Childhood asthma

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers. Such triggers include inhaling pollen or catching a cold or other respiratory infection. Childhood asthma can cause irritating daily symptoms that interfere with play, sports, school and sleep. In some children, asthma can cause dangerous asthma attacks if it's not managed properly.

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.

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 symptoms include:

• A whistling or wheezing sound when breathing out.
• Shortness of breath.
• Chest congestion or tightness.
• Coughing that gets worse if a child:
  • Has a viral infection.
  • Is sleeping.
  • Is exercising.
  • Is in the cold air.

Childhood asthma also might cause:

• Trouble sleeping due to shortness of breath, coughing or wheezing.
• Bouts of coughing or wheezing that get worse with a cold or the flu.
• Delayed recovery or bronchitis after a respiratory infection.
• Trouble breathing that hampers play or exercise.
• Fatigue, which can be due to poor sleep.

Asthma symptoms vary from child to child and might get worse or better over time. Your child might have only one symptom, such as a lingering cough or chest congestion.

It can be difficult to tell whether a child's symptoms are caused by asthma. Wheezing and other asthmalike symptoms can be caused by infectious bronchitis or another respiratory problem.

Take your child to see a healthcare professional if you suspect that your child has asthma. Early treatment will help control symptoms and possibly prevent asthma attacks.

Make an appointment with a health professional if you notice:

• Coughing that is constant, is intermittent or seems linked to physical activity.
• Wheezing or whistling sounds when your child breathes out.
• Shortness of breath or rapid breathing.
• Complaints of chest tightness.
• Repeated episodes of suspected bronchitis or pneumonia.

Children who have asthma may say things such as, "My chest feels funny" or "I'm always coughing." Listen for coughing in children, which might not wake them, when they are 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.

When to seek emergency treatment

In severe cases, you might see your child's chest and sides pulling inward when breathing is difficult. Your child might have an increased heartbeat, sweating and chest pain. Seek emergency care if your child:

• Has to stop in midsentence to take a breath.
• Is using stomach muscles to breathe.
• Has widened nostrils when breathing in.
• Is trying so hard to breathe that the stomach is sucked under the ribs during a breath.

Even if your child hasn't been diagnosed with asthma, seek medical attention immediately if you notice troubled breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing. This progresses to wheezing and labored breathing.

Childhood asthma causes aren't fully understood. 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:

• Viral infections such as the common cold.
• Exposure to air pollutants, such as tobacco smoke.
• Allergies to dust mites, pet dander, pollen or mold.
• Physical activity.
• Weather changes or cold air.

Sometimes, asthma symptoms happen with no apparent triggers.

Factors that might increase a child's chance of developing asthma include:

• Exposure to tobacco smoke, including before birth.
• Previous allergic reactions, including skin reactions, food allergies or hay fever, also called allergic rhinitis.
• A family history of asthma or allergies.
• Early childhood airway infections.
• Living in an area with high pollution.
• Obesity.
• Respiratory conditions, such as a chronic runny or stuffy nose, inflamed sinuses, or pneumonia.
• Gastroesophageal reflux disease (GERD).
• Being male.
• Being Black or Puerto Rican.

Asthma can cause a number of complications, including:

• Severe asthma attacks that need emergency treatment or hospital care.
• Permanent decline in lung function.
• Missed school days or falling behind in schoolwork.
• Poor sleep and extreme tiredness.
• Symptoms that interfere with play, sports or other activities.

Careful planning and avoiding asthma triggers are the best ways to prevent asthma attacks.

• Limit exposure to asthma triggers. Help your child avoid the allergens and irritants that trigger asthma symptoms.
• Don't allow smoking around your child. Exposure to tobacco smoke during infancy is a strong risk factor for childhood asthma, as well as a common trigger of asthma attacks. E-cigarettes or other vaping devices also can make asthma symptoms worse.
• Encourage your child to be active. As long as your child's asthma is well controlled, regular physical activity can help the lungs work more efficiently.

• See your child's healthcare team 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 a health professional can help you make needed treatment adjustments to control symptoms.

• Help your child maintain a healthy weight. Being overweight can make asthma symptoms worse. And excess weight puts your child at risk of other health problems.
• Keep heartburn under control. Acid reflux or bad heartburn might make your child's asthma symptoms worse. To control acid reflux, your child may need prescription medicines or medicines you can buy off the shelf.