often take quite a while for a child to get a definite diagnosis of asthma. So your child may be in the ‘suspected asthma’ phase for a long while. This is especially common for younger children and for children with severe asthma. This doesn’t mean your healthcare professionals aren’t doing their job properly. It also doesn’t mean your family life needs to be put on hold.
“If you can find a way to accept and come to terms with the ‘suspected asthma’ phase, and let go of any anxiety about how quickly you can rule asthma in or out, it can really help you and your child make the most of life during this time.” Debby Waddell, asthma nurse specialist.
What happens after a trial of treatment?
If your child’s symptoms get better after their trial of treatment, it shows they are more likely to have asthma. Your child’s GP or asthma nurse will probably continue the treatment and your child will be monitored to make sure they’re taking the lowest dose possible to manage their symptoms. If your child is old enough (usually around five) to take the tests to check their lung function and their symptoms improve when they take asthma medicines, it’s likely they will be diagnosed with asthma.
If your child’s symptoms don’t get better after their trial of treatment, or if the diagnosis is unclear, more tests may be carried out to continue trying to find out whether or not your child has asthma. Your child’s GP or asthma nurse will explain which tests are suitable for your child.
If your child’s GP or asthma nurse thinks your child might have severe asthma, your child will be referred to a specialist doctor. They will explain what tests and treatment your child will need, and how you can help to manage their symptoms.
If your child’s GP or asthma nurse thinks your child might have a condition other than asthma, you will be offered more tests and/or referred to a specialist who will help you get to the bottom of what’s going on for your child.
Many parents find it hard to explain suspected asthma to family, friends and other people who look after their child, such as child minders. We know from calls to our Helpline that parents worry other people don’t understand what it is or take it seriously because it’s ‘not asthma yet’.
It might help you to remember that at this point your GP has a strong suspicion that it is asthma, and many children will be treated ‘as if’ it’s asthma. Your first priority is to share your child’s asthma action plan with anyone who’s looking after your child. This will help them feel more confident in knowing what your child needs and will show them that your child is being treated for something ‘official’, even though they don’t have an actual diagnosis yet.
You could try explaining suspected asthma like this:
- “My child has suspected asthma – this means asthma is likely but not 100% confirmed”
- “Part of getting a confirmed diagnosis is testing out asthma medicines – so they need to take asthma medicines every day”
- “Another important part of getting a diagnosis is keeping a symptom diary and noticing if symptoms get worse due to certain things like cold weather or dust. If you spot any symptoms coming on or getting worse, please tell me”
- “As my child is taking their asthma medicines it’s unlikely they’ll have an asthma attack – but here’s what to do in case”
Remember - you’re not alone
Most parents of a child with asthma were told their child had ‘suspected asthma’ at some point – it’s a key part of the diagnostic process. If you’re finding the whole process a bit of a challenge you might find it helpful to:
- Remind yourself of other challenges you might have been through before Think back to who supported you through them, where you got good advice and how you coped. Can you draw on that support now for example?
- Talk to other parents going through similar experiences on our forums.
- Call our Helpline on 0300 222 5800 to talk through any concerns with one of our friendly asthma nurse specialists.
- See your child’s GP or asthma nurse - if you have any concerns or questions, jot them down to remind you to ask them at your next appointment, or book an extra appointment to discuss whatever’s on your mind.