Asthma in Children

Learn more about Allergy, Asthma, and Immunology at CHKD

Meet Our Allergy, Asthma, and Immunology Care Team

Asthma is a chronic illness that causes breathing problems.

In an asthma episode, three things happen:

• The airways become inflamed (red and irritated).
• Mucus increases.
• The muscles tighten around the airways.

These three things can cause coughing, severe wheezing, and extreme difficulty breathing. Children with asthma are also more likely to develop other respiratory illnesses, such as bronchitis, pneumonia, and croup.

Asthma may run in families and can be triggered by some of the following:

• allergies to mold, pollen, and pet hair.
• drug reactions.
• weather changes.
• irritants such as smoke, sprays, odors, dust, air pollution, and
  perfumes.
• respiratory viruses.

Though asthma can occur in infancy, it usually begins between 12 months and 5 years of age with another peak as the child enters puberty. Asthma can be mild, moderate, or severe.

Asthma symptoms may go into remission as the child grows and the immune system improves, helping to fight off infections. The older child can learn to avoid the triggers, and as the child’s airway grows, it may become large enough to withstand changes without causing significant symptoms.

Through the use of medications and sometimes allergy shots, we can effectively control the symptoms of asthma.

Asthma medications work in two ways:

• to prevent symptoms from occurring (controllers).
• to stop symptoms once they’ve started (rescue medicines).

Controllers: Controller medicines are taken every day to control asthma. These medicines fight inflammation in your child’s airways and prevent asthma episodes from starting.

Rescue medicines: Rescue medicines help relieve symptoms once they have started. These medicines work quickly to help your child feel better by relaxing the airway muscles, allowing more oxygen to be exchanged, and making breathing easier.

If your child needs either type of medication, your doctor will fully explain the benefits and side effects.

Mild Asthma

A child with a mild case of asthma may experience wheezing and coughing when exercising and an occasional nighttime cough. A mild case of asthma may flare up only four to six times a year and responds quickly to medicines. Children with mild asthma rarely need to see an asthma specialist or visit a hospital emergency room. Children who have mild exercise-induced asthma often can avoid symptoms by using their inhalers (rescue medication) before they warm up for athletic activity.

Moderate Asthma

Children with moderate asthma will have episodes of wheezing and coughing more than four to six times a year. Their wheezing is triggered more easily by respiratory infections. They also have more coughing at night that keeps them awake. These children will have more difficulty participating in sports and may need to take
medicine to control their asthma every day.

Severe Asthma

Children with severe asthma have frequent flare-ups of symptoms that require trips to the doctor and possibly the emergency room. Sometimes a child needs to be hospitalized to get asthma under control. Children with severe asthma may need to see a specialist in addition to the pediatrician and will need to take medicine on a daily basis.

Illnesses that may mimic asthma include:

• sinusitis
• allergies
• immune deficiencies
• pneumonia
• tuberculosis
• cystic fibrosis