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Conditions We Treat

Asthma Belfast

Asthma is the most common chronic respiratory condition in childhood, affecting around 1 in 11 children in the UK. With accurate diagnosis and the right treatment plan, most children with asthma can lead fully active lives.

Child with asthma receiving specialist paediatric care in Belfast

Overview

Asthma is a chronic inflammatory condition of the airways characterised by variable airflow obstruction, bronchial hyperresponsiveness and airway inflammation. In children, it is most commonly allergic (atopic) in nature — triggered by allergens such as house dust mite, pet dander, pollen and mould, as well as viral respiratory infections, exercise, cold air and irritants. Asthma frequently co-exists with eczema, food allergy and allergic rhinitis as part of the atopic march. Accurate diagnosis is essential — many children are either over-diagnosed (treated for asthma when another condition is responsible) or under-diagnosed (symptoms attributed to recurrent chest infections). A specialist assessment ensures the correct diagnosis and the most effective treatment plan.

Expert paediatric assessment in Belfast — Dr Mugilan Anandarajan (FRCPCH) provides thorough, evidence-based evaluation and management for children aged 0–16. No GP referral required.

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Common Symptoms

  • Recurrent wheeze — a high-pitched whistling sound when breathing out
  • Persistent cough — particularly at night, early morning or after exercise
  • Shortness of breath or difficulty breathing, especially with activity
  • Chest tightness or a feeling of pressure in the chest
  • Symptoms triggered by exercise, cold air, viral infections or allergen exposure
  • Nocturnal cough or wheeze disrupting sleep
  • Reduced exercise tolerance or avoiding physical activity
  • Frequent "chest infections" that take a long time to resolve
  • In infants and toddlers: recurrent viral-induced wheeze (may or may not be asthma)

Causes & Triggers

  • Atopic predisposition — family history of asthma, eczema or hay fever
  • Sensitisation to aeroallergens — house dust mite, cat and dog dander, pollen, mould
  • Viral respiratory infections — the most common trigger in young children
  • Exercise — particularly in cold, dry air
  • Tobacco smoke exposure — both prenatal and postnatal
  • Air pollution — traffic-related particulates and nitrogen dioxide
  • Occupational or environmental irritants
  • Obesity — associated with increased asthma prevalence and severity
  • Gastro-oesophageal reflux — can worsen airway hyperresponsiveness
  • Emotional stress and anxiety

Diagnosis & Testing

Diagnosing asthma in children requires a careful clinical history, physical examination and, where possible, objective lung function testing. Dr Anandarajan takes a detailed history of the pattern, frequency and severity of respiratory symptoms, trigger factors, response to bronchodilators, and any co-existing atopic conditions. In children old enough to cooperate (typically 5 years and above), spirometry with bronchodilator reversibility testing and FeNO (fractional exhaled nitric oxide) measurement can objectively confirm airway inflammation and reversibility. Allergy testing (skin prick testing and specific IgE) identifies sensitisation to relevant aeroallergens. In younger children, a trial of treatment with careful monitoring is often the most practical diagnostic approach.

  • Spirometry with bronchodilator reversibility — objective lung function testing (age 5+)
  • FeNO (fractional exhaled nitric oxide) — measures eosinophilic airway inflammation
  • Peak flow monitoring — home diary to document variability over 2–4 weeks
  • Skin prick testing (SPT) — identifies sensitisation to house dust mite, pollen, pet dander, mould
  • Specific IgE blood tests (ImmunoCAP) — for aeroallergen sensitisation
  • Exercise challenge test — for exercise-induced bronchoconstriction
  • Chest X-ray — to exclude other causes of respiratory symptoms
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Management & Treatment

Asthma management in children follows a stepwise approach guided by symptom control and exacerbation frequency. The foundation is a written personalised asthma action plan covering daily preventer therapy, reliever use, and what to do during a flare. Inhaled corticosteroids (ICS) are the most effective preventer therapy for persistent asthma. Dr Anandarajan pays particular attention to inhaler technique and device selection — poor technique is one of the most common reasons for inadequate asthma control. For allergic asthma, allergen avoidance measures (particularly house dust mite reduction) and treatment of co-existing allergic rhinitis are important components of management. For children with severe or difficult-to-control asthma, specialist review may identify modifiable factors or indicate the need for add-on therapies.

  • Personalised written asthma action plan — daily management and emergency guidance
  • Inhaled corticosteroids (ICS) — first-line preventer therapy (e.g. fluticasone, budesonide)
  • Short-acting beta-agonist (SABA) reliever inhaler (e.g. salbutamol) with correct technique
  • Long-acting beta-agonist (LABA) add-on therapy for inadequately controlled asthma
  • Leukotriene receptor antagonist (LTRA — montelukast) — particularly for allergic and exercise-induced asthma
  • Inhaler device review and technique optimisation — spacer use for all children under 12
  • Allergen avoidance advice — house dust mite, pet dander, mould reduction
  • Treatment of co-existing allergic rhinitis (nasal steroids, antihistamines)
  • Allergen immunotherapy (AIT) — for allergic asthma sensitised to house dust mite
  • Biologic therapy (e.g. mepolizumab, omalizumab) for severe refractory asthma

When to Seek a Specialist Opinion

Your child has recurrent wheeze, cough or breathing difficulties
Asthma symptoms are not well controlled on current treatment
Your child is using their reliever inhaler more than twice a week
Asthma is limiting your child's exercise or physical activity
Your child has had a severe asthma attack requiring hospital admission
You are unsure whether your child's inhaler technique is correct
You want to identify and address allergy triggers for your child's asthma
Your child has asthma alongside eczema, food allergy or hay fever
You want a second opinion on your child's asthma diagnosis or treatment
Book an AppointmentAllergy Testing Options
Common Questions

Frequently Asked Questions

Questions parents commonly ask about asthma in children — answered by Dr Mugilan Anandarajan, Consultant Paediatrician, Belfast.

Diagnosing asthma in children under 5 is challenging because they cannot reliably perform lung function tests. Diagnosis is based on a careful clinical history, the pattern of symptoms, response to bronchodilator treatment, and exclusion of other causes. In older children (5+), spirometry, FeNO measurement and peak flow monitoring provide objective evidence. Dr Anandarajan will explain what tests are appropriate for your child's age and symptoms.
Yes. Inhaled corticosteroids (ICS) are the most effective and safest preventer therapy for childhood asthma. The dose of steroid reaching the body from an inhaler is very small compared to oral steroids. The benefits of good asthma control — preventing attacks, protecting lung development and enabling normal activity — far outweigh the very small risks of low-dose ICS. Dr Anandarajan will prescribe the lowest effective dose and review it regularly.
FeNO (fractional exhaled nitric oxide) is a simple, non-invasive breath test that measures the level of nitric oxide in exhaled air — a marker of eosinophilic (allergic) airway inflammation. A raised FeNO supports a diagnosis of allergic asthma and predicts a good response to inhaled corticosteroids. It is particularly useful in children where the diagnosis is uncertain or where treatment response is being monitored.
Yes — for children with allergic asthma who are sensitised to house dust mite, sublingual allergen immunotherapy (SLIT) with house dust mite drops or tablets has good evidence for reducing asthma symptoms and medication requirements. It is a disease-modifying treatment that can reduce sensitisation over time. Dr Anandarajan will assess whether your child is suitable and discuss the options.
Follow your child's written asthma action plan. Give 1 puff of reliever inhaler (salbutamol) via spacer every 30–60 seconds up to 10 puffs. If there is no improvement, or symptoms are severe (unable to speak in sentences, very fast breathing, blue lips), call 999 immediately. Do not leave your child alone. If you do not have a written action plan, ask Dr Anandarajan to provide one at your next appointment.
No. You can book directly at Kingsbridge Private Hospital or Ulster Independent Clinic without a GP referral. Dr Anandarajan sees children aged 0–16 with asthma of all severities.
Many children with mild asthma do improve significantly in their teens, particularly boys. However, asthma does not always disappear — around 50% of children with asthma will continue to have symptoms in adulthood, particularly those with severe disease, persistent sensitisation to allergens, or co-existing eczema. Good control during childhood protects lung development and reduces the risk of long-term respiratory problems.
A specialist paediatric allergy assessment adds significant value beyond routine GP management. Dr Anandarajan identifies the specific allergens driving your child's asthma (house dust mite, pollen, pet dander), performs FeNO testing to confirm allergic airway inflammation, optimises inhaler technique and device choice, and assesses suitability for allergen immunotherapy — a disease-modifying treatment not available in primary care. Children with difficult or poorly controlled asthma particularly benefit from specialist review.

Have a question not answered here? Contact the clinic or call 028 9066 2878.

Areas We Serve

Asthma Treatment for Families Across Northern Ireland

Families travel from across Northern Ireland to see Dr Anandarajan at Kingsbridge Private Hospital, Belfast. Easily accessible from the M1, M2 and A1 with free on-site parking. No GP referral required.

BelfastLisburnBangorNewtownardsHolywoodCarrickfergusAntrimCraigavonNewryArmaghBallymenaLondonderry / DerryOmaghEnniskillenDownpatrickNewtownabbeyNorth DownArds PeninsulaCounty DownCounty AntrimCounty ArmaghNorthern Ireland

Get expert help for Asthma in Belfast

Dr Mugilan Anandarajan (FRCPCH) provides specialist paediatric allergy assessment at Kingsbridge Private Hospital and Ulster Independent Clinic. No GP referral required. Most major health insurers accepted.

Book a ConsultationAbout Our Specialist

Kingsbridge Private Hospital, 811–815 Lisburn Road, Belfast BT9 7GX

Why parents choose Belfast Allergy Clinic

  • Consultant Paediatrician (FRCPCH)
  • 25+ years clinical experience
  • Children aged 0–16 years
  • No GP referral required
  • Allergy testing available
  • Face-to-face and video consultations
  • Recognised by major insurers
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