Summary
Asthma in children is different from asthma in adults and should be managed using child-specific guidelines. While the number of asthma cases has stabilized in many developed countries, it remains a leading cause of illness and hospitalization in children.
Most children with asthma have mild, intermittent symptoms and do not need daily medication. For those who do require treatment, the goal is to use the lowest effective dose to maintain good symptom control. Treatment plans should be tailored to each child’s needs.
Doctors also consider other possible conditions, as well as environmental factors and medication adherence, especially in very young children or when high doses of inhaled corticosteroids are needed.
Diagnosis and When to Seek Help
If your child has frequent coughing, wheezing, shortness of breath, or tightness in the chest—especially at night or after physical activity—it’s important to see a doctor. Other signs of asthma include:
- Coughing that worsens with exercise, cold air, or allergens
- Frequent respiratory infections that take longer to clear
- Difficulty keeping up with peers due to breathing issues
A doctor will diagnose asthma based on symptoms, medical history, and breathing tests, if appropriate for the child’s age. Since other conditions can mimic asthma, a thorough evaluation is needed, particularly in very young children.
Management
The goal of asthma treatment is to control symptoms, prevent flare-ups, and maintain a healthy, active lifestyle. Management includes:
- Avoiding triggers such as smoke, dust, pet dander, or pollen.
- Using medication as prescribed:
- Reliever inhalers (short-acting bronchodilators) for quick symptom relief.
- Preventer medications (inhaled corticosteroids) for children with frequent or persistent symptoms.
- Creating an asthma action plan with a doctor to guide treatment at home.
Follow-Up and Monitoring
Regular check-ups help ensure that asthma is well controlled and that medication doses remain appropriate. If symptoms worsen, frequent reliever medication use is needed, or nighttime symptoms increase, the treatment plan may need adjustment.
With proper management, most children with asthma can participate in normal activities, including sports and play, without limitations.
History and Exam
Key diagnostic factors
- presence of risk factors
- wheezing episode triggers
- increased work of breathing
- features of atopic disease
Other diagnostic factors
- age>3 years
- dry night-time cough
- dyspnoea on exertion
- expiratory wheezing
Risk factors
- allergic sensitisation
- atopic disease
- respiratory tract infections in early life
- serum eosinophilia
Diagnostic Investigations
1st investigations to order
- spirometry
- peak expiratory flow(PEF)
- response to bronchodilator
Investigations to consider
- airway challenge tests
- exercise challenge test
- FBC
- sweat test
Emerging tests
- fractional expired nitric oxide (FeNO)
Book an Appointment
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