🌬️ Children's Health

All ages — common in school-age children

Childhood Asthma in Nigeria

Managing asthma in your child — triggers, inhalers, and school action plans.

Asthma is the most common chronic disease in Nigerian children. Many cases are diagnosed late or managed inadequately — with emergency medications used as substitutes for proper preventer treatment. With the right management, children with asthma can play sport, sleep through the night, and attend school without limitation.

⚠️ Go to Hospital IMMEDIATELY if your child has:

🚨 Severe breathlessness — the child cannot speak in full sentences

🚨 Blue or pale lips or fingertips — low oxygen; emergency

🚨 Chest is sucked inwards with every breath (subcostal recession)

🚨 Nostrils flaring widely with every breath

🚨 The reliever inhaler is not helping after 4–6 puffs and 15 minutes

🚨 Child is silent (no wheeze) but clearly struggling to breathe — this can indicate very severe asthma

🚨 Child is confused or drowsy

🚨 Rapidly deteriorating despite treatment

Signs Parents Notice

• Recurring wheeze — whistling sound when breathing out

• Night-time or early morning cough that wakes the child

• Cough after exercise (exercise-induced asthma)

• Shortness of breath with play or exercise

• Recurrent chest tightness

• Symptoms triggered by: cold air, dust, smoke, animals, infections

• Symptoms that improve quickly with a reliever inhaler (salbutamol)

• Frequent "chest infections" that respond to bronchodilators — may actually be undiagnosed asthma

Home Care — What You Can Do

Know and avoid triggers

Common triggers in Lagos: dust mites, cockroaches, pet dander, cigarette smoke, mosquito coils, strong perfumes, cold air. Reduce exposure where possible — regularly wash bedding in hot water, avoid feather pillows, don't smoke near the child.

Correct inhaler technique with a spacer

All children using a metered-dose inhaler (MDI) should use a spacer (volumatic/aerochamber). Shake the inhaler, attach to spacer, have child breathe in slowly through the spacer for 5 breaths. Poor technique is the most common reason asthma is poorly controlled.

Use the preventer every day

The preventer inhaler (usually brown or orange) must be used every morning and evening — even when the child feels completely well. It takes 4–8 weeks to reach full effect. Many parents stop it when the child improves — this leads to flares.

Have a written asthma action plan

A plan that tells the school, babysitter, and parents exactly what to do when symptoms worsen. Based on traffic light system — green (well), yellow (worsening), red (emergency). Ask your doctor to provide one.

When to Seek Medical Help

NowAny of the emergency signs above — severe asthma attacks in children can be fatal.

SoonChild waking at night with cough or wheeze more than once a week, using the reliever inhaler more than 3 times a week, or missing school due to asthma — poor control that needs medication review.

RoutineFor diagnosis of suspected asthma, for starting or reviewing a preventer inhaler, or if the child has been using only a reliever inhaler without a preventer.

Common Mistakes to Avoid

🚫 Do not use mosquito coils, aerosol sprays, or smoke near a child with asthma
🚫 Do not stop the preventer inhaler when the child seems well — this is when it is most important
🚫 Do not rely only on the reliever inhaler (salbutamol) without a preventer — this approach leads to poor control and risks severe attacks
🚫 Do not exercise-restrict the child unnecessarily — well-controlled asthma should not limit exercise
🚫 Do not give salbutamol continuously without seeking medical help if the attack is not responding

Tests Your Doctor May Order

Spirometry (children over 5)

Measures lung function and reversibility with bronchodilator — the most objective evidence of asthma. Children under 5 are diagnosed clinically.

Peak Flow Measurement

Simple hand-held device — used for home monitoring. Reduced peak flow during symptoms, improving with reliever inhaler, confirms asthma.

Chest X-ray

Usually normal in asthma — done to exclude other diagnoses (foreign body, TB, pneumonia) when presentation is atypical.

Allergy Testing (Skin Prick Test or Specific IgE)

Identifies allergen triggers — dust mites, cockroaches, pet dander. Guides allergen avoidance advice.

How It Is Treated

Reliever Inhaler (Salbutamol — Blue)

Given as needed for acute symptoms. For exercise-induced asthma — 2 puffs (with spacer) 15–20 minutes before exercise. Using more than 3 times a week (excluding pre-exercise) signals inadequate control.

Preventer Inhaler (Inhaled Corticosteroid — Brown/Orange)

For children with persistent symptoms — twice daily, every day. The cornerstone of long-term asthma management. Low-dose inhaled steroids do not cause growth suppression at the doses used for asthma.

Spacer Devices

Essential for all children using metered-dose inhalers — dramatically improves drug delivery to the lungs. A spacer can be improvised with a plastic bottle if commercial spacers are unavailable, though proper spacers are preferred.

Written School Asthma Action Plan

A signed document from the doctor that tells school staff exactly what medications to give and when, and when to call for emergency help. Reduces school-related asthma deaths.

Acute Asthma Management in Hospital

Nebulised salbutamol + ipratropium, oral prednisolone, oxygen. Severe attacks require IV magnesium sulfate or IV aminophylline in hospital.

Frequently Asked Questions

Will my child outgrow asthma?

Many children with asthma see improvement or apparent resolution in their teens, particularly those with mild, exercise-triggered asthma. However, asthma often returns in adulthood. Medications should not be stopped without medical advice, even if the child appears symptom-free.

Are inhaled steroids safe for children?

Yes — at the doses used in asthma treatment, inhaled corticosteroids have an excellent safety record. The amount reaching the bloodstream is minimal. The risk of uncontrolled asthma (hospitalisation, death) far outweighs any small risk from properly dosed preventer therapy.

My child gets asthma only during a cold — does he need a preventer?

Viral-induced asthma (asthma only with colds) is very common in young children. If episodes are infrequent and mild, a reliever as needed may be appropriate. If episodes are severe, frequent, or lead to hospital admission, a preventer is needed. Discuss with your doctor.

Can a child do sport with asthma?

Yes — and it should be actively encouraged. Swimming is particularly well-tolerated. Pre-exercise salbutamol prevents exercise-induced asthma in most children. Good asthma control means sport should not be limited.

How do I know if the preventer inhaler is working?

After 4–8 weeks of consistent use: fewer night-time symptoms, less need for the reliever inhaler, better exercise tolerance, and fewer school absences. If not seeing improvement, the dose or inhaler technique may need review.