Childhood, or pediatric, asthma is one of the most common chronic conditions in infants and children. It occurs when the airways of the lungs become inflamed, which can make it hard for a child to breathe.

Asthma is the most common noncommunicable disease among children and infants. Research suggests that roughly 5.1 million children under 18 in the United States have asthma. Research also notes that while cases of asthma attacks are going down, roughly half of children with asthma report having one or more attacks.

Asthma is a serious disease that can cause wheezing, difficulty breathing, coughing and can potentially result in permanent lung damage. Asthma is a major cause of missed time from school and severe cases can be fatal.

There is currently no cure, but fortunately, children and caregivers can control childhood asthma with appropriate treatment and management.

In this article, we will discuss childhood asthma and explore its causes, symptoms, and treatment options.

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Childhood asthma is a chronic lung condition that is common in children. Asthma can develop at any age, but most often begins in childhood. In 2019, research from the Centers for Disease Control and Prevention (CDC) indicated that 7% of children in the U.S. had asthma.

Asthma occurs when inflammation and a narrowing of the airways inside the lungs obstruct the air supply. This results in the characteristic wheezing, coughing, chest tightness, and shortness of breath associated with asthma.

Researchers are still unsure on the exact cause of asthma, but both genetic and environmental factors seem to play a significant role.

When a child has asthma, their lungs are extra sensitive to certain triggers. When their lungs interact with a trigger, it causes the airways of the lung to swell, muscles surrounding the airways to tighten, and mucous secretions in the lungs to increase.

This reaction to the trigger causes difficulty breathing and other characteristic symptoms of asthma. When the reaction to these triggers is severe, it can result in an asthma attack.

According to the American Lung Association (ALA), some common triggers of childhood asthma can include:

  • allergens (environmental and food)
  • respiratory infections and colds
  • cigarette smoke, including secondhand smoke
  • indoor and outdoor air pollutants
  • exposure to cold air or sudden changes in temperature
  • exercise
  • excitement and stress

The ALA also notes the following risk factors for developing childhood asthma:

  • family history of asthma
  • respiratory infections during infancy and childhood such as RSV
  • allergies such as eczema or hay fever
  • having a parent that smoked during pregnancy
  • exposure to secondhand smoke
  • exposure to air pollution, particularly for those living in urban areas
  • obesity
  • exposure to certain chemicals

Most children with asthma will present symptoms before they turn 5. Children with asthma will likely show the same symptoms as adults. However, in some children, a chronic cough may be the only symptom. Other possible signs or symptoms include:

  • persistent coughing that occurs during their sleep, due to exercise or cold air, or with a viral infection
  • wheezing or whistling sound while they breathe
  • rapid breathing or shortness of breath
  • chest tightness
  • fatigue
  • infants experiencing problems while feeding
  • avoiding sporting or social events
  • difficulty sleeping due to coughing or breathing problems

Caregivers should also pay attention to whether symptoms frequently recur and if they notice any patterns when symptoms do happen, such as if they occur:

  • at night or early morning
  • during or after exercise
  • during certain seasons
  • after crying or laughing
  • following exposure to common asthma triggers, such as smoke, strong odors, pollen, pet dander, or dust mites

When symptoms of asthma become severe, a person may experience an asthma attack. Attacks can begin suddenly and can range from mild to life threatening.

In some cases, swelling in the airways can prevent sufficient oxygen from reaching the lungs. This may mean that oxygen cannot enter the bloodstream or reach vital organs. In these cases, people may require immediate medical attention.

Click here to learn more about signs and symptoms of asthma in adults.

Diagnosing a child with asthma can be difficult, as they may show no symptoms for a long period before they experience an asthma attack. It may also be difficult to distinguish asthma from other respiratory illnesses, and some children may have difficulty explaining their symptoms.

A doctor will ask about family history and perform a physical and medical exam.

If another family member has asthma or allergies, this increases the chance that the child may have asthma.

If the child is old enough, the exams typically will involve a test that will measure airflow in and out of the lungs. A doctor may also use skin or blood tests to see if the child has allergies that can trigger asthma symptoms.

People can control their asthma and avoid potential asthma attacks by taking their medication and avoiding possible triggers. Typically, a doctor will prescribe two types of asthma medication — one for quick relief and one for long-term control.

Quick relief, or rescue, medications quickly relax and open the airways to help relieve symptoms during an asthma flare-up. A doctor may also suggest a person use them before exercise. Doctors call these medications short-acting beta-agonists. They include albuterol and levalbuterol.

Controller medications can help a person have fewer and milder asthma attacks over time but will not help if a person is having an asthma attack. These include:

  • corticosteroids
  • combination inhalers, containing corticosteroids and long-acting beta-agonists
  • anticholinergics
  • leukotriene inhibitors

It is important for those with more persistent symptoms to take both types of medication and not rely just on quick relief medications.

In some cases, a doctor may suggest biologics to treat severe or difficult-to-treat asthma. A doctor can administer biologics via injections or infusions. The doctor may do a blood test to determine if biologics are suitable to treat the type of asthma a person has.

There are also some home remedies that may help ease symptoms of asthma. Learn more about them here.

Unfortunately children cannot completely outgrow asthma. It is a chronic condition, meaning it does not go away.

Some people may think children do outgrow asthma if they have fewer symptoms or attacks as they age. However, asthma can cause permanent changes to the airways, and asthma symptoms can return at any time. Even after a long period, certain triggers can cause an asthma flare-up.

While there is currently no cure for asthma, children can learn to control it. Following an appropriate asthma action plan, which often includes medication and lifestyle changes, can help people decrease asthma attacks and manage the condition.

Childhood asthma is a common lung condition among children. Exposure to certain triggers causes inflammation and a narrowing of the lungs, which can result in coughing and difficulty breathing.

Researchers are unsure of the exact cause of asthma but environmental and genetic factors play a role. While a cure does not currently exist, following an appropriate asthma action plan can help a child manage and control their asthma symptoms.