Overview

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling airborne pollen or catching a cold or another 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 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.

Symptoms

Common childhood asthma signs and symptoms include:

  • Frequent, intermittent coughing
  • A whistling or wheezing sound when exhaling
  • Shortness of breath
  • Chest congestion or tightness
  • Chest pain, particularly in younger children

Other signs and symptoms of childhood asthma include:

  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • Bouts of coughing or wheezing that get worse with a respiratory infection, such as a cold or the flu
  • Delayed recovery or bronchitis after a respiratory infection
  • Trouble breathing that may limit play or exercise
  • Fatigue, which can be caused by poor sleep

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. 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 day-to-day asthma symptoms, but also may prevent asthma attacks.

Make an appointment with your child's doctor if you notice:

  • Coughing that's constant, intermittent or seems to be linked to physical activity
  • Wheezing or whistling sounds when your child exhales
  • Shortness of breath or rapid breathing
  • Complaints of chest tightness
  • Repeated episodes of suspected bronchitis or pneumonia

If your child has asthma, he or she may say such things as, "My chest feels funny" or "I'm always coughing. Listen for bouts of coughing when your child is asleep. This coughing may or may not awaken 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

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:

  • Has to stop in midsentence to catch his or her breath
  • Is using abdominal muscles to breathe
  • Has widened nostrils when breathing in
  • Is trying so hard to breathe that the abdomen is sucked under the ribs when he or she breathes in

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.

Causes

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:

  • Inherited traits
  • Some types of airway infections at a very young age
  • Exposure to environmental factors, such as cigarette smoke or other air pollution

Increased immune system sensitivity causes the lungs and airways to swell and produce mucus when exposed to certain triggers. Reaction to a trigger may be delayed, making it more difficult to identify the trigger. These 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 occur with no apparent triggers.

Risk factors

Factors that may increase your child's likelihood of developing asthma include:

  • Exposure to tobacco smoke
  • Previous allergic reactions, including skin reactions, food allergies or hay fever (allergic rhinitis)
  • A family history of asthma, allergic rhinitis, hives or eczema
  • Living in an urban area with increased exposure to air pollution
  • Obesity
  • Respiratory conditions, such as a chronic runny or stuffy nose (rhinitis), inflamed sinuses (sinusitis) or pneumonia
  • Heartburn (gastroesophageal reflux disease, or GERD)
  • Being male
  • Being black

Complications

Asthma may cause a number of complications, including:

  • Severe asthma attacks that require emergency treatment or hospital care
  • Permanent narrowing of the airways (bronchial tubes)
  • Missed school days or getting behind in school
  • Poor sleep and fatigue
  • Symptoms that interfere with play, sports or other activities

Prevention

Careful planning and steering clear of asthma triggers are the best ways to prevent asthma attacks.

  • Limit exposure to asthma triggers. Be proactive in helping 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.
  • Encourage your child to be active. As long as your child's asthma is well-controlled, regular physical activity can condition the lungs to work more efficiently.
  • See the doctor when necessary. Check in on a regular basis. Don't ignore signs that your child's asthma may 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 any needed treatment adjustments to keep symptoms under control.
  • Help your child maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts your child at risk of other health problems.
  • Keep heartburn under control. Acid reflux or severe heartburn (gastroesophageal reflux disease, or GERD) may worsen your child's asthma symptoms. He or she may need over-the-counter or prescription medications to control acid reflux.