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Asthma in children and infants

How can I tell if my child has asthma?

Not all children have the same asthma symptoms, and these symptoms can even vary from episode to episode in the same child. Possible signs and symptoms of asthma in children include:

  • Frequent coughing spells, which may occur during play, at night, on waking, or while laughing or crying.
  • A chronic cough (which may be the only symptom)
  • Less energy during play
  • Rapid breathing (intermittently)
  • Complaint of chest tightness or chest "hurting"
  • Whistling sound when breathing in or out -- called wheezing
  • See-saw motions in the chest from laboured breathing. These motions are called retractions.
  • Shortness of breath, loss of breath
  • Tightened neck and chest muscles
  • Feelings of weakness or tiredness.

While these are some of the symptoms of asthma in children, they can also occur in other conditions and you should seek medical advice for any illness that complicates your child's breathing. About half of infants and toddlers with repeated episodes of wheezing with shortness of breath or cough (even though these illnesses usually respond to asthma medications) will not have asthma by the age of six. 

How common is asthma in children?

Asthma is the leading cause of chronic illness in children. In the UK, over 1.1 million children have asthma. Asthma can begin at any age (even in the very elderly), but most children have their first symptoms by the age of five.

There are many risk factors for developing childhood asthma. These include:

  • Nasal allergies ( hayfever) or eczema (allergic skin rash)
  • A family history of asthma or allergies
  • Frequent respiratory infections
  • Low birth weight
  • Exposure to tobacco smoke before or after birth
  • Being raised in a low-income environment.


How is asthma in children diagnosed?

Asthma in children can often be diagnosed on the basis of medical history, symptoms and a physical examination. Keep in mind that often when you take your infant or older child to the doctor with asthma symptoms, the symptoms may be gone by the time the doctor evaluates the child. That is why parents are key to helping the doctor understand the child’s signs and symptoms of asthma.

  • Medical history and asthma symptom description: Your child's doctor will be interested in any history of breathing problems you or your child may have had, as well as a family history of asthma, allergies, a skin condition called eczema, or other lung disease. It is important that you describe your child's symptoms -- cough, wheezing, shortness of breath, chest pain, or tightness -- in detail, including when and how often these symptoms have been occurring.
  • Physical examination: A simple lung function test called spirometry may be recommended once a child is old enough to perform the test – usually after the age of five. Spirometry measures the amount of air in the lungs and how fast it can be exhaled. A small hand-held device called a peak flow meter may also be used to assess how much air the child can blow out in one breath (peak expiratory flow rate or PEFR). These tests help the doctor determine how severe the asthma is. Other tests may also be ordered to help identify particular " asthma triggers" for your child's asthma. These tests may include allergy skin testing, blood tests (IgE or RAST) and X-rays.
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