The latest prescribed medicines are very effective in controlling most children’s asthma and in minimising the number of school days lost. Good communication between parents and teachers should reassure the child that school staff are there to help if any problems arise.

Patient/teacher contact
Ideally, the parents of each child with asthma should meet the teacher at the beginning of the school year. Check that the child’s records in the school office include details of the name and phone number of the child’s doctor, and any hospital or specialist the child is attending.

Suggestions for matters to be discussed include:

1. An agreed time and place for regular daily treatment, at breaktimes for example. A supervised area such as an office might be used to build up a recognised school routine for children with asthma. If a teacher is asked to administer medicines or to supervise or remind children to take their medicines, parents should write to the secretary or chairperson of the school board of management, outlining the teacher’s role. This is for legal reasons, to ensure that the teacher is fully covered by the school’s insurance policy.

2. An agreed procedure for taking reliever medicines. A procedure should be set up so that when the child feels the need to use a reliever inhaler, the teacher can be alerted with the minimum of interruption.

3. Who keeps the medicines? This will depend on the child’s age and the type of medicine. Inhalers could be kept by either child or teacher. If held by the teacher, it is important that the child’s name is written on the inhaler. It is essential that relievers are immediately available to the child at all times. Medicines must only be given to the child for whom they are prescribed.

4. Triggers. The teacher may be asked to help the child avoid certain triggers.

5. If a child is noticeably wheezy or breathless, the teacher should check that the required asthma medicines are taken. If the problem persists, medical help should be sought without delay. Parents should always be kept up to date with treatment that the child has received in school.

Asthma and school leisure activities
Normal activity should be the goal for all but those with the most severe asthma. Nearly all children with asthma become wheezy during exercise. After a five minute run, a child can get a severe attack of wheezing and coughing which can last half an hour or more if it is not treated. This is called exercise-induced asthma (EIA). Teachers can help to identify undiagnosed asthma by spotting children who cough a lot after exercising in the winter.

Wheezing due to asthma is usually worse on cold, dry days and prolonged spells of exercise are more likely to induce asthma than short bursts. Also, exercising with the arms or legs alone is less likely to trigger an attack than exercise using both.

Swimming is an excellent form of exercise for children with asthma, and seldom provokes an attack. PE teachers should encourage children with asthma to take part in sport, to take their medication beforehand and to keep it with them during the class. Children who are inactive may become psychologically and socially isolated. Also, a child who is physically fit is probably better able to cope with an asthma attack. It can be pointed out to children that many famous sportsmen and women have asthma. However, no child should be forced to continue games if they say they are too wheezy.

Some inhalers can prevent exercise-induced asthma, and it is recommended that they be taken five to 10 minutes before scheduled activities. Use before breaktime may help. Parents should confirm this with the teacher. If a child regularly suffers from breathlessness or wheeze with exercise, the teacher should discuss this with the parents, as the doctor can often help by making adjustments to the child’s treatment.

The symptoms of exercise-induced asthma may be prevented if the child takes a dose of reliever medicine before beginning exercise. Children should warm up before playing games. Several 30-second sprints over five to 10 minutes may protect the lungs for up to an hour or so.

For more information, contact the Asthma Society of Ireland on freephone, 1850 44 54 64.

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