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's 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 they:

• Have family members with asthma

• Have environmental allergies, food allergies, or eczema

• Are around tobacco smoke

• Are around air pollution

• Have another health problem, such as sinus problems or 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 their healthcare provider for a diagnosis.

How is asthma diagnosed in a child?

To diagnose asthma, your child’s healthcare provider will ask about your child's symptoms, possible triggers, family history, and health history. They may recommend these tests:

• Spirometry. This test checks lung function. It uses a device called a spirometer. This test 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 specific 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 your child to a pulmonologist. This is a healthcare provider with special training to treat lung conditions. Your child may also be referred to an asthma and allergy specialist. This is a healthcare provider 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.

• Allergy shots (immunotherapy). 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 ages 6 and older.

Asthma medicines can be given in different ways. They may be given as a pill, inhaler, nebulizer, or injection. Your child's healthcare team can help you know how to use the inhaler or nebulizer correctly.

Some asthma medicines such as a rescue inhaler work quickly to relieve asthma symptoms. Other medicines help with long-term asthma control and shouldn't be used in an emergency. Make sure you know which medicines are for quick relief. Ask your child's healthcare provider any questions you have about your child's medicines and when to use them.

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 directed

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 them away from the triggers

• Not letting your child smoke or use e-cigarettes

• Giving your child medicine as directed to prevent symptoms

• Keeping your child up to date on vaccines as directed by their healthcare provider

• Creating and keeping an Asthma Action Plan

  • The Asthma 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 healthcare provider can help you fill it out and update 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 or childcare providers 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

Call 911right away if your child has any of these:

• Symptoms or conditions as directed by your Asthma Action Plan

• Lips or nails are turning blue

• Nostrils flare each time they inhale

• Can't talk or walk at a normal pace

• Rapid breathing (30 or more breaths per minute)

• The skin between your child's ribs or under their neck sinks in when they breathe (retractions)

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 important 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.