Asthma in Babies, Toddlers and Children

Can babies have asthma?

We don’t always know why a baby develops asthma but some causes can be:

  • Family history of asthma, allergies or eczema (atopic dermatitis)
  • Premature birth
  • A viral infection (such as respiratory syncytial virus, or RSV), especially when the baby is less than 6 months old
  • A mother who smokes during pregnancy

As many as 80% of children that will have asthma develop symptoms before the age of 5.

What are symptoms of asthma in babies?

In infants and toddlers, it may be hard for parents, and even doctors, to recognize symptoms are due to asthma. Bronchial tubes in infants, toddlers and preschoolers are already small and narrow, and colds and other illnesses can inflame airways, making them even smaller and more irritated.

Asthma symptoms will vary from child to child. The challenge with infants is that they cannot tell you how they are feeling.

Babies with asthma may experience difficulty breathing – you may notice their bellies moving more when inhaling or exhaling and the nostrils of their nose may flare out. You might also notice:

  • Wheezing or a whistling sound when breathing
  • Fast, shallow breathing
  • Coughing
  • Fussiness and tiring easily
  • Problems eating
  • Blue tint to skin and fingernails
Photo of african male doctor examining baby boy

How is asthma diagnosed in a baby?

It can be difficult for doctors to diagnose asthma in infants because it is not easy to measure lung function in children who are of preschool age or younger. Diagnosis will rely on the parents and the symptoms they report, as well as the family’s medical history.

The doctor will ask about when your baby coughs or has trouble breathing. It may be helpful to take notes at home about the time of day and what your baby is exposed to when symptoms are present. Tell the doctor about any family members that have asthma or allergies.

photo of a doctor showing a mother and child how to use a nebulizer

How are babies treated for asthma?

Infants can receive asthma medications through an inhaler, but often a nebulizer with a mask is a more efficient and effective way to deliver their asthma medication. A nebulizer is a machine that delivers liquid medication in a warm mist.

Be mindful to follow the medication instructions given to you by your doctor and on the package insert.

How common is asthma in children?

Asthma is the most common chronic condition in children and affects nearly 1 in 10 children. It is also the primary reason children miss school – an average of 13.8 million lost days of school each year. Asthma in children can be especially serious because children have smaller airways than adults.

What are the symptoms of asthma in older children?

Symptoms of asthma in children who are 6 years of age or older can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies. Common symptoms include:

  • Coughing, especially at night
  • A wheezing or whistling sound, especially when breathing out
  • Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly. Children with asthma may describe this like it feels like something is squeezing or sitting on their chest
  • A lack of energy or feeling weak or tired
  • Frequent colds that settle in the chest

How is asthma diagnosed in older children?

Asthma is typically diagnosed with a medical exam and a test that measures the airflow in and out of the lungs. Your child may have one asthma symptom, or several of them. You may think it’s just a cold or bronchitis. If the symptoms come back, that’s a clue your child might have asthma. In addition, symptoms may worsen when your child is around asthma triggers, such as irritants in the air (smoke or strong odors, for example) or allergens like pollen, pet dander and dust mites.

Tell your child’s pediatrician if anyone in your family has asthma, allergies or atopic dermatitis. These conditions often run in families; if they run in yours, it’s more likely your child will have them.

You may be referred to an allergist who may perform skin or blood tests to see whether your child has any allergies that can trigger asthma symptoms. These tests can be done at any age. You can help your child’s doctor by completing a childhood asthma control test prior to your
visit.

Photo of child with an asthma inhaler

How is asthma treatment different for older children?

Sometimes when asthma is suspected, the doctor will put your child on a trial of asthma medication to see if it helps. If your child gets better while taking the medicine, it can be a signal that your child’s symptoms are due to asthma. The medication will depend on how severe your child’s symptoms are and how often they occur.

The goal of treatment for children include:

  • Managing the child’s environment to avoid triggers
  • Treating the airway inflammation and bronchospasm with medication
  • Keeping asthma in control so activity does not need to be limited
  • Teaching the child about asthma, their medications and how to be as healthy as possible in a way they can understand

When administering medication to your child, make sure to follow the instructions given to you by your doctor and on the package insert.

What other steps can I take if my child has asthma symptoms?

Children can develop asthma symptoms for a variety of reasons – viruses, allergens and irritants are some of the causes. Sometimes the time of year, such as during the September asthma peak, can cause a child to develop symptoms of asthma. Here are some suggestions on what you can do:

  • Address allergens and irritants that set off symptoms and find ways to reduce exposures that touch off asthma flares. Uncertain about triggers? See an allergist for testing.
  • Review inhaler technique with your child. Ask about using a valved holding chamber – a handheld device that attaches to the inhaler and captures and directs the medication to the airways.
  • Make sure your child stays on medication schedule throughout the year, even when there are no symptoms. This may include taking daily asthma anti-inflammatory medications as prescribed. Note the expiration dates of medications and refill prescriptions as necessary.
  • Involve children in the conversation, helping them understand when, why and how to take medications and other ways to keep asthma under control.

Will my child outgrow asthma?

Asthma is rarely outgrown – it often persists into adulthood. However, some parents see the symptoms of asthma go away as their child grows. This could be the result of the child’s lungs growing larger or the immune system adapting over time. However, sensitivity to allergens as an asthma symptom trigger may still remain. And for many, symptoms often reappear years later.

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Download Our Free “Understanding Asthma” Guide

Are there other conditions that may look like asthma or complicate asthma?

There are other types of respiratory conditions that are different than asthma.  The symptoms, diagnosis and treatment can vary depending upon the condition. Here are some of them.

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COPD

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respiratory syncytial virus (RSV)

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alpha-1 antitrypsin deficiency

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COVID-19

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sleep apnea

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bronchiectasis

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influenza, infections and viruses

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Vocal cord dysfunction