In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling pollen or catching 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 from asthma in adults, but children face unique challenges. The condition is a leading cause of emergency department visits, hospitalizations and missed school days.
Unfortunately, childhood asthma can't be cured, and symptoms can 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:
Childhood asthma might also cause:
Asthma signs and symptoms vary from child to child, and might get worse or better over time. Your child might have only one indication, such as a lingering cough or chest congestion.
It can be difficult to tell whether your child's symptoms are caused by asthma. Periodic or long-lasting wheezing and other asthma-like symptoms can be caused by infectious bronchitis or another respiratory problem.
Take your child to see the doctor if you suspect he or she has asthma. Early treatment will help control symptoms and possibly prevent asthma attacks.
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." Listen for coughing, which might not wake your child, when he or she is asleep. Crying, laughing, yelling, or strong emotional reactions and stress also might trigger coughing or wheezing.
If your child is diagnosed with asthma, creating an asthma plan can help you and other caregivers monitor symptoms and know what to do if an asthma attack occurs.
In severe cases, you might see your child's chest and sides pulling inward as he or she struggles to breathe. Your child might have an increased heartbeat, sweating and chest pain. Seek emergency care if your child:
Even if your child hasn't been diagnosed with asthma, seek medical attention immediately if he or she has trouble breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing, which progresses to wheezing and labored breathing.
Childhood asthma causes aren't fully understood. Some factors thought to be involved include:
Increased immune system sensitivity causes the lungs and airways to swell and produce mucus when exposed to certain triggers. Reaction to a trigger can be delayed, making it more difficult to identify the trigger. Triggers vary from child to child and can include:
Sometimes, asthma symptoms occur with no apparent triggers.
Factors that might increase your child's likelihood of developing asthma include:
Asthma can cause a number of complications, including:
Careful planning and avoiding asthma triggers are the best ways to prevent asthma attacks.
See the doctor when necessary. Check in regularly. Don't ignore signs that your child's asthma might not be under control, such as needing to use a quick-relief inhaler too often.
Asthma changes over time. Consulting your child's doctor can help you make needed treatment adjustments to keep symptoms under control.
Asthma can be hard to diagnose. Your child's doctor will consider the symptoms and their frequency and your child's medical history. Your child might need tests to rule out other conditions and to identify the most likely cause of the symptoms.
A number of childhood conditions can have symptoms similar to those caused by asthma. To complicate the issue further, these conditions also commonly 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.
Conditions that can cause asthma-like symptoms include:
The following are tests your child might need.
Lung function tests (spirometry). Doctors diagnose asthma with the same tests used to identify the disease in adults. Spirometry measures how much air your child can exhale and how quickly. Your child might have lung function tests at rest, after exercising and after taking asthma medication.
Another lung function test is brochoprovocation. Using spirometry, this test measures how your lungs react to certain provocations, such as exercise or exposure to cold air.
The asthma tests used, however, aren't accurate before 5 years of age. For younger children, your doctor will rely on information you and your child provide about symptoms. Sometimes a diagnosis can't be made until later, after months or even years of observing symptoms.
If your child seems to have asthma that's triggered by allergies, the doctor might recommend allergy skin testing. During a skin test, the skin is pricked with extracts of common allergy-causing substances, such as animal dander, mold or dust mites, and observed for signs of an allergic reaction.
Initial treatment depends on the severity of your child's asthma. The goal of asthma treatment is to keep symptoms under control, meaning that your child has:
Treating asthma involves both preventing symptoms and treating an asthma attack in progress. The right medication for your child depends on a number of things, including age, symptoms, asthma triggers and what seems to work best to keep his or her asthma under control.
For children younger than age 3 who have mild symptoms of asthma, the doctor might use a wait-and-see approach. This is because the long-term effects of asthma medication on infants and young children aren't clear.
However, if an infant or toddler has frequent or severe wheezing episodes, a medication might be prescribed to see if it improves symptoms.
Preventive, long-term control medications reduce the inflammation in your child's airways that leads to symptoms. In most cases, these medications need to be taken daily.
Types of long-term control medications include:
Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex HFA), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler) and others. Your child might need to use these medications for several days to weeks before getting the full benefit.
Long-term use of these medications has been associated with slightly slowed growth in children, but the effect is minor. In most cases, the benefits of good asthma control outweigh the risks of possible side effects.
Combination inhalers. These medications contain an inhaled corticosteroid plus a long-acting beta agonist (LABA). They include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), fluticasone and vilanterol (Breo Ellipta), and mometasone and formoterol (Dulera).
In some situations, long-acting beta agonists have been linked to severe asthma attacks. For this reason, LABA medications should always be given to a child with an inhaler that also contains a corticosteroid. These combination inhalers should be used only for asthma that's not well-controlled by other medications.
Quick-relief medications quickly open swollen airways. 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:
If your child's asthma is triggered or worsened by allergies, your child might benefit from allergy treatment, such as the following, as well:
Long-term asthma control medications such as inhaled corticosteroids are the cornerstone of asthma treatment. These medications keep asthma under control and make it less likely that 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 the long-term control medication.
Inhaled short- and long-term control medications are used by inhaling a measured dose of medication.
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:
Children who have enough coordination and understanding might use a hand-held device to measure how well they can breathe (peak flow meter). 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 might 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 observe symptoms and work with the doctor to adjust medications as needed.
If your child's symptoms are completely controlled for a time, your child's doctor might recommend lowering doses or stopping asthma medications (step-down treatment). If your child's asthma isn't as well-controlled, the doctor might want to increase, change or add medications (step-up treatment).
Taking steps to reduce your child's exposure to 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:
While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to determine possible side effects. Alternative treatments to consider include:
Herbal remedies and supplements. A few herbal remedies have been tried for asthma, including black seed, fish oil and magnesium. However, further studies are needed to assess their benefit and safety.
Herbs and supplements can have side effects and can interact with other medications your child is taking. Talk to your child's doctor before trying any herbs or supplements.
It can be stressful to help your child manage asthma. Keep these tips in mind to make life as normal as possible:
Use a written asthma action plan. Work with your child's doctor to develop your child's action plan, and give a copy to all of your child's caregivers, such as child care providers, teachers, coaches and the parents of your child's friends.
Following a written plan can help you and your child identify symptoms early, providing important information on how to treat your child's asthma from day to day and how to deal with an asthma attack.
Be encouraging. Focus attention on what your child can do, not on limitations. Involve teachers, school nurses, coaches, relatives and friends in helping your child manage asthma.
Encourage normal play and activity. Don't limit your child's activities out of fear of an asthma attack — work with your child's doctor to control exercise-induced symptoms.
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 to an allergist, lung doctor (pulmonologist) or other specialist. Here's some information to help you get ready for your child's appointment.
Make a list of:
For asthma or asthma-like symptoms, questions to ask your doctor include:
Don't hesitate to ask other questions.
The doctor is likely to ask questions, including:
© 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.