Asthma is a chronic disease that affects the function and lining of the airways or tubes of the lungs. It narrows the airways and makes it difficult to breathe.
There are different degrees of asthma. Some children may have mild asthma with rare flare-ups. Others may have a severe, constant asthma.
Inflamed Bronchial Tube
Tightening of the muscles around the airway and chronic inflammation cause airways to narrow. This makes it hard to breathe.
The exact causes of asthma are unknown, but genetics play a role.
Certain conditions are known to trigger an asthma attack. These include:
- Respiratory infection—more common in younger children
- Exercise, especially in cold air—more common in teenagers
Substances that cause allergies include:
- Animal dander
- Food, rarely
- Sinus infections
- Tobacco smoke or other chemical irritants
- Sudden change in weather
Factors that may increase your child’s chance of asthma include:
- Family history
- History of allergies and/or eczema
- Exposure to tobacco smoke
- Respiratory infections before age 1, especially bronchiolitis, and common colds before 6 months of age
- Premature birth
- Chlorinated pool use in children who are already at risk for asthma
- Taking some medications, such as aspirin or other non-steroidal anti-inflammatory drugs
Symptoms may include:
- Shortness of breath
- Trouble breathing
- Chest tightness
- Complaints of chest pain
- Difficulty during feeding in infants
- Trouble sleeping
- Avoiding exercise or sports
You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen to your child’s lungs. Your child may be referred to a specialist. A pulmonologist focuses on the lungs. An allergist/immunologist focuses on allergies.
Your child's lungs may be tested. This can be done with:
- Spirometry test
- Challenge test
- Medication trial
Images may be taken of your child's bodily structures. This can be done with x-ray.
Your child may be tested for common allergens that may trigger symptoms. This can be done with skin testing.
Your child's oxygen concentration may be measured. This can be done with pulse oximetry.
Talk with your child’s doctor about the best plan for your child. You and your child's doctor should also create an asthma action plan. This is a plan your child will follow to help control asthma and handle asthma attacks. Treatment will vary based on symptoms and the number of asthma episodes your child has. It is important that you stick to your child's treatment plan.
Treatment options include the following:
You can help your child reduce the chance of triggering an asthma attack by making lifestyle changes, such as:
- Know what your child is allergic to and avoid known triggers. These may include certain pollen, dust, foods, and air pollution.
- Avoid outside activities if there are high levels of air pollution, pollen, or mold spores.
- Keep your windows closed during seasons with high pollen or mold spores. Air conditioning may help filter out allergens during warm seasons.
- Consider getting a portable HEPA unit air cleaner to use in sleeping areas, for your heating/cooling system, and your vacuum cleaner.
- Avoid exposing your child to tobacco smoke.
- Have proper heating, cooling, and ventilation systems in your home.
- Keep the humidity down in your house. This may help prevent the growth of mold.
Medications used to treat asthma fall into one of two categories:
Long-term medications are used to avoid asthma attacks, but will not treat an existing attack. Medication may include any combinations of:
- Inhaled corticosteroids to prevent airway swelling and inflammation
- Inhaled long-acting beta agonists relax the airways and keep them from tightening
- Oral leukotriene modifiers to prevent airway inflammation and swelling, decrease the amount of mucus in the lungs, and open the airways
- Inhaled cromolyn or nedocromil to prevent airways from swelling from contact with an asthma trigger
Short-term control medications are used to treat an asthma attack. Medication may include any combinations of:
- Inhaled quick-acting beta agonists and anticholinergic agents to open the airways
- Oral corticosteroids to reduce severe airway inflammation
In addition to the medications, children older than 6 months should get a yearly flu shot. Children with asthma are at a higher risk of having complications from the flu.
Your child’s asthma may be triggered by allergies. In this case, your doctor may advise allergy shots. These shots are small amounts of an allergen injected into the skin. Over time, your child will react less to the specific allergen(s). With less triggers, the asthma also decreases.
Sublingual immunotherapy may also be used. This type of treatment involves putting the allergic substances under the tongue, rather than using allergy shots.
There are no known ways to prevent your child from developing asthma. You can encourage your child with asthma to reduce the risk of asthma episodes by following the treatment plan and avoiding triggers. General guidelines include:
- Avoid strong chemicals or odors like perfume.
- Avoid challenging outdoor exercise during days with high air pollution, a high pollen count, or a high ozone level.
- If cold weather triggers your asthma, avoid strenuous activities in cold weather. If you must, use a scarf or mask to warm the air before it reaches your lungs.
- Avoid secondhand smoke. Do not allow anyone to smoke in your home.
- Don't use a wood-burning stove or fireplace, including unvented gas fireplaces.
American Academy of Allergy, Asthma, & Immunology
Asthma and Allergy Foundation of America
Asthma Society of Canada
Canadian Lung Association
Asthma in children. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 27, 2015. Accessed August 10, 2015.
Asthma overview. American Academy of Allergy, Asthma, & Immunology website. Available at: http://www.aaaai.org/patients/allergic_conditions/pediatric_asthma/diagnosis_asthma.stm. Accessed August 10, 2015.
SW Stoloff. The current and future state of asthma treatment. Clinical Cornerstone: The Current and Future State of Asthma Treatment. 2008; 8(4):26-43.
What causes asthma? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Causes.html. Updated August 4, 2014. Accessed August 10, 2015.
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8/23/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Beasley R, Clayton T, et al. Acetaminophen use and risk of asthma, rhinoconjunctivitis and eczema in adolescents: ISAAC phase three. Am J Respir Crit Care Med.2011 Jan 15;183(2):171-8.
10/8/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ducharme F, Chroinin M, et al. Addition of long-acting beta2-agonists to inhaled corticosteroids versus same dose inhaled corticosteroids for chronic asthma in adults and children. Cochrane Database Syst Rev. 2010;(5):CD005535.
5/4/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Woodfine L, Neal RD, et al. Enhancing ventilation in homes of children with asthma: pragmatic randomised controlled trial. Br J Gen Pract. 2011;61(592):e724-732.
8/27/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Kim JM, Lin SY, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.
Last reviewed August 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.