Asthma is extremely common, but how can you tell if your baby has infant asthma when he can't even talk? Most of the 6 million children with asthma develop symptoms before the age of 6, and many begin wheezing before 1 year. It is important to diagnose infant asthma because if left untreated, inflammation can cause permanent damage to the lungs.
Diagnosing infant asthma is difficult, because infant asthma symptoms can be so subtle that you might not suspect it. Because your infant can't describe for you or your doctor how he or she is feeling, your doctor relies on your description of the symptoms as well as how your baby acts. Additionally, your doctor will also consider a family history of asthma or allergies in deciding whether your baby has infant asthma.
What Are The Symptoms of Infant Asthma?
Just as in adults, infant asthma symptoms can vary from child to child. In infant asthma, babies may have all of the classic adult asthma symptoms described below, or just one of those symptoms. Additionally, poor feeding, sweating, or appearing uncomfortable may be symptoms of infant asthma.
Common adult asthma symptoms include:
Your doctor may also ask about the following when considering an infant asthma diagnosis:
- Has your child wheezed more than once? Many infants will experience some wheezing after an upper respiratory tract infection. However, if your infant does this frequently, it increases the chances your child has infant asthma.
- Does your child cough at night? Nighttime cough is one of the symptoms used to monitor asthma control and will make your doctor suspicious of infant asthma.
- Does your child wheeze after exposure to allergens? If wheezing occurs after exposure to allergens, then your child could have infant asthma. These allergens include:
- Does your child wheeze when exposed to tobacco smoke? Smoke is a lung irritant that can lead to asthma symptoms.
- Does crying or laughing cause wheezing?
- Does your child breathe so fast that they have difficulty finishing a bottle? Not being able to finish a bottle can be a sign of difficulty breathing.
Not All That Wheezes Is Infant Asthma
Wheezing can be caused by a number of other conditions and infections. Bronchiolitis, or inflammation of the small airways of the lungs, is the most common condition besides asthma that causes wheezing in young children. Caused by the RSV virus and other viruses such as influenza and parainfluenza, this condition can mimic asthma in infants by causing recurrent wheezing or reactive airway disease. Other conditions that may cause wheezing include:
- Congenital heart disease
- Cystic fibrosis
- Foreign object stuck in the respiratory tract
- Tracheoesophageal fistula
- Upper respiratory tract infection
Infant Asthma Treatment
Infant asthma is treated with many of the same medications as adult asthma. Your doctor may elect to start treatment if they are unsure whether your child has a diagnosis of infant asthma, or they may monitor symptoms for a period of time.
While you may be worried about side effects of treatment, asthma medications are generally well-tolerated. You can learn more about asthma medication side effects here.
Few studies have been performed to look at how well the typical asthma medications work in infants. Most of the current recommendations are derived from expert opinion, and many of the asthma medications are not FDA-approved for infant asthma, although your doctor may still use them. Importantly, there is not good evidence for the use of inhaled steroids in infant asthma, so these medications are used infrequently.
Infant Asthma - When To Call The Doctor
One of the most important skills as a parent of a child with asthma-like symptoms is to know when you need to call your doctor or head to the emergency department. If you suspect wheezing and your child has never wheezed before, it is important to promptly see a healthcare provider to figure out what is causing the wheezing.
All of the following symptoms in your infant are indications that you need to bring him or her to a healthcare provider for emergency care immediately:
- Wheezing that occurs while breathing both in and out
- Coughing that has become continuous
- Very fast breathing
- Retractions, which means your infant's skin is pulled into their chest as they inhale
- Shortness of breath
- Becoming pale
- Blue lips or fingernails (called cyanosis)
Just because your infant wheezes does not mean they have asthma. However, you want to be sure you have your child evaluated to make sure they do not have infant asthma.
National Heart, Lung, and Blood Institute. Accessed: January 8, 2009. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma
Asthma. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine. Editors: Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. May 2005, 5th edition.