Phil Kieran: Could my daughter grow out of her asthma?

The smaller airways in the lungs become inflamed and overreactive, leading to episodes of impaired breathing. 

When these airways narrow, it becomes more difficult for air to move through them, creating the characteristic whistling sound of the wheeze that any parent familiar with asthma will know.

Treating asthma usually involves two types of inhalers: a reliever (blue) and a preventer (different shapes and colours). 

The goal of asthma treatment is to no longer need the reliever and to have few or no symptoms while using the preventer inhaler. 

So, if your asthma is well-controlled, a blue inhaler should last at least three to four months. If you are going through your blue inhalers faster than this, you need to see your GP and discuss increasing the preventative treatment (or make sure you’re using the preventer as directed). 

An exception is if you play sports, we don’t count the dose of blue inhaler you take before exercise in this measure.

Asthma can vary in severity as we age, and it’s not unusual for it to become milder as we get older. If your asthma is well-controlled for an extended period, it will also become more stable. 

This can mean we would reduce treatment and potentially stop it altogether. The ‘stepping down’ treatment is done in a specific order, depending on the child’s symptoms and severity.

In your case, with your daughter only on two inhalers, I would potentially look at the dose of the preventer inhaler and reduce this and then see if her asthma has deteriorated. 

Taking several peak flow readings can measure how easily air can exit the lungs and help determine if treatment reductions are safe.

You can buy a peak-flow meter in pharmacies or online for about €15. The Children’s Hospital Colorado has an excellent video on YouTube on how to use them.

Childhood asthma often gets better around puberty, so your daughter may continue to see an improvement in her asthma.

There is some debate about ‘growing out of asthma’.

Some people have so few symptoms that they no longer require treatment, so it is practical to say they have grown out of their asthma, although they should probably be careful about their respiratory health going forward. 

Even more than others, those who have asthma should not smoke or vape, and they should get yearly flu vaccines as they may still be more vulnerable to severe respiratory problems.

If you have a question for Dr Phil Kieran, please send it to parenting@examiner.ie