Principles of maintenance management of asthma in children

The aim of management of asthma in children is to maintain a normal quality of life, free of asthma symptoms and without adverse effects of asthma treatment.

Before starting drug therapy for asthma in children, confirm that the diagnosis is correct. Diagnosis differs between age groups:

for diagnosis in children 6 years and older, see Asthma diagnosis: children 6 years and older, adolescents and adults
for diagnosis in children 5 years and younger, see Assessment of wheeze and asthma in children 5 years and younger—it is not possible to make a formal diagnosis of asthma in this age group.

For information about wheeze in infants 12 months and younger, see here. Wheezing in infants 12 months and younger is most commonly a symptom of acute viral bronchiolitis rather than asthma.

Drug therapy for asthma in children is introduced in a stepwise manner—see Stepwise therapy of wheeze and asthma: children 1 to 5 years and Stepwise therapy of asthma: children 6 years and older. For younger adolescents (younger than 14 years), the recommendations for managing asthma in children apply in most situations. For older adolescents, the recommendations for managing asthma in adults apply in most situations; see Maintenance management of asthma in adults and adolescents.

Control of asthma is defined as good, partial or poor—see Classification of asthma symptom control in children. Maintenance management relies on a continuous cycle of reviewing response and adjusting therapy, aiming to establish the minimum drug regimen that achieves good control.

In addition to drug treatment, optimised management of asthma in children should include:

a written asthma action plan to manage exacerbations
training in inhaler technique (see Inhalational drug delivery devices)
management of comorbidities that can reduce asthma control (eg obesity, rhinitis and rhinosinusitis, and anxiety and depression)
patient and carer education about avoiding triggers for asthma—in children, a viral respiratory tract infection is the most common trigger for asthma
general advice about maintaining a healthy lifestyle (diet, weight and activity)
maintenance of current immunisations—including annual influenza vaccination (for more information about vaccinations, see the Australian Immunisation Handbook ).