Asthma is a common lung condition in kids and teens. It causes breathing problems, with symptoms like coughing, wheezing, and shortness of breath. Anyone can have asthma, even babies, and the tendency to develop it often runs in families.
Asthma affects the bronchial tubes, or airways. When someone breathes normally, air goes in through the nose or mouth and then into the trachea (windpipe), through the bronchial tubes, into the lungs, and finally back out again.
But people with asthma have inflamed airways that produce lots of thick mucus. The airways also are overly sensitive (or hyperreactive) to certain things, like exercise, dust, or cigarette smoke. This hyperreactivity makes the smooth muscle that surrounds the airways tighten up. The combination of airway inflammation and muscle tightening narrows the airways and makes it hard for air to move through.
More than 25 million people have asthma in the United States. In fact, it's the No. 1 reason kids chronically miss school. And flare-ups are the most common cause of pediatric emergency room visits due to a chronic illness.
Some kids have only mild, occasional symptoms or only show symptoms after exercising. Others have severe asthma that, if not treated, can greatly limit how active they are and cause changes in lung function.
But thanks to new medicines and treatment strategies, kids with asthma don't need to sit on the sidelines and their parents don't need to worry constantly. With knowledge and the right asthma management plan, families can learn to better control symptoms and asthma flare-ups, letting kids do just about anything they want.
Many kids with asthma can breathe normally for weeks or months between asthma flare-ups (also called asthma attacks, flares, episodes, or exacerbations) that cause the airways to narrow and become blocked, making it hard for air to move through them.
Flare-ups often seem to happen without warning, but they usually develop over time during a complicated process of increasing airway blockage.
All children with asthma have airways that are inflamed, which means that they swell and produce lots of thick mucus. And their airways are overly sensitive, or hyperreactive, to certain asthma triggers.
When exposed to these triggers, the muscles surrounding the airways tend to tighten, which makes the already clogged airways even narrower. Things that trigger flare-ups differ from person to person. Some common triggers are exercise, allergies, viral infections, and smoke.
So an asthma flare-up is caused by three important changes in the airways:
Together, the swelling, excess mucus, and bronchoconstriction narrow the airways and make it difficult to move air through (like breathing through a straw). During an asthma flare-up, kids may have coughing, wheezing (a breezy whistling sound in the chest when breathing), chest tightness, an increased heart rate, sweating, and shortness of breath.
Diagnosing asthma can be tricky and time-consuming because kids with asthma can have very different symptoms. For example, some kids cough constantly at night but seem fine during the day, while others seem to get a lot of chest colds that linger. It's common for kids to have symptoms like these for months before being seen by a doctor.
When considering a diagnosis of asthma, a doctor rules out other possible causes of the symptoms. He or she asks questions about the family's asthma and allergy history, performs a physical exam, and might order a chest X-rays or lung function tests.
During this process, parents will give the doctor such detailed information as:
This information helps the doctor understand the pattern of symptoms, which can help determine what type of asthma the child has and how best to treat it.
To confirm the diagnosis of asthma, a breathing test may be done with a spirometer, a machine that analyzes airflow through the airways. A spirometer also can be used to see if the child's breathing problems can be helped with medicine, which is a primary sign of asthma.
The doctor may take a spirometer reading, give the child an inhaled medication that opens the airways, and then take another reading to see if breathing improves. If the medicine eases airway narrowing significantly, then there's a strong possibility that the child has asthma.
If your child is diagnosed with asthma, it's important to learn how to manage asthma so it won't control your family. Educate yourself about asthma and learn to identify and eliminate triggers.
Help your child keep an asthma diary, develop and follow an asthma action plan, and take medicines as prescribed. Also, a peak flow meter — a handheld tool that measures breathing ability — can be used at home. When peak flow readings drop, it's a sign of increasing airway inflammation.
Kids who have exercise-induced asthma (EIA) develop asthma symptoms after being very active (running, swimming, biking, etc.). Some develop symptoms only after physical activity, while others have additional asthma triggers.
With the proper medicines, most kids with EIA can play sports like other kids. In fact, asthma affects more than 20% of elite athletes, and 1 in every 6 Olympic athletes, according to the American Academy of Allergy, Asthma, and Immunology.
Usually, a doctor can diagnose EIA after taking a medical history. But sometimes more tests, including an exercise challenge in a lung function laboratory, are done confirm the diagnosis. The doctor might want to focus on a child's tolerance for a particular exercise, as not every type or intensity of exercise affects kids with EIA the same way.
If exercise is the only asthma trigger, the doctor may prescribe a medicine to be taken before exercising to prevent airways from tightening up. Even after kids take a preventive medicine, though, asthma flare-ups can still happen. So parents or older kids should carry the proper quick-relief medicine (also called rescue or fast-acting medicine) to all games and activities. Quick-relief medicines work immediately to relieve asthma symptoms.
Tell the school nurse, coaches, club leaders (Boy Scouts, Girl Scouts, etc.), teachers, and any other caregivers about your child's asthma care plan so that he or she can take medication as needed when away from home.
About 75% to 85% of people with asthma have some type of allergy. Even if the main triggers are colds or exercise, allergies can sometimes play a minor role in making asthma worse.
How do allergies cause flare-ups in kids with asthma? Kids inherit the tendency to have allergies from their parents. With any kind of allergy, the immune system overreacts to normally harmless allergens. Those substances (such as pollen) can cause allergic reactions in some people. As part of this overreaction, the body produces an antibody — called immunoglobulin E (IgE) — that recognizes and attaches to the allergen when the body is exposed to it.
When this happens, it starts a process that ends in the release of certain substances in the body. One of them is histamine, which causes allergic symptoms that can affect the eyes, nose, throat, skin, gastrointestinal tract, or lungs. When the airways in the lungs are affected, symptoms of asthma can happen.
The released histamine is what causes the familiar sneezing, runny nose, and itchy, watery eyes associated with some allergies — ways the body attempts to rid itself of the invading allergen. In kids with asthma, histamine also can trigger asthma symptoms and flare-ups.
An allergist can usually pinpoint allergies. Once they're identified, the best treatment is to avoid exposure to them whenever possible, such by taking environmental control measures inside the home.
When triggers can't be avoided, antihistamine medicines (to block the release of histamine in the body) or nasal steroids (to block allergic inflammation in the nose) might be prescribed. In some cases, an allergist can prescribe immunotherapy, a series of allergy shots that gradually make the body unresponsive to specific allergens.
The severity of a child's asthma symptoms will fall into one of four main categories of asthma, each with different characteristics and requiring different treatment approaches:
Asthma severity can both worsen and improve over time, placing a child in a new asthma category that needs different treatment.
All kids with asthma should follow a custom asthma action plan to control symptoms. And even mild asthma should never be ignored because airway inflammation is present even in between flare-ups.
|American Academy of Allergy, Asthma, and Immunology The American Academy of Allergy, Asthma, and Immunology offers up-to-date information and a find-an-allergist search tool.|
|American College of Allergy, Asthma, and Immunology The ACAAI is an organization of allergists-immunologists and health professionals dedicated to quality patient care. Contact them at: American College of Allergy, Asthma, and Immunology|
85 W. Algonquin Road
Suite 550 Arlington Heights, IL 60005
|Allergy and Asthma Network/Mothers of Asthmatics (AAN-MA) Through education, advocacy, community outreach, and research, AAN-MA hopes to eliminate suffering and fatalities due to asthma and allergies. AAN-MA offers news, drug recall information, tips, and more for treating allergies and asthma. Call: (800) 878-4403|
|Asthma Action Plan When things are confusing, a plan really helps. Check out this asthma action plan, which you can print out and use to manage breathing trouble.|
|Dealing With Asthma Triggers Don't pull that asthma trigger! If you have asthma, certain things may cause you to cough and have trouble breathing. Find out more about asthma triggers in this article for kids.|
|Dealing With Asthma Triggers Triggers are substances or activities that are harmless to most people. But in people with asthma, they can lead to coughing, wheezing, and shortness of breath. Read this article for tips on dealing with asthma triggers.|
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|School and Asthma Lots of teens have asthma. Here are tips on keeping it under control so you don't have a flare-up in school.|
|Asthma Action Plan Use this printable sheet to help reduce or prevent flare-ups and emergency department visits through day-to-day management of your child's asthma.|
|Asthma Action Plan Use this printable sheet to help manage your asthma.|
|First Aid: Asthma Flare-Ups During a flare-up or attack, it's hard to breathe. While some flare-ups are mild, others can be life threatening, so it's important to deal with them right away.|
|Allergies Your eyes itch, your nose is running, you're sneezing, and you're covered in hives. The enemy known as allergies has struck again.|
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|Asthma Center Visit our Asthma Center for information and advice on managing and living with asthma.|
|What's a Peak Flow Meter? Even if you're breathing OK, an asthma flare-up may be just around the corner. How can you tell? You can use a tool called a peak flow meter. Find out what a peak flow meter is and what it can do for you.|
|How Can I Deal With My Asthma? Asthma is more common these days than it used to be. The good news is it's also a lot easier to manage and control.|
|How Do Asthma Medicines Work? Two different types of medicines are used to treat asthma: quick-relief medicines and long-term control medicines. Read about how they work - and why people might need to take them.|
|How Do Asthma Medicines Work? Kids who have asthma need to take medicine. But what kind of medicine do they take and what does it do? Let's find out.|
|What's a Peak Flow Meter? Kids who have asthma use peak flow meters to measure how well they are breathing. Find out more in this article for kids.|
|Handling an Asthma Flare-Up How can you prepare for an asthma flare-up? Find out in this article for kids.|
|Dealing With an Asthma Flare-Up Asthma flare-ups, or attacks, can be handled, but it's even better if you can prevent them from happening. Find out how to deal with flare-ups.|
|Do Allergies Cause Asthma? Kids who have allergies are more likely to have a breathing problem called asthma. Find out more in this article for kids.|
|Do Allergies Cause Asthma? Although allergies and asthma are separate conditions, they are related. People who have allergies - particularly ones that affect the nose and eyes - are more likely to have asthma.|
|Do Allergies Cause Asthma? Some things that cause an allergic reaction, such as pollen or dust, can also trigger asthma symptoms. But not everyone who has allergies develops asthma and not all case of asthma are related to allergies. Find out about the connection here.|
|Asthma-Safe Homes You want to feel good in your own home, right? If you have asthma, you can take steps to remove or minimize triggers at home that cause breathing problems and asthma flare-ups.|
|Managing Asthma Asthma control can take a little time and energy to master, but it's worth the effort. Learn more about ways to manage your child's asthma.|
|When to Go to the ER if Your Child Has Asthma If your child has asthma, it's important to know when going to the ER is the right choice.|
|School and Asthma If a kid has asthma, he or she needs to know how to handle it at school. Find out more in this article for kids.|
|Asthma and Teens The teen years can be rough for kids, and they can be even rougher for teens with asthma. These tips can make parenting a teen with asthma a bit easier.|
|Asthma Asthma is a condition that affects a person's airways, also known as breathing tubes. Find out more in this article for kids.|
|Allergy Shots Many kids battle allergies year-round, and some can't control their symptoms with medications. For them, allergy shots (or allergen immunotherapy) can be beneficial.|
|Asthma Center Asthma keeps more kids home from school than any other chronic illness. Learn how to help your child manage the condition, stay healthy, and stay in school.|
|Dealing With Asthma Triggers Triggers - substances, weather conditions, or activities - can lead to flare-ups in kids with asthma. By knowing and avoiding triggers, you'll help minimize your child's asthma symptoms.|
|Handling an Asthma Flare-Up Because they can be life threatening, asthma flare-ups can and should be treated at their earliest stages. So it's important to recognize their early warning signs.|
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