What Parents Need to Know About the New Asthma Guidelines

What’s New in Asthma Diagnosis and Treatment For Children?

By Dr Mitsu Shah, Paediatric GP at Kidswell Health

Asthma is one of the most common long-term conditions in children. Good control can make a huge difference to your child’s health, school attendance, and overall quality of life.

In 2024, asthma care guidelines in the UK were updated to make diagnosis and treatment safer, simpler, and more effective. If your child has asthma or symptoms like wheezing or a persistent cough, here’s what you need to know.

1. Changes to Asthma Diagnosis in Children

For children under 5, asthma is now diagnosed clinically. This means it’s based on your child’s symptoms and how well they respond to treatment, as breathing tests aren’t always reliable in younger children.

Your GP may recommend a trial of low-dose inhaled steroids (ICS) for 8–12 weeks to see if symptoms improve.

For children aged 5 and over, asthma should be confirmed with simple tests like spirometry, FeNO (Fractional exhaled Nitric Oxide), or peak flow diaries – alongside a review of symptoms and history.

Why this matters:
We want to be sure we’re treating the right condition, avoiding both over-treatment and under-treatment.

We offer advanced FeNO Asthma Testing

At Kidswell Health, we offer FeNO breath testing – a quick, pain-free and non-invasive way to measure airway inflammation. This on-site test helps:

• Confirm or rule out asthma
• Monitor response to treatment
• Detect inflammation early, even before symptoms worsen

Our experienced team ensures accurate results in a calm, child-friendly setting.

👉 Learn more about our FeNO testing

2. What’s Changing in Asthma Treatment?

Many children were previously prescribed a reliever inhaler (usually the blue inhaler) to use “when needed.” The latest guidelines now discourage this as a standalone treatment.

Why are relievers no longer recommended on their own?

• They don’t treat the underlying inflammation, just the symptoms.
  
• Overuse can increase the risk of asthma attacks and hospitalisations.
  
• The more frequently it’s used, the less effective it becomes, like a sticking plaster that covers the issue without addressing the cause.
  

That’s why every child who needs a reliever inhaler should also be on a preventer inhaler, such as an inhaled corticosteroid (ICS), to reduce airway inflammation and prevent flare-ups.

What’s recommended now?

• Under 5s: Daily use of a preventer (steroid) inhaler plus a reliever if needed. Treatment will be reviewed regularly and reduced if symptoms settle.
  
• Children aged 5–11: First-line treatment is now a daily low-dose preventer inhaler plus a reliever when needed. If symptoms remain uncontrolled, your GP may recommend more advanced options like MART (Maintenance and Reliever Therapy).
  

3. What Is MART Therapy?

MART (Maintenance and Reliever Therapy) is a safer, simpler way of managing asthma using a single inhaler for both daily prevention and symptom relief.

Why MART is beneficial (especially for ages 12+ and sometimes 5–11):

✅ Reduces asthma attacks and flare-ups
✅ Fewer hospital visits
✅ Simplifies routines with just one inhaler
✅ Offers immediate protection during flare-ups

A simple way to think about it:

A reliever inhaler is like mopping up a puddle — MART fixes the leak and cleans up the mess.

Concerned about steroid use?

Research shows inhaled steroids may slightly reduce adult height by about 0.5cm but significantly reduce life-threatening asthma risks.

4. Every Child Should Have a Personal Asthma Action Plan

A personalised asthma plan outlines:

• Which medications to take and when
  
• How to spot warning signs of worsening asthma
  
• What to do in an emergency

We’ll help you create one tailored to your child’s needs.

5. Yearly Asthma Reviews Are Essential

Children should now have a structured asthma review at least once a year which includes:

• Checking symptom control
  
• Reviewing inhaler technique
  
• Monitoring medication use
  
• Ensuring the reliever isn’t overused
  
• Adjusting treatment as needed
  

6. The Allergy-Asthma Connection: Why Holistic Care Matters

Asthma is often linked to allergies like eczema, hay fever, and food allergies. Managing these can significantly improve asthma control.

• Hay fever: Reducing hay fever symptoms lowers asthma risks.
  
• Eczema: Well-managed eczema can ease airway sensitivity.
  
• Other allergies: Dust, pets, and food triggers should be addressed for better asthma control.
  

Children with well-managed allergies tend to have fewer asthma flare-ups and less time off school.

7. Smoking, Vaping & Other Triggers

Avoiding triggers is crucial. This includes:

• No smoking or vaping indoors
  
• Limiting exposure to pollution (e.g. avoiding walks on busy roads)
  
• Identifying triggers like viruses, cold air, or exercise — and managing them proactively.
  

Even seemingly harmless triggers like summer barbeques can cause flare-ups.

Final Thoughts

These updates aim to reduce flare-ups, hospital visits, and help your child thrive. If you’re unsure about your child’s current treatment or have noticed more symptoms, we recommend booking a review.

Our paediatric team is here to guide you through these changes, from diagnosis to long-term management.

Book an asthma review with us today
📞 020-3011-1843
📧 reception@kidswellhealth.com

We’re here to make asthma care clearer, safer, and more effective – so your child can enjoy life to the fullest.

Additional Resources

🌐 Visit Asthma + Lung UK for helpful resource