Patient education: Asthma in children (The Basics)

What is asthma? — Asthma symptoms can be mild or severe. And they can come and go. An asthma "attack" is when symptoms start suddenly. This can be scary. It happens when the airways in the lungs become more narrow and inflamed (figure 1).

Asthma can run in families.

What are the symptoms of asthma? — Asthma symptoms can include:

●Wheezing, or noisy breathing

●Coughing, often at night or early in the morning, or during exercise

●A tight feeling in the chest

●Trouble breathing

Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although it is rare, an asthma attack can lead to death.

Is there a test for asthma? — Yes. The doctor might have your child do a breathing test to see how their lungs are working. Most children 6 years and older can do this test. This test is useful, but it is often normal in children with asthma if they have no symptoms at the time of the test.

The doctor will also do an exam and ask questions such as:

●What symptoms does the child have?

●How often do they have the symptoms?

●Do the symptoms wake them up at night?

●Do the symptoms keep them from playing or going to school?

●Do certain things make symptoms worse, like having a cold or exercising?

●Do certain things make symptoms better, like medicine or resting?

How is asthma treated? — Asthma is treated with different types of medicines. The medicines can be inhalers, liquids, or pills. Your doctor will prescribe medicine based on your child's age and symptoms. Asthma medicines work in 1 of 2 ways:

●Quick-relief medicines stop symptoms quickly. These medicines should only be used once in a while. If your child regularly needs these medicines more than twice a week, tell their doctor. You should also call your child's doctor if this medicine is used for an asthma attack and symptoms come back quickly, or do not get better. Some children get hyperactive, and have trouble staying still, after taking these medicines.

●Long-term controller medicines control asthma and help prevent future attacks. If your child has frequent symptoms or several severe episodes in a year, they might need to take these each day.

Almost all children with asthma use an inhaler with a device called a "spacer." Some children need a machine called a "nebulizer" to breathe in their medicine. The spacer and nebulizer both help get more medicine into your child's lungs, where it is needed (figure 2). A doctor or nurse will show you the right way to use these.

It is very important that you give your child all of the medicines that the doctor prescribes. You might worry about giving a child a lot of medicine. But leaving your child's asthma untreated has much bigger risks than any risks that the medicines might have. Asthma that is not treated with the right medicines can:

●Prevent children from doing normal activities, such as playing sports

●Make children miss school

●Damage the lungs

What is an asthma action plan? — An asthma action plan is a list of instructions that tell you:

●What medicines your child should use at home each day

●What warning symptoms to watch for (which suggest that asthma is getting worse)

●What other medicines to give your child if the symptoms get worse

●When to get help or call for an ambulance

You, your child, and their doctor will work together to make an asthma action plan for your child. As part of the action plan, your child might need to use a device called a "peak flow meter." This device is used at home to see how well your child's lungs are working. The doctor will show you and your child the right way to use a peak flow meter.

Can asthma symptoms be prevented? — There are things that you and your child can do to help prevent asthma attacks. Your doctor or nurse will talk to you about what is most important for your child.

In general, you can:

●Lower your child's risk of getting sick – In children, viral infections are the most common asthma "trigger." (Triggers are things that make symptoms worse.) Examples include the common cold, the flu, and coronavirus disease 2019 (COVID-19).

It's important that children get the COVID-19 vaccine, plus all recommended boosters. This will lower the risk of severe illness if they do get COVID-19. They should also get a flu shot every year.

If you think that your child might have an infection, tell their doctor or nurse. They can help you figure out if the child needs treatment.

●Avoid other triggers – Other common triggers include smoke, air pollution, dust, mold, pollen, strong chemicals or smells, and very cold or dry air. For some people, being around certain animals can trigger symptoms. Exercise and stress can also be triggers.

If your child can't avoid certain triggers, talk with their doctor about what they can do. For example, they might need to take an extra dose of their quick-relief inhaler medicine before they exercise or are around things that they are allergic to.

●Know how and when to give your child their medicines – If your child takes controller medicines, it's important to follow all of the instructions to help prevent symptoms. You should also make sure that you know how and when to give their quick-relief medicine.

●See the doctor or nurse regularly – If your child needs asthma medicine every day, they should see their doctor or nurse regularly. For many children, this means every 3 to 6 months. At these appointments, they will ask about your child's symptoms, check how well their lungs are working, and talk about their treatment plan.

What will my child's life be like? — Most children with asthma are able to live normal lives. You can help manage your child's asthma if you:

●Make changes in your life to avoid your child's triggers.

●Keep track of your child's asthma.

●Follow the action plan.

●Tell the doctor when your child's symptoms change.

Sometimes, asthma gets better as children get older. They might not have asthma symptoms when they become adults. But other children can still have asthma when they grow up.

When should I call the doctor? — Call for an ambulance (in the US and Canada, call 9-1-1) if your child has severe symptoms during an asthma attack like:

●They have so much trouble breathing that they cannot talk.

●The skin and muscles around their ribs are pulling in with each breath (called "retractions").

●Their lips or fingernails turn gray or blue.

●They are very drowsy or not responding normally.

Call your child's doctor or nurse if:

●Your child has an asthma attack and the symptoms do not improve, or get worse, after using a quick-relief medicine.

●Your child needs to use their quick-relief medicine more than 2 times a week.

●Your child cannot do their normal activities because of their asthma symptoms.

●You have any questions about your child's medicines.

More on this topic

Patient education: Medicines for asthma (The Basics)
Patient education: Avoiding asthma triggers (The Basics)
Patient education: Asthma in adults (The Basics)
Patient education: Flu (The Basics)
Patient education: Cough in children (The Basics)
Patient education: Breathing tests (The Basics)
Patient education: Exercise-induced asthma (The Basics)

Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics)
Patient education: Asthma treatment in children (Beyond the Basics)
Patient education: Exercise-induced asthma (Beyond the Basics)
Patient education: Trigger avoidance in asthma (Beyond the Basics)
Patient education: Asthma inhaler techniques in children (Beyond the Basics)
Patient education: How to use a peak flow meter (Beyond the Basics)