Childhood Asthma

Asthma is lifelong disease that affects airways, the tubes that carry air in and out of your lungs. Asthma makes the walls of your airways sore and swollen, and also makes them sensitive to things like pollen, pet dander, mold, and dust mites. When your child’s airways react to these things, they can get narrow and deliver less air to the lungs. When these symptoms get very bad, it is called an asthma attack. Severe asthma attacks can be fatal and require emergency medical treatment.

Asthma is a lifelong condition, but there are steps you and your child’s healthcare provider can take to diagnose and treat asthma and prevent asthma attacks.

The list below describes some common asthma symptoms. They’re listed from bad to worse, in the order your child might experience them during a worsening asthma flare-up:

• Coughing. The first thing you might notice is a persistent (ongoing) cough. Nighttime coughing is common.
• Wheezing. You may hear a high-pitched whistling sound as your child breathes out or in. This wheezing means that the air is having trouble moving through their airways.
• Struggling to breathe, chest tightness. Your child might find it hard to breathe and can feel chest pain or tightness.
• Shallow breathing. Your child may find it hard to take a deep breath.
• Fast breathing. As breathing becomes shallow, it may also get faster. Fast breathing for young children is 50 or more breaths a minute while at rest. Adults and older children are breathing fast if they’re taking 30 or more breaths a minute while at rest.
• Retractions. As an asthma flare-up worsens, the skin and muscles between the ribs and at the base of the throat may pull in or “retract” with each breath in. This sign is most often seen in children and means that they are really struggling to breathe.
• Life-threatening symptoms. If an asthma flare-up becomes very severe, retractions and wheezing may actually begin to go away. Breathing will become very shallow, and, because your child’s body isn’t getting enough oxygen, their face and lips may turn slightly blue. Symptoms like these are very dangerous and require immediate emergency care.

You should see a healthcare provider if you think that your child may have asthma. The healthcare provider can give you medicine to prevent asthma attacks.

If your child is showing signs of an asthma attack, get medical care right away. If the attack is severe, take your child to the emergency room. Asthma attacks can be fatal.

We don’t know for sure what causes a child to have asthma. We do know that a person is more likely to have it if someone in their family has it. It is usually present from the time at birth.

For a person who has asthma, we know a lot about what triggers asthma attacks. You can identify these in your environment and take steps to reduce them.

Some of asthma triggers include:

• Animal dander. People aren’t actually allergic to animal fur, but to a substance found in pet dander (flakes of skin) and saliva. Even a short-haired pet or a pet that doesn’t shed will have dander.
• Pollen is a powdery substance made by blooming plants. If your child’s asthma is worse during parts of the year — they may have hay fever or sneezing, itchy nose or eyes — pollen may be a trigger for them.
• Molds grow in warm, damp, and poorly lit places — like a bathroom, closet, basement, and even behind wallpaper — and may cause asthma symptoms.
• Dust mites and cockroaches. These pests can cause allergic responses in people with asthma.
• Eggs, milk, wheat, soy, fish, corn, seafood, nuts, and peanuts are common triggers, as are sulfites, an additive found in processed foods and drinks.

You may find that only some of these triggers affect your child. Asthma triggers are different from person to person. The triggers listed here are some of the most common, but your triggers might not be on this list.

If you or your doctor think your child may have asthma, your doctor will take steps to diagnose this condition. Some things your doctor might do include:

• Physical exam. Your doctor will listen to your child’s breathing and look for signs of asthma. This can include difficulty breathing, wheezing, or allergy symptoms.
• Lung function test. Spirometry (spy-ROM-ih-tree) is a test to check how your lungs are working. During this test, your child breathes into a device that measures how fast they can breathe out and how much air they can breathe in.

These are the most common tests for diagnosing asthma. Your doctor may use other tests if they need more information to diagnose asthma. These tests can help your doctor find related problems:

• Allergy testing can be used to find out if your child is allergic to substances like pollen, pet dander, dust mites, or foods.
• Lung function testing to measure how your child’s lungs work during physical activity and see if their asthma is triggered. This test is called bronchioprovocation (bron-KEY-oh-PRAH-voh-KAY-shun).
• Tests for similar conditions like reflux disease, vocal cord dysfunction, or sleep apnea can help your doctor rule out other possible conditions.
• An x-ray or EKG can be used to take a picture of your child’s lungs and airways so that your doctor can look for foreign objects or other diseases.

Asthma can be harder to diagnose in children who are less than 5 years old, because children often have other conditions that are similar to asthma, like colds or respiratory infections. If your healthcare providers thinks your child has asthma, they may ask questions about your family history or whether your child has had an allergic reaction to pollen or other allergens.

Asthma is a lifelong disease, but your treatments can help with your child’s asthma symptoms. You and your child can also take steps on your own that will help make prevent symptoms.

Common treatments include:

• Avoiding asthma triggers. Dander, pollen, mold, dust mites, and specific foods can all trigger asthma. While exercise can also trigger asthma, staying active can keep your child’s lungs strong and reduce asthma attacks.
• Quick relief medicines. Your doctor may prescribe your child a quick-acting inhaler that can be used in case your child has an asthma attack.
• Long-term control medicines. These medicines won’t stop an asthma attack that is already happening, but if they are taken every day they can reduce your child’s asthma symptoms.

Your child’s healthcare provider can help you make an Asthma Action Plan to know how to respond to asthma symptoms.

You can work with your child’s healthcare providers to learn how to prevent asthma attacks. The first steps are to:

• Learn to recognize your symptoms. Knowing the signs that your child’s asthma is out of control can help you take early action to avoid or ease a flare-up.
• Learn what triggers your child’s asthma so you can avoid it. A trigger is anything—a condition, a substance, an activity—that makes asthma worse. Common triggers include:
  • Irritants in the air such as tobacco smoke, chimney smoke, kerosene heaters
  • Allergens such as pet dander, pollen, mold, dust mites, cockroaches droppings, or certain foods
  • Respiratory infections such as a cold or the flu
  • Certain weather conditions
  • Emotional stress

National Heart, Lung, and Blood Institute

Centers for Disease Control and Prevention

Asthma is a disease that affects airways in your lungs. Asthma makes airways sore, swollen, and sensitive to triggers like pollen, pet dander, mold, and dust mites. These triggers make your airways narrow and bring less air to your child’s lungs. Severe asthma symptoms can cause an asthma attack, which is an emergency that requires immediate medical treatment.