What is asthma in children?

Asthma in children: Overview

Asthma makes it hard for your child to breathe. During an asthma attack, the airways swell and narrow. Severe asthma attacks can be life-threatening, but you can usually prevent them. Controlling asthma and treating symptoms before they get bad can help your child avoid bad attacks. You may also avoid future trips to the doctor.

How does asthma develop in children?

Asthma usually develops before age 5. In most cases of persistent asthma, the first symptoms (such as wheezing) start in the first years of life.

But it's likely that your child won't develop asthma even if your child wheezes as an infant.

It's also hard to predict if your child will still have asthma as a teen or an adult.

  • In most cases of intermittent asthma associated with respiratory infections (rather than allergies), symptoms tend to become less severe and may go away by the teen years.
  • Children who have moderate to severe asthma may still have asthma as a teen or adult.

What are the symptoms of asthma in children?

When your child has asthma, he or she may wheeze or cough a lot. Your child may also feel tightness in the chest or feel short of breath.

How is asthma treated in babies and younger children?

Babies and small children need early treatment for asthma symptoms to prevent severe breathing problems. They may have more serious problems than adults because their bronchial tubes are smaller.

Babies and young children may be treated with oral or inhaled medicines.

Even if your child's asthma does not appear severe, work with your doctor to make the right plan for your child.

Treatment also includes things you can do to help your child manage asthma, like avoiding things that might trigger symptoms and following an asthma action plan.

Testing for Asthma in Children

Long-Acting Bronchodilators for Your Child

Do children who have asthma need to see a specialist?

Health professionals who can diagnose and treat asthma include:

  • Pediatricians.
  • Family medicine physicians.
  • Nurse practitioners.
  • Physician assistants.
  • Internists.

Your child may need to see a specialist (an allergist or pulmonologist) if your child:

  • Has moderate persistent to severe persistent asthma.
  • Has other health conditions that make it hard to treat asthma.
  • Is not meeting the goals of treatment after several months of therapy.
  • Has had a severe asthma attack.
  • Needs skin testing for allergies.

How can you care for asthma in your child age 12 years or older?

Action plan

  • Make and follow an asthma action plan. It lists the medicines your child takes every day and will show you what to do if your child has an attack.
  • Work with a doctor to make a plan if your child does not have one. It's important that your child take part in writing the plan.
  • Tell adults at school that your child has asthma. Give them a copy of the action plan. They can help during an attack.

Medicines

  • Your child may take an inhaled corticosteroid every day. It keeps the airways from swelling.
  • Your child will take quick-relief medicine for an asthma attack. This is usually inhaled albuterol. It relaxes the airways to help your child breathe.
  • If your doctor prescribed corticosteroid pills for your child to use during an attack, give them to your child as directed. They may take hours to work, but they may shorten the attack and help your child breathe better.

Check your child's breathing

  • Check your child for asthma symptoms to know which step to follow in your child's action plan. Watch for things like being short of breath, having chest tightness, coughing, and wheezing. Also notice if symptoms wake your child up at night or if your child gets tired quickly during exercise.
  • If your child has a peak flow meter, use it to check how well your child is breathing. This can help you predict when an asthma attack is going to occur. Then your child can take medicine to prevent the asthma attack or make it less severe.

Keep your child away from triggers

  • Try to learn what triggers your child's asthma attacks, and avoid the triggers when you can. Common triggers include colds, smoke, air pollution, pollen, mold, pets, cockroaches, stress, and cold air.
  • If tests show that dust is a trigger for your child's asthma, try to control house dust.
  • Talk to your child's doctor about whether to have your child tested for allergies.

Other care

  • Have your child wash their hands often to prevent infections.
  • Have your child drink plenty of fluids.
  • Encourage your child to be physically active, including playing on sports teams. If needed, using medicine right before exercise usually prevents problems.
  • Have your child get an annual flu vaccine. Ask your doctor if your child is up to date on their COVID-19 vaccines.

Helping Your Child Deal With Asthma

What puts your child at risk for asthma?

Your child may be more likely to have asthma if:

Someone in your family has asthma.

Asthma may run in families (be inherited). If this is the case in your family, your child may be more likely than other children to get long-lasting (chronic) inflammation in the airways.

Your child or someone in your family has an allergy, including food allergies.

Children who have an allergy are more likely than other children to get asthma, though not every child with allergies gets asthma. And not every child with asthma has allergies.

Most children with asthma have allergic rhinitis, atopic dermatitis, or both. Having atopic dermatitis as a child may also increase the risk of a person having more severe and persistent asthma as an adult.

Your child had respiratory syncytial virus (RSV) and wheezing at a young age.

Early infection with respiratory syncytial virus that causes a lower respiratory infection increases a child's risk for wheezing. Young children who wheeze have a greater risk for asthma than children who do not wheeze.

Your child’s airways overreact.

Children who inherit a tendency of the airways (bronchial tubes) to overreact often get asthma.

Other risk factors

Other things that may put your child at risk for asthma include:

Secondhand cigarette smoke.

Children who are around secondhand cigarette smoke are at increased risk for getting asthma. If children already have asthma, secondhand smoke makes their symptoms worse.

Cigarette smoking.

Children who smoke are more likely to get asthma when they become teenagers.

Cigarette smoking during pregnancy.

Women who smoke during pregnancy increase the risk of wheezing in their babies. Babies whose mothers smoked during pregnancy also have worse lung function than babies whose mothers did not smoke.

Obesity.

There is a link between obesity in children and asthma. But the reason for the link is unclear. Also, symptoms caused by obesity are sometimes thought to be asthma symptoms.

Exposure to allergens.

Being exposed to allergens such as dust mites, cockroaches, and pet dander may increase a child’s risk for asthma.

Environment.

Environmental factors, such as pollution or dust, may play a role in the development of asthma. Exposure to these things may cause children's immune systems to develop in a way that makes it more likely they will develop allergies or asthma.

How do you educate yourself and your child about asthma?

Educating yourself and your family about asthma is essential for you and your child to have control of the disease. If you understand asthma, you will have an easier time following the different aspects of treatment, such as avoiding substances that cause symptoms (triggers) and knowing what to do during an asthma attack.

Educate yourself or your child about:

Asthma.

Learn all that you can from your doctor about asthma, such as the long-term effects of not treating asthma and the best ways for you or your child to manage the disease.

Medicines.

Learn all that you can about how each of your medicines or your child's medicines helps to treat asthma. Find out about side effects that may occur and what to do if side effects become bothersome.

Part of education is effectively communicating what you don't understand and what you are concerned about.

  • Always ask questions when you don't understand something about the treatment.
  • Discuss any fears and concerns that you or your child may have regarding treatment.
  • Tell your doctor if treatment is disrupting your life; you may be able to find another way to treat your asthma with less disruption.
  • Tell your doctor if treatment is not helping asthma attacks.
  • Tell your doctor if you are not able to follow any aspect of your treatment.

If your child has asthma, you may want to talk with teachers and other school officials about asthma. They can help your child follow his or her treatment plans. You should have a copy of your child's asthma action plan (which tells what to do during an asthma attack) on file in the school office, with the school nurse, and with sports coaches so that school staff will know what to do if your child has an attack at school.

What causes asthma attacks in children?

Asthma attacks happen due to:

  • Long-term (chronic) inflammation in the tubes that carry air to the lungs (bronchial tubes). Inflammation leads to overreaction (hyperresponsiveness) of the tubes to triggers.
  • Tightening of the smooth muscles in the bronchial tubes, causing the airways to get smaller. This reduces airflow in and out of the lungs.
  • Extra mucus produced by the mucous glands in the bronchial tubes. This can occur in some children who have asthma and can interfere with airflow.

Anything that makes your child's asthma or breathing worse can cause an asthma attack.

It may be things that your child is allergic to, such as:

  • Pollen.
  • Dust or dust mites.
  • Pet dander.
  • Cockroaches.
  • Mold.

Other things can cause an asthma attack too, such as:

  • Cigarette smoke, air pollution, and chemicals.
  • A cold, the flu, or another type of upper respiratory infection.
  • Exercise. Many children with asthma have symptoms when they exercise.
  • Dry, cold air.
  • Medicines, such as nonsteroidal anti-inflammatory drugs.
  • Changes in hormones, such as during the start of a girl's menstrual blood flow at puberty.

How does asthma affect your child's life?

Asthma is a challenging condition. It can affect all areas of your child's life.

  • Many children who have asthma miss school days. When this happens, have your child call a friend to ask about the work that was missed. Doing this both helps your child keep up with schoolwork and gives some of the social contact that school provides.
  • Children may doubt their ability to do sports or be in the band. But if your child uses the medicines and keeps asthma symptoms under control, they will likely be able to do these activities.
  • Children may be embarrassed about taking medicine at school. It may help if your child can take the medicine at home or is allowed to keep the medicine with them at school. At times, though, your child may need to go to the school nurse or office to take medicine.
  • Children may feel they are different from their peers because of the need to avoid situations that trigger asthma symptoms, such as going to the homes of friends who have pets. Inviting those friends to your home can help your child interact with other children. But visitors may carry pet allergens on their clothing and other items. Be aware that your child may need to increase the use of asthma-control medicines during such visits.
  • Children may be concerned about having an asthma attack at school or around friends. They may fear that they will not be able to breathe during an attack. If symptoms are controlled daily, children will have fewer, less severe asthma attacks.

If your child's asthma is causing you or your child anxiety, there are things that can help with that, like counseling or family therapy.

What is asthma in children?

Asthma is a lung disease that makes it hard for your child to breathe. It causes the airways that lead to the lungs to swell and get inflamed.

Some children have breathing problems only at certain times, like during allergy season, or when they get a cold, or when they exercise. Others have breathing problems a lot of the time.

When asthma symptoms suddenly get worse (or flare up), the airways tighten and get narrower. These flare-ups are also called asthma attacks or exacerbations (say "ig-ZAS-ur-BAY-shuns").

Treatment can help your child feel and breathe better and help keep your child's lungs healthy. Many children with asthma play sports and live healthy, active lives.

What causes asthma in children?

Experts don't know exactly what causes asthma in children. But we do know that asthma runs in families. And it's much more common in children who have allergies.

Using peak flow to help manage your child's asthma

Follow these tips to use peak flow to help your child manage asthma.

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    Find your child's personal best peak flow.

    Keep a diary of your child's peak flow when their asthma is under control. The doctor will let you know how long to do this. Your child's personal best peak flow is the highest number in the diary.

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    Work with your child's doctor to make an asthma action plan.

    The doctor will add peak flow numbers to each zone in the action plan. The numbers are based on your child's personal best peak flow.

    • Your child is in the green zone when their peak flow number is close to their personal best. It's where you want your child to be.
    • Your child is in the yellow zone when their peak flow number is much lower than their personal best. Their asthma may be getting worse.
    • Your child is in the red zone when their peak flow number is very low. It means danger. Get medical help.
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    Check your child's peak flow to find which zone your child is in.

    Or you can use your child's symptoms and peak flow to find the zone. Check your child's peak flow as often as your doctor recommends.

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    Follow the steps in the action plan for the zone your child is in.

    This can include what medicines to give and when to call for help.

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    Ask the doctor how often to recheck your child's personal best peak flow.

    If it's changed, the numbers on your child's action plan may need to be changed.

Asthma in children 12 years and older: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child has severe trouble breathing.

Call your doctor now or seek immediate medical care if:

  • Your child has an asthma attack and does not get better after you use the action plan.
  • Your child coughs up yellow, dark brown, or bloody mucus (sputum).

Watch closely for changes in your child's health, and be sure to contact your doctor if:

  • Your child's wheezing and coughing get worse.
  • Your child needs quick-relief medicine on more than 2 days a week within a month (unless it is just for exercise).
  • Your child has any new symptoms, such as a fever.

Arthur Explains Asthma

Arthur's parents wave goodbye while Arthur walks into the park

Hi. I'm Arthur. I have asthma. Here I am going to Day Camp in the park.

When I was first getting used to having asthma, I didn't want to spend all day away from my parents. I worried about having a breathing problem. But I learned some things about how to take care of my asthma. And I learned how to get help when I need it. Now I don't worry anymore!

Arthur shows what his lungs look like, with a close-up of the tubes

Having asthma means that sometimes I have a hard time getting air into my lungs. See, lungs have tubes in them. Air moves through those tubes with each breath.

When my lungs are working their best, the tubes are wide open. Like a big straw! But when I have an asthma episode, the tubes get smaller. Then there's not as much room for air to get through. It's kind of like when you chew on a straw and then it doesn't work so great.

How Arthur feels before an asthma episode, when one is starting, and when the episode gets bad

Here's what an asthma episode feels like to me.

First, I feel just fine. Then my chest starts to feel tight and kind of itchy inside. After that, my breaths start to sound a little funny. It's kind of like the sound a cat makes when it purrs. But a big cat, like a tiger or something! Because I'm much bigger than a house cat. If the episode keeps going, it gets hard for me to take a breath. I cough a lot, and I have trouble talking.

It was scary at first. But now things are better. I learned that there are things I can do to help take care of my asthma.

Arthur thinks about pollen on flowers, dust from a dog digging, and smoke from a grill

I keep an eye out for the things that can cause my breathing problems. My doctor calls those things "triggers."

It took a while for my parents and me to figure out what my triggers are. After a while, we learned that things like dust, pollen from plants, and smoke in the air give me problems. So I try to watch out for those things.

I know other kids who have different triggers. They have problems when they spend too much time around a cat, or when they run.

Arthur holds his asthma plan, thinking about the pill he takes and the inhaler he uses

Medicines help my asthma too. So I make sure to always take mine like I'm supposed to. I take a pill every day. And I use my inhaler when I need it.

Sometimes when other kids see my inhaler, they want to learn about it. So I tell them what it does. But I never share my inhaler. The medicine in it helps me because I need it. But it could hurt kids who don't need it.

I also have a special plan for what to do if I start to have trouble breathing. Grown-ups like my school nurse and my camp leader have copies of my plan too. That way, they know how to help me if I need it.

Arthur and his camp leader show each other their inhalers

And guess what? I learned that my camp leader has asthma too! So she knows all about asthma plans and inhalers. Her inhaler looks different than mine. But they both do the same thing.

My camp leader said she learned she had asthma when she was my age. She told me about all kinds of famous people who have asthma too. Even actors, and presidents, and sports stars!

Arthur and his camp leader run a three-legged race

Even though I have asthma, I can still do most things other kids can do. I just make sure I pay attention to how I'm feeling. And I tell a grown-up if I start to feel the signs of an asthma episode. Then we follow my plan for what to do.

On the last day of camp, I even won the three-legged race with my camp leader!

She said, "Arthur, we make a good camp team! When you get older, you could be a camp leader too."

That sounds like a pretty good job. I told her that if I decide not to be an actor or the president, then I'll think about it.

What things does Arthur do to help his asthma that might help you too? How does it feel to you when you start to have an episode? Do you know what your asthma triggers are yet? If not, what might help you figure them out?

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