Playing sports is a great way for kids to improve their health and wellbeing. However, it’s natural to be apprehensive about your child joining a sports team if they have a chronic medical condition such as asthma or diabetes; particularly if you are not going to be present – for example, at school or at after school training sessions.

Children should be encouraged to exercise regardless of most illnesses, and being well prepared can help things go more smoothly and calm your nerves. Here are some tips for managing kids’ medicines on the sports field with examples of common conditions and medicines for children.

Do your off-field preparation

It is often possible to manage your child’s condition so that they won’t need a medicine while they are playing (e.g. by taking an appropriate puffer before the game). However, make sure the person responsible for your child knows about their condition and what they might need to do if the child has symptoms requiring treatment, or has a medical emergency.

It’s all about the pre-game talk

The coach, the sports teacher or other adults responsible for your child may have no experience with the same health condition or medicines as your child. Simple clear instructions will help everyone. Make sure they have a record of the name of any medicine your child might need, how it should be given and any side effects your child may experience. Start this conversation early in case someone at the sports club or school needs to be trained.

Check if there is a written policy outlining the training and guidelines that the coaches, etc. have received — for example, whether or not they will give your child their asthma medicine or allow them immediate access to it, and the procedures they need to follow in the event of an emergency. A school is likely to have one, but a small sports club or individual team may not. Knowing if there is someone in charge of first aid or if there are restrictions on who is and isn’t allowed to handle and administer medicines can help you to identify the best person to talk to about your child’s medicine needs. Issues to discuss include: if any training is required for using the medicine, any gaps in the care provided (e.g. different coaches each week) or where to store the necessary medicines.

Have a game plan  

Let the coach know about any plan or instructions for managing your child’s medical condition. Discuss a place where a written plan can be easily accessible at short notice. If your child has a chronic illness then they probably already have a written management plan. If not, ask your child’s doctor to help you develop a plan for managing their illness during sporting activity.

Remember that if your child’s asthma is well managed in general, the less likely they are to suffer an attack when they are exercising. Also, some sports or types of exercise might be more or less suitable for your asthmatic child – e.g. running on a cold dry morning frequently brings on asthma whereas swimming at an equivalent pace in a heated pool rarely does so.

If your child has asthma, provide an up-to-date asthma plan outlining what to do if their asthma symptoms worsen, and which medicines they need. Include instructions, or a demonstration, of how to correctly use puffers, metered dose inhalers, and delivery aids such as spacers, so that administering the medicine isn’t a problem if needed. Ensure that your child knows how to use their inhalers (assuming they are not too young to do this). A guide on how to use asthma devices can be found on the NPS MedicineWise website.

In some cases you might want to let the coach know what triggers your child’s asthma (e.g. exercise in cold temperatures).

All children with diabetes should have an individual diabetes plan which is updated at least once a year, or whenever there are changes to their treatment. You can get a diabetes plan from your diabetes educator. It makes no difference whether your child has type 1 or type 2 diabetes, if they take injected or oral medicines, use an insulin pump, or simply manage their condition with diet. None of these treatments should stop them from participating fully in sports.

However, children may still experience blood glucose highs (hyperglycaemia) and lows (also known as ‘hypos’ orhypoglycaemia) when they exercise, especially with certain diabetes medicines — in particular insulin. A ‘hypo’ is more likely during exercise, so make sure the coach knows what to look for (e.g. shakiness, weakness, light-headedness) and will stop your child exercising immediately if they show the signs. Give the coach some jellybeans, glucose tablets or juice to give to your child if they experience a hypo.

Action plans are critical for children with severe allergies. Inform the coach if your child has allergies, what an allergic reaction might look like and what steps to take if your child becomes ill. If your child has an adrenaline autoinjector (Anapen and EpiPen), the coach, teacher or supervising adult will need to know how to use it. It’s also important that they understand how critical this is and that if in doubt, its better to give adrenalin than to delay treatment.  Illustrated action plans showing the use of Anapen and EpiPen are available from The Australasian Society of Clinical Immunology and Allergy website for your doctor to fill out (go to ‘Anaphylaxis resources’).

Your child’s adrenaline autoinjector should be stored in a cool dark place (between 15°C and 25°C), but not in the fridge. Store the autoinjector where it can be quickly and easily accessed – don’t lock it away in a locker somewhere. Check the expiry date and make a note in your diary to replace the autoinjector as necessary.

Antibiotics and pain relievers   
Most children will at some time have short-term medical needs, including antibiotics for bacterial infections (such as a skin infection) or pain relief medicines like paracetamol (e.g. Panadol) or ibuprofen (e.g. Nurofen). There is no medical reason for them to not participate in sports while taking these medicines. However, if they are not feeling very well and should probably give sports a miss until they are better. Also, in some cases (e.g. a skin or chest infection), your child could still be contagious for around 24 hours after starting antibiotics and shouldn’t really be mixing closely with other children.

The game strategy

* Make sure the coach has your phone number and can contact you in an emergency.

* Supply the coach with a small quantity of any medicine and related equipment (e.g. asthma spacer or oral syringe for measuring liquid medicines) that may be required.

* Make sure each item is clearly labelled with your child’s full name.

* Check the expiry date of the medicine and replace it before it runs out.

* Supply the coach with all the medicine packaging so they are able to check and follow the dosing instructions when giving the medicine.

* Ensure medicines are stored appropriately – most medicines should be stored in their original container, in a cool dry place at room temperature (below 25°C or 30°C).

* Keep medicines out of reach of children, but easily accessible for adults in an emergency.

* Make sure your child knows where their medicine is stored and who to go to to access it.

Keep everyone involved up to date with your child’s condition and make sure you are kept up to date with when and how medicines have been given to your child during sports. Strong and open communication between yourself and the coach is the key to ensuring your child’s health, safety and enjoyment on the sports field.