Text Moira Vallet-Goldstein

What is asthma?

Asthma is a chronic inflammatory disease of the bronchial airways. During an asthma attack, the muscles that surround the bronchial tubes constrict, narrowing the air passages and making it difficult to breathe. Symptoms of asthma can be mild to severe, intermittent to chronic. 

The one point to remember is that even when symptoms are mild, asthma should not be ignored. Untreated or under treated asthma can lead to severe respiratory distress and in rare cases, sudden death. Asthma is the most common chronic disease of childhood affecting 12.5% of children. 

Symptoms of asthma

Coughing and/or wheezing are typical symptoms of asthma, and often the first one’s parents will notice. But coughing and wheezing are also common symptoms of other respiratory illnesses.  If your child is still young, and particularly if they’re under five, it can be hard to tell if their cough or wheeze is due to asthma. 

Some physicians do not like to give a diagnosis of asthma to young infants and toddlers as other conditions such as croup or bronchiolitis can be responsible for the asthma like symptoms. Until your child is over five, it’s likely that you’ll be told your baby or toddler has ‘suspected asthma’ or that your child’s symptoms are being treated as asthma because it’s too soon to be able to give an asthma diagnosis.

Symptoms of croup

Babies and toddlers (under three) are more likely than older children to get respiratory infections like croup. Croup is a viral infection of the larynx (voice box) which causes a distinctive ‘barking’ cough and a harsh, grating sound on breathing in (known as ‘stridor’). A croup attack can look a bit like an asthma attack. If your child has repeated bouts of croup, they may be more likely to develop asthma.

Symptoms of bronchiolitis

Bronchiolitis is also more common in babies and young children. This is caused by a virus that makes the airways in the lungs swell and narrow – which is why your child will cough and wheeze. They’ll also need to make more effort to breathe. Babies with bronchiolitis can go on to have repeated episodes of wheezing and could be more likely to develop asthma.

What causes asthma in babies and young children?

Doctors still do not know what causes some people to get asthma. If a child has a family history of asthma or allergies, a specific allergy, or has a mother who smoked during pregnancy, he/she has a higher chance of getting asthma early in life.

A respiratory virus, an illness that occurs in the lungs, is one of the most common causes of asthma symptoms in children five years old and younger. Although both adults and children experience respiratory infections, children have more of them. At least half of children with asthma show some sign of it before the age of five. Viruses are the most common cause of acute asthma episodes in infants six months old or younger.

But how can you tell if your baby or toddler has asthma, or if they’re coughing and wheezing because of a cold or virus they’ve picked up?

The signs and symptoms of asthma in a baby or toddler include:

  • Fast breathing
  • Working harder to breathe (nostrils flaring, skin is sucking in around and between the ribs or above the sternum, or exaggerated belly movement)
  • Panting with normal activities such as playing
  • Wheezing (a whistling sound)
  • Persistent coughing
  • Difficulty sucking or eating
  • Tiredness, not interested in normal or favourite activities
  • Cyanosis, a tissue colour change on mucous membranes (tongue, lips, and around the eyes) and fingertips or nail beds – the colour appears greyish or whitish on darker skin tones and bluish on lighter skin tones.

Coughing and wheezing is more likely to be asthma if your child is:

  • coughing or wheezing more at night or early in the morning
  • the cough or wheeze won’t go away or keeps coming back
  • wheezing without other cold symptoms
  • coughing with a dry cough
  • coughing or wheezing after running around, laughing or being in the cold
  • having other symptoms too, such as breathlessness, a tight chest or a tummy ache
  • coughing or wheezing more when they come into contact with triggers like pollen, dustmites, pets, or pollution.

How you can prepare in case your child has an asthma attack

  1. Learn the warning signs for increasing asthma in infants and toddlers.
  2. Know your child’s particular asthma symptom “pattern”.
  3. Develop an Asthma Action Plan with your child’s doctor. Make sure the plan has a course of action to follow if asthma symptoms get worse. Understand when your child needs emergency care.
  4. Stick with the Asthma Action Plan every day even if your child’s symptoms are gone.
  5. Teach your young child to tell when they are not feeling well.
  6. Work out an emergency plan of action to follow if your child has a serious asthma episode, for example what hospital you will use.
  7. Who will take care of your other children.
  8. How your medical coverage provides for emergency care.

What you can do to reduce asthma symptoms in your child

  • Learn your child’s triggers for example pollen, dust, smoke and keep your child away from these.
  • Follow your asthma management plan and give the medicines prescribed by your child’s doctor.
  • Avoid smoking near your child. 

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