Getting an asthma diagnosis for your child

IF YOU’VE BEEN TOLD YOUR CHILD MIGHT HAVE ASTHMA, YOU’RE IN THE RIGHT PLACE FOR SUPPORT AND ADVICE.

VIDEO: Watch asthma nurse, Debby Waddell explain how children are diagnosed with asthma. 

Parents often tell us they feel confused or frustrated when they’re told their baby or child has ‘suspected asthma’ and wonder why the GP can’t just say it’s asthma. Even though getting an asthma diagnosis can take time, particularly if your child is under five, you can help your GP work towards either confirming a diagnosis or ruling one out. 

 How Are  Children Diagnosed with Asthma Infographic

What does suspected asthma mean?

If your GP’s told you that your child has ‘suspected asthma’, it means they think asthma is a strong possibility, but because of your child’s age they can’t give a definite diagnosis now.

This is because asthma symptoms come and go, and because there are lots of other reasons why very young children cough and wheeze, including colds and viral infections.

For parents this can be a frustrating time, but it’s worth remembering that your child’s GP is following a recommended process to make sure your child gets the right diagnosis.

On the positive side 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.

“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, mum to Oliver, 11.

What the GP will do if they suspect your child has asthma

Asthma tests

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, for example spirometry. The results of these tests will allow the GP to diagnose or rule out asthma.  

If your child is very young (under five), 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 several months, or even a few years, before they can confirm or rule out a diagnosis of asthma. If this is the case your GP will decide to monitor your child, using either a ‘watch and wait’ approach or a trial of treatment.

‘Watch and wait’

If your child isn’t having symptoms at the moment, your GP may decide to monitor them without giving them any treatment, known as a ‘watch and wait’ approach. This allows your GP to see if symptoms come back, and if they follow any pattern.

Although it may feel like you’re in limbo, it’s actually a very useful stage because it gives your GP time to understand your child’s symptoms and triggers and help your child get the best care. During this time, your child might be referred to an asthma nurse in your local GP surgery so you can get extra help and support.

Trial of treatment

“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, mum to Gabriel, 10

UK medical guidelines recommend a monitored trial of treatment to help find out whether or not a child has asthma.  This is where a preventer and a reliever inhaler are prescribed to see if they help your child’s symptoms.

At this stage, your child’s GP or asthma nurse will regularly monitor how your child is getting on with the treatment(s) they’ve been prescribed. If the medicines make a difference to your child’s symptoms this suggests they probably do have asthma.

Some parents worry about giving their child asthma medicines, especially before their child has a definite diagnosis. It might help to know that your child will be prescribed the lowest dose possible to help them stay symptom-free. Even if it turns out your child doesn’t have asthma, the doses of medicines prescribed are very unlikely to cause side effects.

If your child’s old enough and able to use a low-range peak flow meter, 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 -  which is why monitoring your child's symptoms is also important.

What happens after a trial of treatment?

If your child’s symptoms get better after their trial of treatment, it shows they’re 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 needed 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 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.

How you can help the diagnosis process along

Try to attend all your child’s follow-up appointments so you can talk about how your child’s been. This is also a chance for the GP or asthma nurse to review your child’s medicines and make sure they’re on the lowest dose possible to keep them well,.

As a parent, there’s a lot you can do to help your child’s GP come to a diagnosis. For example:

Track your child’s symptoms

You can help your child’s GP or asthma nurse build a picture of your child’s asthma by keeping a symptom diary or calender. Note down the dates and times you notice symptoms and what triggered them such as exercise, petting the family dog, or being in the park. If your child’s been given a peak flow meter to use, write down the results next to the symptoms they had on that day.

Give your child their medicines as prescribed

The results of your child’s trial of treatment will be much more useful if your child’s taken the right dose of treatment at the right times every day. So stick to a good routine and make sure your child isn’t skipping doses.

Make sure your child knows how to use their inhalers and spacers properly

Ask your child’s GP or asthma nurse, or a pharmacist to show you the correct technique. Even a small tweak to the way your baby or child takes their inhaler can make a difference to how much medicine gets down into their lungs where they need it. It’s a good idea to watch your child take their inhalers so you can make sure they’re taking them in the right way.

Download and share a written asthma action plan

Written asthma action plans give you step-by-step instructions for giving your child their asthma medicine and what to do if you notice your child’s symptoms are getting 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 (we recommend taking a photo on your phone and sharing it). Your child’s GP or asthma nurse will fill out the action plan with you. 

We know from calls to our Helpline that parents worry other people won’t understand what ‘suspected asthma’ is or take it seriously because it’s ‘not asthma yet’. Sharing your child’s asthma action plan with family and anyone looking after you child will help them understand that your child is being treated for something, even though they don’t have an official diagnosis yet.

Getting support and looking after yourself

The whole process of getting a diagnosis for your child can really take it out of you, making you more emotional than usual. It might help to:

Try not to worry

It can often take time 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 babies, toddlers and younger children and for children with difficult or severe asthma. This doesn’t mean your healthcare professionals aren’t doing their job - just that the process they’re going through takes time.

“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

VIDEO: Asthma UK nurse, Debby Waddell answers your common concerns about children being diagnosed with asthma.