September sees the return to school for children after the summer holidays. While the return to routine is welcomed, it can be challenging for children with asthma. Research by Asthma + Lung UK found that in 2022/2023, there was a 348% rise in hospital admissions in 5-14-year-olds with an asthma attack in September compared to the previous month1. This staggering rise highlights the importance of helping parents or guardians manage their child’s asthma effectively as the school year begins.
Understanding the September asthma epidemic1
Many factors can contribute to the increase in asthma flare-ups when children return to school, including:
- Interrupted medication routines throughout the summer holidays,
- Exposure to triggers on the return to school,
- Emotional stress experienced when starting a new school or school year.
With this in mind, parents or guardians must be well educated and prepared for the return to school.
How can parents or guardians prepare?
Various steps can be taken to ensure the return to school runs smoothly with minimal impact on a child’s asthma symptoms.
Arrange a pre-school check-up
Asthma reviews are essential for well-controlled asthma. Arranging a pre-school check-up provides a good opportunity to:
- Assess how well your child’s asthma is controlled,
- Review medication,
- Check inhaler technique.
During the review, consider asking about Fractional exhaled Nitric Oxide (FeNO) testing. FeNO is a non-invasive test that measures airway inflammation in the lungs, which is often found in asthma. It can help confirm an asthma diagnosis if there is uncertainty, determine how well inhaled corticosteroids work, and guide adjustments in treatment2.
A FeNO test can be helpful if your child’s symptoms are inconsistent or you are unsure whether their asthma is fully under control heading into the school year.
FeNO testing with the NObreath® FeNO device
The NObreath® is a portable, non-invasive FeNO testing device designed to aid in asthma diagnosis and management. Carrying out a FeNO test with the NObreath® is quick and easy, making it the perfect choice for asthma care and management in children. The latest joint guidelines from the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) recommend a FeNO test as the first-line test for asthma diagnosis in children3.
Understand your child’s asthma triggers
Triggers differ from person to person; one thing that might set symptoms off in one person may not cause symptoms in another, so it is essential to understand what triggers your child’s asthma. Common school-related triggers could include4:
- Dust,
- Pollen,
- Cold air,
- Physical activity,
- Stress,
- Classroom pets.
If you know your child’s triggers, it would be a good idea to communicate with the school staff to ensure they are aware, so triggers can be avoided if possible.
Communicate with the school
We briefly touched on communication with the school regarding triggers. However, it is important that the staff are aware of your child’s asthma, triggers and medication. When preparing your child’s medication and supplies, it is a good idea to label everything correctly and ensure the school is aware so inhalers can be stored safely at school. You should also ask about the school’s medication use and self-administration policy.
Teach self-management skills
Education is key, so the more your child knows about asthma and treatment, the better. They must know how to recognise their symptoms and how to use their inhaler correctly. Providing the correct age-appropriate education empowers your child to recognise worsening symptoms and when to ask for help.
Going back to school can be challenging for children and parents or guardians. However, asthma doesn’t need to impact this transition. The back-to-school process should run smoothly with the correct education, treatment, and preparation. We should also recognise that while starting a new school year can cause an exacerbation in asthma symptoms, it is important to remain vigilant throughout the year, ensuring your child’s asthma is well-controlled.
For more information on FeNO testing with NObreath® and its integral role in the asthma pathway, visit the website here.
References
- Number of children in hospital with life-threatening asthma attacks could quadruple as they return to school [Internet]. Asthma + Lung UK. 2024. Available from: https://www.asthmaandlung.org.uk/media/press-releases/number-children-hospital-life-threatening-asthma-attacks-could-quadruple-they
- NHS England. NHS Accelerated Access Collaborative» Fractional Exhaled Nitric Oxide (FeNO) [Internet]. www.england.nhs.uk. Available from: https://www.england.nhs.uk/aac/what-we-do/innovation-for-healthcare-inequalities-programme/rapid-uptake-products/fractional-exhaled-nitric-oxide/
- NICE. Overview | Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) | Guidance | NICE [Internet]. Nice.org.uk. NICE; 2024. Available from: https://www.nice.org.uk/guidance/NG245
- Asthma at school and nursery | Asthma + Lung UK [Internet]. www.asthmaandlung.org.uk. 2024. Available from: https://www.asthmaandlung.org.uk/conditions/asthma/child/life/school
