Medically reviewed by Nidhi Kotwal, MBBS and Anayansi Lasso-Pirot, MD.
Having asthma is often described as feeling like a fish out of water. It is a chronic lung disease that affects more than four million children in the United States. Their scary “fish out of water” feeling generally results from the narrowing (bronchoconstriction) or swelling (inflammation) of their airways.
Although asthma is not curable, when well-controlled, children with asthma can participate in most activities and, often, thrive. The best way to keep children healthy is to develop an Asthma Action Plan that includes regular check-ins with your child’s doctor, identifying and avoiding their triggers whenever possible, and recognizing the early symptoms of an asthma attack and knowing what to do if one occurs.
Recognizing Signs of Asthma in Kids
Recognizing asthma symptoms in children is an essential step to keeping them healthy. Asthma symptoms in kids can differ from symptoms in adults. Below are some common signs in kids:
- Coughing at night or during exercise
- Having low endurance
- Tiring quickly
- Shortness of breath (rapid breathing)
- Chest pain and tightness
- Lingering colds (more than 5-7 days)
Symptoms of an Asthma Attack
It’s important to pay attention to your children’s regular breathing patterns. They alert you to the early signs of an asthma attack:
- Persistent cough
- Wheezing (high-pitched noise heard when breathing out)
- Fast breathing
- Nasal flaring
- Mouth breathing
- Not being able to complete a sentence when speaking
- Being less active
Learn What Triggers Your Child
The same issues don’t trigger everyone’s asthma. Identifying the causes of your child’s asthma attacks is important. Once you learn their triggers, try to avoid them whenever possible. Something to keep in mind is that when a child’s asthma is well controlled, they are less likely to negatively react to their triggers and have an asthma attack.
Asthma triggers can include the following:
- Air pollution (fumes, smoke, strong odors)
- Allergen exposure (dust mites, mold, pet dander, pollen)
- Exercise or physical exertion
- Medication (a side effect of some drugs)
- Respiratory viruses (the common cold, RSV, the flu)
- Strong emotions (stress or laughter)
Reduce Known Trigger Exposure
Once you identify the triggers, find ways to stop or reduce exposure.
- Dust, sweep and wash bedding regularly, and don’t allow pets to sleep in bedrooms.
- Avoid exposure to:
- Secondhand smoke
- Strong chemical odors
- Deodorizing sprays
- Scented candles
- Scented lotions
- Scented bath or hair products
- Monitor outdoor air quality. Avoid going outside on days with high pollen counts or air pollution alerts. Most weather apps display air quality alerts for local areas; alternatively, you can visit AirNow.gov.
- When going outside in cold weather, make sure your child’s mouth is covered. This step prevents dry air from irritating the airways. Dry air may cause coughing, shortness of breath or wheezing.
- During cold and flu season, help your child:
- Avoid sick individuals when possible
- Eat a balanced diet
- Stay hydrated
- Wash their hands often (and wash yours, too!)
- Engage in sports and stay active. If needed, modify the type of physical activity and find sports with built-in rest periods. For some, indoor sports are a better choice. Ensure your child receives a sports physical and discuss how asthma may impact their activities during this time.
Plan Ahead
Be prepared for an asthma attack. Work with your child’s doctor to create an Asthma Action Plan that helps prevent and control asthma. Learn the different zones to control asthma, what to do and when it’s time to see a health care provider:
- Green Zone: Doing well, and the asthma is under control
- Yellow Zone: Having some breathing difficulties
- Red Zone: Can’t catch their breath and an inhaler isn’t helping
Medical Care and Treatment
It’s essential that children have regular check-ups with their pediatrician and/or specialist, especially if they have asthma. Track their asthma symptoms to monitor their lung function. Understand the medications they are prescribed and how to use them properly, including the correct dosage, frequency of use and the correct administration method.
Types of Asthma Medication
- Bronchodilators open and relax the airways. They reduce chest tightness, coughing, shortness of breath and wheezing. They can be short- or long-acting.
- Controller medicine helps control daily symptoms. Corticosteroid inhalers help reduce mucus and prevent airway swelling. Oral pills known as leukotriene modifiers block the effects of leukotrienes, which are chemicals that cause the airways to become tight and swollen. Combination inhalers include a corticosteroid and a bronchodilator.
- Oral corticosteroids come in pill or liquid form. They are used during an asthma flare-up for a short duration.
- Biologics are medications that target the cause of inflammation in the body. They are for severe asthma.
A nebulizer turns asthma medicine into a mist. Some children need to take controller medicine daily. Rescue medication is used to treat symptoms such as chest tightness, coughing, shortness of breath and wheezing. Sticking to your child’s Asthma Action Plan will help you make sure their asthma is under control.
Always keep a rescue inhaler with a spacer nearby in case of an emergency. Ensure your child and all involved in their care know how and when to use one.
The doctor or pharmacist should explain how to take the medication. There are different types of inhalers, each with specific ways to use them. If not administered correctly, the medicine may not be delivered effectively.
When to Seek Emergency Care
If your child starts experiencing breathing difficulties, it’s time to refer to the Asthma Action Plan. Follow the steps. Seek emergency care if at any time your child has any of the following symptoms:
- Short of breath while talking
- Lips or face appear blue
- Lethargic or limp
- Using chest or neck muscles to breathe
- The rib cage is pulling in
- No improvement after rescue medications
Educating the Child, Family and Caregivers on Asthma
Asthma is a chronic condition, which means it may last for a long time or even a lifetime. It can have flare-ups, and your child may need more or different medications from time to time. Once well controlled, the provider may decrease the medications, but your child will always have asthma. This makes it necessary for your child, family and all caregivers to understand asthma.
Educate your child on their disease and symptoms. Ask your child’s health care provider if they offer appointments for teaching. Alternatively, there are many organizations that teach kids and their families about asthma:
- American Academy of Allergy Asthma & Immunology
- American Lung Association
- American Thoracic Society
- Asthma and Allergy Foundation of America
Everyone involved in your child’s care should be aware of what the Asthma Action Plan is and where it can be found. Inform everyone about your child’s known triggers. Know where the medications are, how to use them and when to follow emergency protocols. To support a healthy life, your child and their caregivers should monitor the child’s breathing, learn about asthma triggers and maintain regular contact with your child’s pediatrician.
Watch an Interview
In this MPT “Your Health” segment, learn about asthma in children, the importance of having an Asthma Action Plan and much more from Dr. Nidhi Kotwal, associate professor of pediatrics at the University of Maryland School of Medicine and a pediatric pulmonologist at the University of Maryland Children’s Hospital.
More to Read
- Understanding Chronic Illness in Children: A Guide for Parents and Caregivers
- Take a Deep Breath: How to Use an Inhaler
- Should I Take My Child to the Emergency Room?
- Adult-Onset Asthma: Causes, Symptoms, Diagnosis and Treatment
- Should You See a Pulmonologist?
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