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Asthma in Children

What is asthma in children?

Asthma is a long-term (chronic) lung disease that causes your child's airways to become sensitive to certain things (triggers). Several things happen to the airways when a child is exposed to triggers:

  • The lining around the airways swells.
  • The muscles around the airways tighten.
  • The airways make more thick mucus than normal.

All of these things will cause the airways to narrow. This makes it hard for air to go in and out of your child’s lungs and causes asthma symptoms.

What causes asthma in a child?

Experts don't know the exact cause of asthma. They think it is partly passed down through families. But it can also be caused by many other things such as the environment, infections, and chemicals.

Which children are at risk for asthma?

A child is more likely to get asthma if he or she:

  • Has family members with asthma
  • Has environmental allergies, food allergies, or eczema
  • Is around tobacco smoke
  • Is around air pollution
  • Has another health problem such as sinus problems and being overweight

What are the symptoms of asthma in a child?

Symptoms can occur a bit differently in each child. Children with asthma have times when they have few, if any symptoms. They also have times when symptoms flare up. Symptoms may include:

  • Cough that is either constant or comes and goes
  • Wheezing or whistling sound that is heard while your child is breathing
  • Trouble breathing or shortness of breath while your child is active
  • Chest tightness
  • Tiredness
  • Cough at night
  • Noisy breathing

The symptoms of asthma can look like other health conditions. Have your child see his or her healthcare provider for a diagnosis.

How is asthma diagnosed in a child?

To diagnose asthma, your child’s healthcare provider may recommend these tests:

  • Spirometry. This test checks lung function. It uses a device called a spirometer. This test can be done in young children, including babies. But it is most often done in children who are age 6 or older. 
  • Peak flow monitoring . A peak flow meter is used to measure the amount of air a child can blow out of the lungs. This measurement can be done at home. It is often helpful for day-to-day monitoring of asthma symptoms.
  • Chest X-rays. This diagnostic test uses energy beams to make images of internal tissues, bones, and organs on film.
  • Allergy tests. Allergy tests can show if your child has allergies that may be causing asthma or making it worse.

How is asthma treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider may refer you to a pulmonologist. This is a doctor with special training to treat lung conditions. Your child may also be referred to an asthma and allergy specialist. This is a doctor with special training in treating both asthma and allergies. Your child’s treatment is based on how severe the symptoms are and how easily they are controlled. Treatment includes finding triggers and ways to stay away from them. It will also include medicines.

Asthma medicines include:

  • Bronchodilators. These medicines are used to help open the narrowed airways. They may ease coughing, wheezing, shortness of breath, or trouble breathing.
  • Anti-inflammatory medicines (inhaled or oral steroids).  These medicines help ease the inflammation in the airways.
  • Anti-leukotrienes. These medicines help decrease the narrowing of the airways. These are often given by mouth. They are often used to treat mild symptoms.
  • Allergy shots (i mmunotherapy). This can be used to decrease allergies to environmental triggers such as dust, pollen, or animal allergies that can trigger asthma flares in some people.
  • Biologic medicines. These are injected medicines used for certain types of severe asthma. They are available for children age 6 and older.

What are possible complications of asthma in a child?

Asthma that is not well controlled may cause:

  • Severe asthma attacks. These can lead to a stay in the hospital or even death.
  • Lasting damage to the airways
  • Increased time in the hospital or the emergency department
  • Missed school or other activities

What can I do to prevent asthma in my child?

Asthma can’t be completely prevented. There are steps you can take to reduce the chance of your child having asthma. They include:

  • Not being around secondhand smoke
  • Staying away from air pollution

In most children, asthma flare-ups can be prevented by:

  • Staying away from known triggers
  • Carefully managing symptoms
  • Taking medicines as instructed

How can I help my child live with asthma?

You can help manage your child’s asthma by:

  • Finding out your child’s triggers and keeping him or her away from them
  • Giving your child medicine as directed to prevent symptoms
  • Creating and keeping an asthma action plan
    • The action plan has information on your child’s medicines. It also says what to do when symptoms occur, and what to do in an emergency. Your child's provider will review and updat it as needed at each office visit. You can share it with family, babysitters, and school officials.
  • Closely watching asthma symptoms to know when they are getting worse
  • Knowing what to do when asthma gets worse
  • Keeping scheduled follow-up appointments
  • Letting school officials know about your child's asthma and their asthma action plan.

Work with your child’s healthcare provider to find the best way to take care of your child’s asthma. There are guidelines for children from newborn to age 4, ages 5 to 11, and ages 12 and older.

The more information a person with asthma has, the better the asthma can be controlled.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child’s symptoms are not well-controlled. For example, your child is waking at night with symptoms or is having trouble with daily activities. Or your child needs their rescue medicine more often.

Call your child’s healthcare provider or get medical help right away if your child has severe symptoms. These severe symptoms can include:

  • Trouble breathing
  • Trouble sleeping
  • Trouble walking
  • Trouble talking
  • Coughing that won’t go away
  • Wheezing when breathing in and out
  • Wheezing that gets worse after medicine should be working (most quick-relief medicines work within 15 minutes)
  • Feeling faint, dizzy, or weak

Call 911 if your child has any of these:

  • Lips or nails are turning blue
  • Nostrils flare each time he or she inhales
  • Can't talk or walk at a normal pace
  • Rapid breathing (30 or more breaths per minute)

Key points about asthma in children

  • Asthma is a long-term (chronic) lung disease.
  • Symptoms include trouble breathing, wheezing, chest tightness, and coughing.
  • Staying away from the things that cause asthma symptoms (triggers) is an important part of asthma treatment.
  • Medicines are used to prevent and control symptoms during flare-ups.
  • Asthma can cause serious complications if it is not well-controlled.
  • An up-to-date asthma action plan is key to managing asthma.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
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