Filed under: Children's Health
With childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as airborne pollen. In other cases, childhood asthma flares up with a cold or other respiratory infection. Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, unmanaged asthma can cause dangerous asthma attacks.
Childhood asthma isn't a different disease than asthma in adults, but children do face unique challenges. Asthma in children is a leading cause of emergency department visits, hospitalizations and missed school days. Unfortunately, childhood asthma can't be cured and symptoms may continue into adulthood. But with the right treatment, you and your child can keep symptoms under control and prevent damage to growing lungs.
Common childhood asthma signs and symptoms include:
Other signs and symptoms of childhood asthma include:
The first signs of asthma in young children may be recurrent wheezing triggered by a respiratory virus. As children grow older, asthma associated with respiratory allergies is more common.
Asthma signs and symptoms vary from child to child, and may get worse or better over time. While wheezing is most commonly associated with asthma, not all children with asthma wheeze. Your child may have only one sign or symptom, such as a lingering cough or chest congestion.
It may be difficult to tell whether your child's symptoms are caused by asthma or something else. Periodic or long-lasting wheezing and other asthma-like symptoms may be caused by infectious bronchitis or another respiratory problem.
When to see a doctor
Take your child to see the doctor as soon as possible if you suspect he or she may have asthma. Early treatment will not only help control disruptive asthma flare-ups, it may also prevent permanent lung changes that can worsen asthma symptoms.
Make an appointment with your child's doctor if you notice:
If your child has asthma, he or she may say things such as, "My chest feels funny" or "I'm always coughing." Asthma can be worse at night, so listen for coughing during sleep or coughing that wakes your child. Crying, laughing, yelling, or strong emotional reactions and stress also may trigger coughing or wheezing.
If your child is diagnosed with asthma, creating an asthma action plan can help you and other caregivers monitor symptoms and know what to do if an asthma attack does occur.
When to seek emergency treatment
Even if your child hasn't been diagnosed with asthma, seek medical attention immediately if he or she has any trouble breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing, which progresses to wheezing and labored breathing.
Severe asthma symptoms
In severe cases, you may see your child's chest and sides pulling inward as he or she struggles to breathe. Your child may have an increased heartbeat, sweating and chest pain. Seek emergency care if your child:
The underlying causes of childhood asthma aren't fully understood. Developing an overly sensitive immune system generally plays a role. Some factors thought to be involved include:
Increased immune system sensitivity causes the lungs and airways to easily become swollen and produce mucus when exposed to certain triggers. These triggers vary from child to child and can include:
Sometimes, asthma symptoms occur with no apparent triggers.
Factors that may increase your child's likelihood of developing asthma include:
Asthma may cause a number of complications, including:
You're likely to start by taking your child to your family doctor or your child's pediatrician. However, when you call to set up an appointment, you may be referred immediately to an allergist, lung doctor (pulmonologist) or other specialist. Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your child's appointment, and what to expect from the doctor.
What you can do
These steps can help you make the most of your child's appointment:
Time with your child's doctor is limited, so prepare a list of questions to help you make the most of the appointment. List your questions from most important to the least important. For asthma or asthma-like symptoms, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you during your child's appointment.
What to expect from your child's doctor
The doctor is likely to ask a number of questions, which may include:
Asthma can be hard to diagnose. Your child's doctor will consider the nature and frequency of symptoms and may use tests to rule out other conditions to identify the most likely cause of his or her symptoms.
A number of childhood conditions can have symptoms similar those caused by asthma. To make things more complicated, these conditions also commonly co-occur with asthma. So your child's doctor will have to determine whether your child's symptoms are caused by asthma, a condition other than asthma, or both asthma and another condition. Some conditions that can cause asthma-like symptoms include:
The doctor will ask for a detailed description of your child's symptoms and health. Your child may also need medical tests.
If you suspect your child has asthma, it's important to see a doctor as soon as possible. Early diagnosis and proper treatment can prevent disruptions from daily activities such as sleep, play, sports and school. It may also prevent dangerous or life-threatening asthma attacks.
For children younger than age 3 who have symptoms of asthma, the doctor may use a wait-and-see approach. This is because the long-term effects of asthma medication on infants and young children aren't clear. If an infant or toddler has frequent or severe wheezing episodes, a medication may be prescribed to see if it improves symptoms.
Allergy skin tests for allergic asthma
If your child seems to have asthma that's triggered by allergies, the doctor may want to do allergy skin testing. During a skin test, the skin is pricked with extracts of common allergy-causing substances and observed for signs of an allergic reaction. This test may help identify whether your child is allergic to animal dander, mold, dust mites or other allergens. This information can be useful in taking steps to help your child avoid his or her particular asthma triggers.
The goal of asthma treatment is to keep symptoms under control all of the time. Well-controlled asthma means that your child has:
Treating asthma involves both preventing symptoms and treating an asthma attack in progress. Preventive, long-term control medications reduce the inflammation in your child's airways that leads to symptoms. Quick-relief medications quickly open swollen airways that are limiting breathing. Most children with persistent asthma use a combination of long-term control medications and quick-relief medications, taken with a hand-held inhaler.
In some cases, medications to treat allergies also are needed. The right medication for your child depends on a number of things, including his or her age, symptoms, asthma triggers and what seems to work best to keep his or her asthma under control.
Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:
Also called rescue medications, quick-relief medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your child's doctor recommends it. Types of quick-relief medications include:
Treatment for allergy-induced asthma
If your child's asthma is triggered or worsened by allergies, your child may benefit from allergy treatment as well. Allergy treatments include:
Don't rely only on quick-relief medications
Long-term asthma control medications such as inhaled corticosteroids are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely your child will have an asthma attack.
If your child does have an asthma flare-up, a quick-relief (rescue) inhaler can ease symptoms right away. But if long-term control medications are working properly, your child shouldn't need to use a quick-relief inhaler very often. Keep a record of how many puffs your child uses each week. If he or she frequently needs to use a quick-relief inhaler, take your child to see the doctor. You probably need to adjust his or her long-term control medication.
Inhaled medication devices
Inhaled short- and long-term control medications are used by inhaling a measured dose of medication.
Asthma action plan
Work with your child's doctor to create a written asthma action plan. This can be an important part of treatment, especially if your child has severe asthma. An asthma action plan can help you and your child:
Depending on his or her age, your child may use a hand-held device to measure how well he or she can breathe (peak flow meter). Using a written asthma action plan can help you and your child remember what to do when peak flow measurements reach a certain level. The action plan may use peak flow measurements and symptoms to categorize your child's asthma into zones, such as the green zone, yellow zone and red zone. These zones correspond to well-controlled symptoms, somewhat-controlled symptoms and poorly controlled symptoms. This makes tracking your child's asthma easier.
Your child's symptoms and triggers are likely to change over time. You'll need to carefully observe symptoms and work with the doctor to adjust medications as needed. If your child's symptoms are completely controlled for a period of time, your child's doctor may recommend lowering doses or taking your child off a medication (stepping down treatment). If your child's asthma isn't as well controlled, the doctor may want to increase, change or add medications (stepping up treatment).
Taking steps to reduce your child's exposure to his or her asthma triggers will lessen the possibility of asthma attacks. Steps to help avoid triggers vary depending on what triggers your child's asthma. Here are some things that may help:
Help your child stay healthy
Staying active and treating other conditions linked to asthma will help keep your child's asthma under control.
While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative treatments that may help with asthma include:
It can be stressful to help your child manage his or her asthma. Keep these tips in mind to make life as normal as possible:
Careful planning and steering clear of asthma triggers are the best ways to prevent asthma attacks.