The number of children with asthma has risen dramatically in the past few decades.  With the wheezing comes worrying. 

Could your child be the one who is touched by this common chronic disease? Here’s what parents need to know about asthma. 

Asthma is a health problem that tends to run in families. Sufferers have overly sensitive airways that swell, tighten and make too much mucus. Who’s at highest risk of getting asthma? Children who are born premature, live with smokers, or have parents or close family members who have allergies or asthma are more likely to get the disease. Health experts are still trying to figure out what causes asthma, but it seems to be a combination of family history and exposure to environmental causes.

About half of children with asthma develop symptoms by age two. Nearly 80% will have symptoms by age five. Still, detecting asthma in babies and toddlers can be hard. When very young children get certain lung infections, their tiny airways easily fill with mucus. This can lead to wheezing that may sound like asthma, but isn’t.

Look for these symptoms each time your child gets a cold or viral illness: 

• Shortness of breath
• Chest tightness
• Coughing — especially at night, early in the morning, and during or after exercise
• Wheezing

Don't Wait

If you think your child may have asthma, don’t wait. Take them to see a doctor. A medical history, certain breathing tests, and allergy screenings can help decide if treatment is needed.

What causes asthma symptoms? Possible culprits include cigarette smoke, dust mites and pets. Allergies are a common trigger for asthma symptoms. If your child has allergies, managing the triggers may lead to fewer asthma problems.

Tips to Manage Triggers
Work with the doctor to find your child’s allergic triggers. Then talk through ways you can avoid or control them. For example:

• Dust mites. These microscopic bugs thrive in mattresses, pillows, bedding and other cloth items. Encase mattresses and pillows in covers and minimize extra bedding items such as throw blankets, stuffed animals and decorator pillows. Wash bedding regularly in hot water.
• Indoor mold. Mold and mildew grow in damp areas. Depending on the time of year and area you live in, keep indoor humidity levels no more than 50%. Scrub any visible mold from hard surfaces with water and detergent. Dry the area completely. Fix and seal any leaks.
• Furry animals. Ban dogs and cats from your child’s room. If your child has a pet hamster, rabbit or guinea pig, have someone else clean the cage.

Treating Allergies
Talk with your child’s doctor about allergy treatments. Choices include:

• Nasal sprays. Steroid nasal sprays are now often the main treatment for allergies. They are safe when used as directed and you can buy them without a prescription.  Check with your child’s doctor before using.
• Prescription drugs. Your child’s doctor has some options when it comes to prescription medications for asthma. Talk through them during an exam.
• Allergy shots. This treatment is generally used for severe allergies when other treatments don’t work. Shots can help the immune system become less sensitive to allergy-causing items. Regular visits to the doctor’s office are needed for at least three years. Children with severe asthma may not be able to take allergy shots.

Keep Asthma Under Control

Make sure you have an Asthma Action Plan. The plan should outline steps to help your child during an asthma flare up. Share the plan with your child’s school and any caregivers, including grandparents and babysitters. 

Get help if you see any of these warning signs. They could mean your child’s asthma is getting worse. Talk to your child’s doctor if:

• Your child’s symptoms are more acute, happen more often or cause your child to lose sleep.
• Your child is missing school because of asthma or cannot complete activities as usual.
• Your child’s medicine doesn’t seem to work as well.
• Your child needs quick-relief medicine  two or more times per week. 
• Your child needs to go to the hospital due to an asthma attack.

Keep a daily log of your child’s peak-flow meter  readings so you can tell if it is low or varies day-to-day. Your doctor may also ask you to track these readings for a couple of weeks leading up to an office visit.

A change in medicine or other steps might help keep your child’s asthma symptoms under control.

Sources: Childhood Asthma,  American Academy of Allergy, Asthma & Immunology, 2023; Asthma Facts and Figures,  Asthma and Allergy Foundation of America, 2023;  Asthma,  National Institutes of Health, 2022

Originally Published 6/1/2016; Revised 2020, 2022, 2024