Childhood Allergy and Asthma Care in Gurugram

Is it asthma or just recurrent cough?

Patterns that suggest asthma include cough or wheeze that returns with every cold, symptoms at night or in the early morning, breathlessness with exercise or laughter, and a family history of asthma, eczema or allergic rhinitis. Diagnosis rests on this pattern and on response to treatment; lung function testing is possible in older children.

Inhalers, spacers and technique

Inhaled medicine delivered through a spacer is the standard of care for children, and reaches the airway more reliably than syrups. Technique is demonstrated and then checked at follow-up, because a large share of apparently uncontrolled asthma is actually medicine that never reached the lungs.

Concerns about inhaled steroids are common and worth raising directly. The doses used in childhood asthma are small, act locally in the airway, and are reviewed and stepped down when control allows.

Triggers and the written action plan

Common triggers include viral infections, dust, smoke, strong smells, cold air and outdoor pollution, which matters particularly in the Delhi NCR winter. The action plan sets out daily treatment, what to do when symptoms start, and the point at which the family should seek emergency care.

Air quality in Delhi NCR

Asthma management in Gurugram has to account for air quality in a way that guidance written elsewhere does not. From roughly late October through January, particulate levels rise sharply with crop residue burning, cooler stagnant air and Diwali, and many children who are stable for most of the year deteriorate predictably during this period.

Planning for it beats reacting to it. Check the AQI daily during those months and use it to decide on outdoor activity, shifting sport and play indoors when levels are high and preferring early morning or later evening when they are somewhat lower. Keep windows closed on bad days; a HEPA air purifier in the bedroom is the single most useful purchase for a child with asthma in this region, since it covers the hours they spend in one room. A properly fitted N95 mask helps for unavoidable outdoor time, while cloth and surgical masks do not filter fine particulates. Many children need their preventer treatment stepped up in advance of this season rather than after symptoms return, and that is worth planning at an autumn review.

Preventer and reliever: the distinction that matters most

Confusion between the two inhalers is behind a large share of poorly controlled childhood asthma. The reliever, usually a blue inhaler, relaxes the airway muscles within minutes and is used when symptoms occur. It does nothing to the underlying inflammation and provides no protection against the next episode.

The preventer works on that inflammation, takes days to weeks to build its effect, and must be taken every day whether or not the child has symptoms. Because it produces no immediate sensation, families frequently conclude it is not working and stop it once the child is well, which is precisely when it is doing its job. A useful marker of control is reliever use: needing it more than about twice a week generally means the preventer regimen needs review rather than more reliever. Rinsing the mouth and spitting after a steroid preventer avoids oral thrush and hoarseness.

Using a spacer properly

A spacer is not an optional accessory for children, it is what makes the inhaler work. Used without one, most of the dose from a metered-dose inhaler lands in the mouth and throat rather than the lungs, because coordinating a press with a slow breath in is beyond most children and difficult even for adults.

The technique is straightforward once shown. Shake the inhaler, fit it to the spacer, and use a well-fitting mask over nose and mouth for younger children or a mouthpiece once a child can seal their lips around it. Press once and let the child breathe normally through the spacer for around five breaths, or thirty seconds. Where a second dose is needed, wait about thirty seconds and repeat with a single press rather than firing several puffs into the chamber at once. Wash the spacer monthly in warm soapy water and leave it to air dry without rinsing or wiping the inside, since drying with a cloth builds static that makes the medicine stick to the walls. Bring the inhaler and spacer to every appointment so technique can be checked; it drifts over time in almost everyone.

Recognising an attack, and when to get help

Families need to know in advance what deterioration looks like, because it is difficult to judge for the first time during an episode. Early signs include increased coughing, particularly at night or with exercise, wheeze, and needing the reliever more often than usual.

Seek emergency care if the child is too breathless to speak in full sentences, to eat or to walk; if the skin is sucking in between or below the ribs or at the base of the neck with each breath; if the reliever is not helping or the effect is lasting less than about four hours; if the lips or fingertips look blue or grey; or if the child becomes drowsy, confused or unusually quiet. A child who has stopped wheezing but is working harder to breathe is deteriorating, not improving, and needs urgent assessment. While arranging transport, keep giving reliever through the spacer and keep the child sitting upright rather than lying flat.

Frequently asked questions