Asthma in Children in the UAE: Signs, Triggers and Inhalers

Asthma is a long-term condition in which a child’s airways become swollen and narrow, causing cough, wheeze and breathlessness. It often shows up as a cough at night or after running, not only as a wheeze. In the UAE the usual triggers are colds, dust, smoke and sudden changes between hot outdoor air and cold air conditioning. Asthma is controlled well with the right inhalers, and your pediatrician can tell you whether your child’s symptoms fit.

What are the signs of asthma in a child?

The signs vary by age, and a wheeze is only one of them. Look for:

• a cough that is worse at night or in the early morning
• a cough or wheeze after running, laughing or crying
• a whistling or squeaky sound when your child breathes out
• breathing that looks fast or hard, with the belly or the skin between the ribs pulling in
• a tight chest, which older children describe as “a squeezing feeling”
• coughs and colds that always seem to go to the chest and take weeks to clear

A single wheezy cold in a baby does not mean asthma. Many toddlers wheeze with viruses and grow out of it. Doctors think about asthma when the symptoms keep coming back, come between colds, or happen at night and with exercise.

Could my child’s night cough be asthma?

It could be. A dry cough that wakes your child at night, returns every few weeks and is not explained by a cold is one of the most common ways asthma shows itself, especially in children over 3. Other causes of a night cough include a blocked nose with drip at the back of the throat, reflux and allergies, so the doctor will ask about the pattern before deciding.

It helps to note when the cough happens, what seems to set it off, whether it lasts after a cold has gone and whether your child gets short of breath playing. A short phone video of the cough or breathing is useful for the doctor.

What triggers asthma in children living in the UAE?

Triggers differ from child to child. These are the ones we hear about most from families in Dubai:

Viral infections.

Colds and flu are the most common trigger in young children, and they peak in the winter months.

Dust and sandstorms.

Fine desert dust irritates the airways, and indoor dust mites live in bedding, soft toys and carpets.

Cigarette, shisha and incense smoke.

Smoke at home or in the car makes asthma worse. This includes bukhoor and oud.

Sudden temperature change.

Going from hot outdoor air into cold air conditioning can set off a cough in some children. A dirty air-conditioner filter can also circulate dust.

Allergies.

Pollen, pets, mould and some foods can trigger asthma in children who are also allergic. See our guide to avoiding seasonal allergies in Dubai.

Exercise.

Running games can bring on a cough or wheeze, especially in cold or dusty air.

Strong smells.

Perfume, cleaning products and air fresheners can irritate the airways.

Air conditioning does not cause asthma. It matters mostly when it is cold, dusty or poorly maintained.

How is asthma diagnosed in children?

There is no single test for asthma in young children. The doctor listens to the chest, asks about your child’s symptoms and triggers, looks at the family history of asthma, eczema and allergies, and sees how your child responds to treatment. Children over about 5 or 6 may be able to do a breathing test.

Because other conditions can look like asthma, the diagnosis is usually made over a few visits, and sometimes after a trial of treatment. If your child needs tests or a specialist, we arrange the referral.

What are reliever and preventer inhalers?

Most children with asthma use two kinds of inhaler. They do different jobs.

A reliever inhaler

opens the airways quickly during symptoms. It is used when your child has a cough, wheeze or tight chest, and in an attack. It is usually blue.

A preventer inhaler

is used every day, even when your child feels well. It calms the swelling in the airways over time, so there are fewer symptoms and fewer attacks. It does not work straight away, which is why it is easy to stop too early.

The doctor decides which medicines your child needs and in what dose. Do not change doses or stop the preventer without asking, even if your child looks well.

Inhaled medicines work directly in the lungs, so they need much smaller doses than tablets or syrups. The NHS explains inhalers clearly for parents.

What is a spacer, and does my child need one?

A spacer is a plastic chamber that attaches to the inhaler so your child can breathe the medicine in slowly. Young children cannot time a puff with a breath, so a spacer helps the medicine reach the lungs and not stay in the mouth and throat. Babies and toddlers use a spacer with a soft face mask. Older children use one with a mouthpiece.

To use it:

1. Shake the inhaler and attach it to the spacer.
2. Place the mask or mouthpiece so it fits snugly, without a gap.
3. Press one puff into the spacer.
4. Let your child take 5 to 6 slow breaths through it.
5. Repeat for each puff, shaking the inhaler between puffs.

Ask the doctor or nurse to watch you do it once. Many inhaler problems come from technique, not the medicine.

How can I reduce asthma triggers at home?

• Keep your home smoke-free, including shisha, bukhoor and cigarettes, and do not smoke in the car.
• Wash bedding weekly in hot water and keep soft toys off the bed.
• Have air-conditioner filters cleaned regularly.
• Keep windows closed on dusty or sandstorm days, and keep your child indoors if the air looks hazy.
• Check which cleaning products and sprays set off a cough, and use fewer of them.
• Make sure your child has their flu vaccine each year, since flu often triggers an attack. Our vaccination schedule shows when it is due.

Can children with asthma play sports?

Yes. Exercise is good for children with asthma, and most can do everything their friends do. If exercise sets off symptoms, the doctor can suggest a plan, such as a warm-up and a puff of reliever before activity. Tell your child’s teacher and coach about the asthma and make sure the reliever inhaler is easy to reach.

When to see a doctor

How we can help at myPediaclinic

Dr. Medhat Abu-Shaaban, Consultant Pediatrician and Medical Director, and Dr. Tala Belbeissi, Consultant Pediatrician, see children with recurrent cough, wheeze and suspected asthma through our allergies and eczema service. We listen to your child’s chest, work out what the pattern points to, teach inhaler and spacer technique and write an asthma action plan. If your child needs a lung specialist or further tests, we arrange the referral. Both consult in English and Arabic at our clinic in Dubai Healthcare City.

Frequently asked questions