Asthma Symptoms in Children

Asthma is the most common chronic lung disease in children. It involves inflammation and narrowing of the airways, which can make it difficult to breathe. The Centers for Disease Control and Prevention (CDC) estimates that about 6 million children in the United States live with asthma.

If asthma isn't diagnosed, it can result in significant physical and emotional distress, missed school, hospital visits, costly healthcare appointments, and missed work for caregivers. Because other illnesses like common colds, flu, and even general congestion can also cause trouble with breathing, sometimes diagnosing asthma is tricky, especially in very young kids.

When to See a Health Care Provider for Asthma in Kids - Illustration by Ellen Lindner

Verywell / Ellen Lindner

Knowing what signs and symptoms to be aware of can help you bring up any concerns to your healthcare provider. It can also give you clues as to when to seek emergency care.

This article will review the signs and symptoms of asthma in children.

Signs and Symptoms of Asthma in Kids

Symptoms of asthma can vary from child to child, and sometimes kids with asthma will have periods where they have no symptoms. Common symptoms can include:

These symptoms can also be indicative of other ailments or illnesses, so if your child has any of these, see your healthcare provider for an exam.

Asthma Attacks

While not all asthma symptoms indicate an asthma attack, when the symptoms worsen, they may lead to an asthma attack. Symptoms of an asthma attack can include:

  • Wheezing (high-pitched whistle or purring sound, mostly when breathing out)
  • Cough
  • Tight chest
  • Trouble breathing

Causes of Asthma in Kids

No one knows the exact cause of asthma, and causes may vary among individuals. Generally, however, asthma results from an overreacting or hyper-responsive immune system to something in the environment such as:

  • Allergens (pollen, pet dander, dust mites, mold)
  • Irritants in the air (smoke, chemicals, fumes, strong odors)
  • Certain weather conditions (extreme cold, dry, or wet air, or wind)

This response causes inflammation and mucus production, making it difficult to breathe. The muscles surrounding the airways may also become tight, contributing to even more difficulty breathing. Over time, this can cause airways to thicken.

Genetics are also thought to play a role in the development of asthma. This can explain why some people exposed to variables and risk factors develop asthma, whereas others exposed to the same things don't.

Risk Factors

Risk factors are variables that increase a person’s risk of a disease or condition. Having risk factors doesn't necessarily mean you'll develop the condition, but it does increase your risk. The more risk factors present, the more likely it is you'll develop the condition.

Asthma is disproportionately diagnosed in urban minority children in low-income households. Black children have higher rates of asthma than Latinx or white children.

Black and Latinx children also report more emergency room visits due to asthma and morbidity from asthma than white children.

Risk factors for asthma that children from low-income families may face include:

  • Increased stress
  • Lower quality home environments
  • Polluted air and water
  • Exposure to tobacco smoke and pollutants
  • Chronic stress, which is linked with higher inflammation that's associated with asthma

Other risk factors for childhood asthma include:

  • Family history of asthma
  • Allergies
  • Being overweight
  • Respiratory infection during infancy

How Is Asthma Diagnosed in Kids?

Diagnosing asthma in children, especially very young children, can be tricky. Along with taking a medical history, doing a physical exam, and asking about any risk factors, as well as when symptoms occur and what triggers them, healthcare providers may do a variety of tests, including:

  • Lung function tests: Like spirometry, which measures how much and how fast air moves when you breathe
  • Spirometry with bronchodilator tests: To measure the air moving in and out before and after taking inhaled medicine to relax airway muscles
  • Peak expiratory flow (PEF) tests: To measure how fast you can blow air out with maximum effort
  • Fractional exhales nitric oxide (FeNO) tests: To measure levels of nitric oxide in your breath, which can reflect lung inflammation
  • Allergy tests: To let the healthcare providers know whether your immune system reacts to certain triggers, which may also be triggers for asthma

In children under 6 years of age, getting a diagnosis can be harder because they may not be able to do all of the usual tests. Your provider may decide to prescribe asthma medication for a short time, based on the presenting symptoms and reported history, to see if your child responds.

Treatment and Management

Controlling asthma is important to prevent any breathing problems and reduce the risk of asthma attacks. The treatment for asthma will depend on your child’s symptoms, overall health, the severity of the asthma, and their age. Your provider may also refer you to a pulmonologist who specializes in lung illnesses, or an allergist.

In addition to treatments, figuring out any triggers is often part of the management plan. Avoiding triggers can help your child reduce the risk of symptoms.

Clinical Treatment

Your healthcare provider may prescribe short-term relief medicines to help treat symptoms during an attack. These may be the only treatments your child needs if their asthma is mild. An inhaler will be prescribed, and this needs to be carried at all times and used as directed.

Medications used for short-term relief include:

  • Inhaled short-acting beta2-agonists (SABAs): To relax tight muscles around the airways so air can pass through
  • Oral or intravenous corticosteroids: To reduce inflammation during an asthma attack
  • Short-acting anticholinergics: To open airways quickly; less effective than SABAs but people who can't tolerate SABAs may find this easier to use

Control medications are for long-term use and are taken daily to prevent symptoms. These can include:

Home Remedies

Talk with your child’s healthcare provider before using any home remedies or supplements for their asthma. Even non-prescription, “all-natural” remedies may be dangerous for children or interact with medication.

At home, avoiding known triggers or allergens and adhering to an asthma action plan can help you and your child manage their asthma.

What Is an Asthma Action Plan?

Everyone with asthma should have an asthma action plan, but this is especially important for children. This written plan has your child's name and information, their primary healthcare provider's name and contact information, instructions on how to manage their asthma, and what to do in an emergency. It usually lists the medicines used, signs and symptoms of a worsening condition, and signs of an emergency.

There has also been research on exercise and dietary changes for children with asthma. For some children, implementation of exercise has been found to improve their asthma symptoms.

However, for some children, this can make asthma worse. Before starting any exercise regimen with your child, talk with your provider.

Being overweight is associated with worse asthma symptoms and outcomes, and a healthy diet can help with weight management and overall health.

One study found that children who were overweight and followed a diet with a nutritionist not only reported weight loss, but also had reduced asthma symptoms, improvements in lung volume, and improved quality of life.

Talk with your healthcare provider about whether dietary changes may be helpful and whether there is a nutritionist available that can supervise meal plans specifically for children with asthma.

When to See a Healthcare Provider

Getting an accurate diagnosis of asthma as soon as possible is important for your child’s health. See your healthcare provider as soon as possible if your child:

When to Seek Emergency Treatment

Sometimes emergency treatment is necessary with asthma. Seek emergency care if:

  • Your child’s lips or nails are turning blue
  • Your child’s nostrils are flaring when they breathe in
  • There's constant wheezing
  • The prescribed treatments aren't relieving asthma symptoms
  • They can't talk because it’s hard to breathe
  • The area between/below the ribs and the neck visibly pull in during breathing (retraction)

Outlook for Asthma in Kids

Although there's no cure for asthma, there are ways to manage it. Research is ongoing about improved medications and treatments for asthma. With proper diagnosis and an appropriate treatment plan, your child can enjoy the activities they’ve always loved.

Summary

Asthma is a common lung condition in children. Symptoms can mimic other illnesses, so being aware of the specific signs can help you understand what might be affecting your child and when to see a healthcare provider. Early diagnosis is important so that inflammation can be addressed and treated.

A Word From VeryWell

Seeing your child having trouble breathing can be a scary thing. But asthma is treatable and manageable, which is why a diagnosis is so important.

You can work together with your healthcare provider to create a plan to identify and avoid triggers and establish what to do in an event of an asthma attack or worsening symptoms.

Frequently Asked Questions

  • What age does asthma usually start?

    Most children with asthma start to have symptoms before the age of 5. Even infants can show signs of asthma, so it’s important to see your child’s healthcare provider if they have any symptoms.


  • What does an asthma attack look like in a child?

    An asthma attack usually involves wheezing or coughing. Your child might say they have a tight chest or have trouble breathing and/or talking. They might also be breathing very quickly or trying very hard to breathe.

  • What does an asthma cough sound like?

    In children, a cough might be present for days or weeks, especially at night. It might also occur with wheezing, or high-pitched whistling when breathing.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Johns Hopkins Medicine. All about asthma in children.

  3. Seattle Children's. Asthma attack.

  4. National Heart, Lung, and Blood Institute. Asthma.

  5. Oland AA, Booster GD, Bender BG. Psychological and lifestyle factors for asthma exacerbations and mortality in children. World Allergy Organization Journal. 2017;10,35. doi: 10.1186/s40413-017-0169-9

  6. American Lung Association. Asthma risk factors.

  7. Asthma and Allergy Foundation of America. Asthma action plan.

  8. Lu KD, Forno E. Exercise and lifestyle changes in pediatric asthma. Curr Opin Pulm Med. 2020;26(1):103-111. doi:10.1097/MCP.0000000000000636

  9. Guillemenault L, Williams EJ, Scott HA, et al. Asthma and diet: is it time to adapt our message? Nutrients. 2017;9(11):1127. doi: https://doi.org/10.3390/nu9111227

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  11. American Lung Association. When to see your doctor.

  12. American College of Allergy, Asthma, & Immunology. Asthma in children.

By Jaime R. Herndon, MS, MPH
Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.