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, unmanaged asthma can cause dangerous asthma attacks.

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.

Unfortunately, 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.
• Frequent coughing that worsens when your 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 your child's symptoms are caused by asthma. Wheezing and other asthma-like symptoms can be caused by infectious bronchitis or another respiratory problem.

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

Make an appointment with your child's provider 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 abdominal muscles to breathe.
• Has widened nostrils when breathing in.
• Is trying so hard to breathe that the abdomen 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, which progresses to wheezing and labored breathing.

Childhood asthma causes aren't fully understood. Some factors thought to be involved include having:

• A tendency to develop allergies that runs in the family.
• Parents with asthma.
• 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 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 occur with no apparent triggers.

Factors that might increase your 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.
• 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 require emergency treatment or hospital care.
• Permanent decline in lung function.
• Missed school days or falling behind in schoolwork.
• Poor sleep and fatigue.
• 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.
• 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 health care provider 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 your child's provider can help you make needed treatment adjustments to control symptoms.

• 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 might worsen your child's asthma symptoms. To control acid reflux, your child may need prescription medicines or medicines you can buy off the shelf.