What to Know About Childhood Asthma

Asthma is the most common non-communicable disease in children and infants. Research shows that about 5.1 million children under the age of 18 in the United States have asthma. Research also shows that while the incidence of asthma attacks is decreasing, about half of children with asthma report having one or more attacks.

Asthma is a serious disease that can cause wheezing, difficulty breathing, coughing, and possibly permanent lung damage. Asthma is a major cause of absenteeism from school and severe cases can be life-threatening.

There is currently no cure, but fortunately, children and caregivers can control childhood asthma with proper treatment and management.

In this article, we will discuss childhood asthma and explore its causes, symptoms and treatment options.

What is Childhood Asthma?

Childhood asthma is a chronic lung condition that is common in children. Asthma can occur at any age, but often begins in childhood. In 2019, research from the Centers for Disease Control and Prevention (CDC) indicated that 7% of children in the United States had asthma.

Asthma occurs when inflammation within the lungs and narrowing of the airways obstructs the supply of air. This typically results in wheezing, coughing, chest tightness, and shortness of breath associated with asthma.

Causes

Researchers are still unsure of the exact cause of asthma, but both genetic and environmental factors seem to play an important role.

When a child has asthma, their lungs are more sensitive to certain stimuli. When their lungs react to a stimulus, it causes the airways in the lungs to swell, the muscles around the airways to tighten, and mucus to build up in the lungs.

This response to the stimulus causes difficulty breathing and other characteristic asthma symptoms. When the reaction to these triggers is severe, it can result in an asthma attack.

According to the American Lung Association (ALA), some common triggers of childhood asthma may include:

• Allergens (environmental and food)
• Respiratory infections and colds
• Cigarette smoke, including secondhand smoke
• Indoor and outdoor air pollution
• Exposure to cold air or sudden changes in temperature
• exercise
• Motivation and stress

The ALA also notes the following risk factors for developing childhood asthma:

• Family history of asthma
• Respiratory infections such as RSV during infancy and childhood
• Allergies such as eczema or hay fever
• Having parents who smoke during pregnancy
• Exposure to secondhand smoke
• Exposure to air pollution, especially for those living in urban areas
• obesity
• Exposure to certain chemicals

Symptoms

Most children with asthma will show symptoms before age 5. Children with asthma will have similar symptoms as adults. However, in some children, a chronic cough may be the only symptom. Other possible signs or symptoms include:

• A persistent cough that occurs during their sleep, due to exercise or cold air, or with a viral infection
• Wheezing or whistling while breathing
• Rapid breathing or shortness of breath
• Chest tightness
• Fatigue
• Babies face problems during breastfeeding.
• Avoid sports or social events.
• Difficulty sleeping due to coughing or difficulty breathing

Caregivers should also pay attention to whether symptoms recur frequently and if they notice a pattern when symptoms occur, such as if they:

• Night or early morning
• During or after exercise
• During certain seasons
• After crying or laughing
• After exposure to common asthma triggers, such as smoke, strong odors, pollen, pet dander, or dust particles

When asthma symptoms become severe, a person may have an asthma attack. Attacks can start suddenly and range from mild to life-threatening.

In some cases, inflammation in the airways can prevent enough oxygen from reaching the lungs. This can mean that oxygen cannot enter the blood and reach vital organs. In these cases, people may need immediate medical attention.

Diagnosis

Doctors diagnose asthma based on a child’s symptoms, medical and family history, and a physical exam. Children aged around five and older can usually do lung function tests, such as spirometry, which measures how much air a child can breathe out and how quickly. For younger children, a doctor may prescribe asthma medication for a trial period and see whether symptoms improve.

Treatment and Management

Asthma treatment usually involves two kinds of medication:

• Controller (preventer) medications: such as inhaled corticosteroids, taken every day to reduce airway inflammation and prevent symptoms.
• Quick-relief (reliever) medications: such as a short-acting bronchodilator inhaler, used during symptoms or an attack to open the airways quickly.

Young children often use an inhaler with a spacer and sometimes a face mask, which helps the medication reach the lungs. Doctors also give families a written asthma action plan that explains which medicines to take every day, how to recognize worsening symptoms, and what to do in an emergency. Sharing this plan with schools and caregivers is important.

Reducing exposure to triggers — such as smoke, dust mites, pet dander, and mold — and keeping vaccinations, including the yearly flu vaccine, up to date can help prevent flare-ups. Read about different types of asthma and breathing exercises that help air flow.

When to Seek Emergency Care

Call emergency services if a child:

• is struggling to breathe or cannot speak in full sentences
• has lips, face, or fingernails that look blue or gray
• is using neck or chest muscles to breathe, or the skin is pulling in between the ribs
• does not improve after using their quick-relief inhaler
• is unusually drowsy or confused