A baby with asthma might wheeze, cough, and breathe fast. Asthma is a chronic condition that causes airway inflammation and sensitivity to inhaled irritants.
About half of all children with asthma show some signs of the condition before they reach the age of 5 years. But not all babies with asthma-like symptoms go on to have asthma later in life.
Doctors can treat asthma in babies with medications that help open the airways.
Anyone who recognizes signs of breathing problems in a baby should contact a doctor. Parents and other caregivers can take various steps to reduce risk factors and limit the baby’s exposure to triggers, such as smoke, pet dander, pollen, and dust mites.
Below, we explore home care strategies, asthma symptoms in babies, and how doctors diagnose and treat the issue.
Asthma-like symptoms can be difficult to recognize in babies. They can resemble signs of other issues, including other respiratory illnesses.
In babies, symptoms of breathing problems that may indicate asthma include:
- flared nostrils
- breathing very fast
- exaggerated stomach movements, as though they are using their stomach muscles to breathe
- coughing at night or when doing everyday things
- problems eating
- wheezing, a whistling sound in the chest, that may be audible from far away
- a bluish tint to the face, fingernails, or lips, which can indicate a low oxygen supply
Seek emergency medical care if a baby’s face has a bluish tint, or if they have difficulty eating or drinking due to fast breathing, flared nostrils, exaggerated stomach movements, or lethargy.
In babies, asthma can closely resemble other medical conditions, such as:
- acid reflux
- aspiration, which involves accidentally inhaling something, such as fluid
- an upper respiratory infection
- bronchiolitis, a lung infection
- croup, a type of inflammation
- a foreign body becoming stuck in the airway
- cystic fibrosis
Another condition that may share symptoms with asthma is laryngomalacia. This involves being born with a weakness in the cartilage just under the vocal cords.
As a result, a baby may breathe noisily. The noise, in this case, comes from parts of the upper airways, such as the trachea. As a baby gets older, the cartilage becomes firmer.
The primary difference between asthma and some of the health issues above is that asthma symptoms tend to continue, as asthma is a chronic condition.
In a baby with asthma, the airways in the lungs become smaller and inflamed more easily than those of babies without asthma — even after a short illness. This pattern can help doctors make an asthma diagnosis.
Factors that can increase the likelihood of an infant developing asthma include:
- a family history of allergies, asthma, or atopic dermatitis, the most common form of eczema
- smoking during pregnancy
- premature birth
- more severe symptoms of respiratory infections, such as with the respiratory syncytial virus
When babies aged 6 months and younger experience acute episodes of wheezing, a viral infection is usually the cause.
Diagnosing asthma in babies can be challenging. A doctor cannot use the typical lung function tests because babies cannot exhale or inhale on command.
As a result, doctors do not typically diagnose “asthma” in babies. If a baby has asthma-like symptoms, the doctor may diagnose “reactive airway disease” and confirm an asthma diagnosis when the child is older and if the symptoms persist.
To check for the issue in a baby, a doctor may:
- Give medications to open the airways and see whether the symptoms improve.
- Give allergy tests to check for sensitivities to common triggers, such as dust mites, mold, pet dander, and pollen — in an older baby or toddler.
- Order imaging studies, such as X-rays, to examine the lungs.
They may also make a referral to an allergy or lung specialist for further testing and treatment.
Asthma is a chronic condition with no cure. However, many babies with asthma-like symptoms, such as wheezing, do not go on to have asthma later in life.
Inhalers and nebulizers are the medication delivery systems for people with asthma.
Even a young infant may be able to receive medications through an inhaler that has an attachment called a spacer and an infant-sized mask.
A nebulizer, which people sometimes call a breathing machine, delivers liquid medication in combination with compressed air. The result is a medicated mist that a baby breathes in.
A doctor will recommend how many times a day a baby should receive their asthma medicine.
Some medications that require an inhaler or a nebulizer are short-acting drugs, such as albuterol. This medication helps quickly open the airways to make it easier to breathe.
The doctor may also prescribe long-acting medications containing steroids to reduce inflammation and keep the airways open.
It is crucial that a child only receives the asthma medication prescribed for them, in the specified dosage. A doctor can provide specific, personalized guidance.
A doctor may also recommend reducing the baby’s exposure to allergens that commonly trigger asthma symptoms. Examples include smoke, pet dander, pollen, and dust mites.
Parents and caregivers can try:
- washing bed linen and cloth toys at least once a week in water that is 130ºF (54.4ºC) or hotter to kill dust mites
- vacuuming at least once a week to remove excess dust
- preventing cigarette smoke from entering the home or car
- preventing pets from entering the baby’s bedroom
- using air purifiers with high-efficiency particulate air, or HEPA, filters to reduce the amount of dander and dust in the home
- using an allergy-proof crib mattress cover with a tight weave to prevent dust mites from entering the mattress
If a parent or another caregiver smokes outside the home, they should change their clothes when they come back in.
It may also help to speak with the pediatrician before introducing potentially allergenic foods, such as peanuts, cow’s milk, eggs, and wheat into the baby’s diet — although it is rare for food allergies to cause asthma in babies.
If there is a family history of food sensitivities, it may help to introduce these foods slowly, in small amounts to ensure that the baby does not have a reaction that causes breathing problems. Paying close attention to food labels can be key.
Wheezing and breathing problems in babies can be worrying. Anyone who notices these or other signs that may point to asthma should speak with the child’s doctor as soon as possible.
If a baby’s face has a bluish tint, or if they have difficulty eating or drinking due to fast breathing, flared nostrils, exaggerated stomach movements, or lethargy, they need emergency care.