Asthma often starts early in life, and recognizing symptoms in young children is crucial for timely diagnosis and effective treatment.
Lynda Mitchell
CEO, Allergy & Asthma Network
Asthma often first appears in childhood, with many symptoms emerging before the age of 5. It is the most common chronic childhood disease, affecting nearly 1 in 10 children. Asthma can be especially serious in young children because they have smaller, still-developing airways.
What causes asthma to develop in early childhood? Some causes may be:
- Family history of asthma, allergies, or eczema (atopic dermatitis)
- Premature birth
- A severe viral infection (such as respiratory syncytial virus, or RSV)
- A mother who smokes during pregnancy
Pre-existing food allergy or eczema can also increase the risk of asthma in childhood.
Recognizing asthma symptoms can be hard for parents. Some might confuse symptoms of coughing and wheezing with common viral infections. Meanwhile, their children may not be able to understand or explain the breathing problems they are experiencing.
Asthma symptoms to watch for in young children
Coughing and wheezing are the most common symptoms of asthma. Wheezing may sound like whistling when breathing. You may notice the child’s belly moving more or getting sucked under the rubs when inhaling or exhaling.
Other symptoms include:
- Fast, shallow, or irregular breathing
- Fussiness
- Getting tired easily
- Problems eating
An asthma attack is potentially life-threatening and requires immediate treatment. Signs of an asthma emergency in young children include:
- Gasping for air
- Flaring nostrils
- Difficulty speaking because they can’t catch their breath
- Blue tint to skin and fingernails — a sign that not enough oxygen is getting into the bloodstream
Diagnosis and treatment for childhood asthma
The bronchial tubes in babies and young children are usually too small and narrow for lung function testing. Doctors will rely instead on parents and symptoms they report, as well as the family’s medical history.
Doctors will ask if there are specific times or circumstances when the child coughs or has trouble breathing. It may be helpful for parents to take notes at home. Write down the time when symptoms occur and what your baby was exposed to that seemed to cause breathing problems.
After diagnosis, doctors may prescribe inhaled asthma medications. These include quick-relief albuterol and certain inhaled corticosteroids. Children younger than 2 years of age can take these medications using a nebulizer machine.
A nebulizer delivers liquid asthma medication in a warm mist. This method is often more efficient and effective for children, especially when using a face mask attached to the device. This allows the child to breathe in the full amount of medication.
Doctors may prescribe an asthma inhaler device to children ages 4 and older. Younger children often have difficulty coordinating their breathing using a traditional asthma inhaler.
Biologic medications, used to treat moderate to severe asthma, are only given to children ages 6 and older.
Do children outgrow asthma?
Asthma is rarely outgrown; it often persists into adulthood. However, some parents see symptoms of asthma go away as their child grows. This could be the result of the child’s lungs growing larger or the immune system adapting over time.
Sensitivity to allergens and irritants may remain, though. For some, asthma may reappear later in life.
What parents can do
Consult a pediatrician, pediatric allergist, or pulmonologist if your infant or young child is having trouble breathing. If symptoms are severe, go to the hospital or emergency department right away.
In addition to taking medications as prescribed, work with your child’s doctor to pinpoint asthma triggers. These may include viruses, allergens such as pollen or mold, air pollution, or tobacco smoke. Once you identify a trigger, find ways to reduce exposure to it. This will help keep your child’s asthma under control.
