Asthma in Children
Asthma is a common chronic lung disease in children that causes airway inflammation, but it can be effectively managed with proper treatment and trigger avoidance.
Overview
Asthma is a chronic (long-term) lung disease that affects the airways—the tubes that carry air in and out of your lungs. When a child has asthma, these airways can become inflamed and narrowed, leading to wheezing, coughing, and chest tightness. When these symptoms worsen, it is referred to as an asthma attack or flare-up. Asthma is the most common chronic disease of childhood, often beginning before age 5.
Causes & Risk Factors
While the exact cause of asthma is unknown, genetics and environment play significant roles. An asthma attack is often triggered by exposure to specific substances or conditions:
Triggers
- Allergic asthma: Caused by allergens such as dust mites, mold, pets, pollen (grass, trees, and weeds), and waste from pests like cockroaches and mice.
- Nonallergic asthma: Caused by triggers including cold air, certain medicines, household chemicals, infections (colds and the flu), outdoor air pollution, and tobacco smoke.
- Exercise-induced asthma: Occurs during physical activity, particularly in dry air.
Risk Factors
- Exposure to secondhand smoke during pregnancy or early childhood.
- Genetics and family history, particularly if the mother has asthma.
- Race or ethnicity; Black, African American, and Puerto Rican children are at higher risk.
- Presence of other conditions like obesity or allergies.
- Frequent viral respiratory infections during early childhood.
- Sex; asthma is more common in boys during childhood and in girls during the teenage years.
Symptoms
Symptoms range from mild to severe and may occur frequently or sporadically:
- Chest tightness
- Coughing (especially at night or early morning)
- Breathing difficulties (shortness of breath, rapid breathing, or gasping)
- Fatigue
- Dark circles under the eyes
- Irritability
- Wheezing (a whistling sound when breathing out)
- Trouble eating or sucking (in infants)
Warning: Severe asthma attacks can be life-threatening. Seek immediate medical help if a child experiences severe coughing, serious breathing problems, or if their face, lips, or fingernails turn pale or blue.
Diagnosis
Diagnosing asthma in young children can be challenging due to overlapping symptoms with other conditions. Providers may use:
- Physical exam and medical history
- Chest x-ray
- Lung function tests (such as spirometry) to assess lung performance
- Allergy skin or blood tests
- A trial of asthma medicines to see if symptoms improve
Treatment & Management
Treatment plans are developed with a health care provider to manage symptoms and prevent attacks:
- Trigger avoidance: Identifying and removing environmental triggers, such as tobacco smoke.
- Short-term relief medicines: Quick-acting inhalers or other medications used to prevent or relieve symptoms during an attack.
- Control medicines: Used to reduce airway inflammation and prevent narrowing, depending on the severity and frequency of symptoms.