Asthmatic children: a pediatrician's guide: golden rules for a peaceful holiday.

Vacations, yes, but without neglecting respiratory health. In Italy, approximately 1 in 10 children suffers from asthma, making it the most common chronic disease in childhood. If we also consider conditions like allergic rhinitis, respiratory diseases affect up to 30% of children and adolescents. With the arrival of summer, many families ask practical questions: is the beach or the mountains better, and is air conditioning harmful, for example? To help parents navigate this, the Italian Society for Childhood Respiratory Diseases (SIMRI), affiliated with the Italian Society of Pediatrics, offers a short guide with practical tips for best navigating the summer season . This guide is intended for families, but is also useful for pediatricians and healthcare professionals who find themselves answering parents' questions.

Children on a mountain trail (GettyImages)

Simri's mini-guide: no anxiety. "Children with asthma can—and should—experience summer with freedom and safety, but it's essential that families are well-informed," emphasizes Stefania La Grutta, president of Simri. "Our mini-guide was born precisely from the need to offer simple, evidence-based advice to prevent the summer season from becoming a source of anxiety or renunciation. Proper environmental and therapeutic management allows children with asthma to fully participate in outdoor life, sports, travel, and family recreation."

According to pediatricians, the sea and the mountains can offer benefits if chosen as holiday destinations and managed with awareness .

Why mountain air is beneficial: Mountain air is cleaner, with lower concentrations of allergens and air pollutants. It can be particularly beneficial for children with allergic asthma or rhinitis, especially if you choose a location above 1,000-1,500 meters, where the presence of dust mites and pollen is reduced. However, it's best to avoid very high altitudes (above 2,000 m), which can cause hypoxia or worsen symptoms in some children. Also beware of sudden temperature changes between day and night, typical of mountain environments, and the presence of local pollen in the summer months.

Children at the beach (pixabay)

That salty air that helps breathing at the seaside . The sea. The marine environment is generally well-tolerated, thanks to the humid, salty air that can help thin mucus and promote breathing. The seaside is recommended for children with asthma-like bronchitis or recurring respiratory symptoms . However, care should be taken with plants typical of Italian coastal areas, such as wild olive, pellitory, or grasses, which can cause seasonal allergies. It is important to avoid exposure during the hottest hours of the day, especially in the presence of high ozone levels or unfavorable weather conditions. Air conditioning can be a valuable aid in improving respiratory health during the warmer months, even for children with asthma or allergic rhinitis, provided it is used correctly.

Hot weather, children at the beach (Getty)

For those staying in the city, "A cool home microclimate, with controlled temperatures and good air quality, helps reduce exposure to environmental pollutants and allergens such as dust, mold, or pollen. However, if used incorrectly, it can contribute to airway irritation, asthma attacks, or respiratory infections. Ultimately, use it, but with common sense," explains Marina Attanasi, member of the SIMRI Advocacy Committee.

Air Conditioner in the Home (Ipa)

The Golden Rules of Temperature for Asthmatic Children For safe use, Simri recommends a few rules: keep the internal temperature between 24-26°C, avoiding dropping below 22°C; never expose the child to direct air flow : position him or her away from the vents; clean the filters regularly, at least once a month during periods of intensive use; monitor humidity: keep it between 40% and 60%; ventilate the rooms every day: even with the air conditioning on, it is essential to promote air exchange; HEPA filters are recommended for children with allergies or severe asthma; in the car: turn the air on before bringing the children in and turn it off just before arriving at your destination to reduce temperature changes.

In the Simri handbook: never interrupt treatment, even on vacation; carry medications and devices with you (in duplicate, if possible); check the expiration date of medications and the charge level of devices: check that medications are not expired and that devices such as aerosols, electronic inhalers, or pulse oximeters are functioning and have adequate batteries/charge ; carry medical prescriptions and the European Health Insurance Card (EHIC). In case of need, especially abroad, having official health documentation facilitates access to treatment; choose your destination taking into account known allergies and environmental and climatic conditions, also consult apps or websites that provide information on air quality and pollen levels in your chosen destination; monitor symptoms: have a diary or an app to report changes in breathing or frequency of bronchodilator use; avoid exposure to smoke, environmental allergens, strong perfumes, and sudden changes in temperature; consult your pediatrician or specialist before departure, especially if changes in altitude, climate, or travel abroad are expected; Find out about healthcare availability in your chosen location: knowing where to find a pediatrician or pharmacy can make all the difference; prepare a small emergency kit, including a bronchodilator, an antihistamine, a copy of your treatment plan, and your doctor's contact information.

And finally, ensure good hydration and protection from the sun, as heat can worsen respiratory symptoms.