Asthma is a chronic respiratory condition affecting millions of children worldwide, causing inflammation and narrowing of the airways, which leads to problems like difficulty breathing, coughing, wheezing, and chest tightness. In children, asthma can impact daily life, as it limits their daily activities, and even affects school attendance and performance. The exact causes of asthma in children are complex, including genetic factors, environmental triggers like allergens or pollution, and respiratory infections. Proper management through medications, trigger avoidance, and asthma action plans is essential to help children lead healthy, active lives despite the challenges posed by asthma.

What Is Asthma In Children?

Asthma Symptoms In Children

Asthma in children is a chronic respiratory condition where the airways in their lungs become inflamed, narrow, and produce excess mucus, making it difficult for them to breathe, leading to various issues. This inflammation makes the airways highly sensitive to various triggers, such as pollen, dust mites, smoke, pet dander, exercise, and viral infections like the common cold. When exposed to these triggers, a child with asthma may experience symptoms like wheezing, shortness of breath, chest tightness, and coughing, especially at night or early in the morning. In children, asthma can sometimes be more challenging to diagnose because symptoms can overlap with those of other respiratory illnesses, like bronchitis or pneumonia, especially in young children who may not be able to fully tell or explain how they feel. Asthma attacks in children can vary in severity and frequency, ranging from mild and sporadic symptoms to severe, persistent episodes that require emergency medical attention. 

Recognizing asthma symptoms in children early on is essential for effective management and treatment. Managing asthma in children involves a combination of avoiding triggers, monitoring symptoms, and using medications like inhaled corticosteroids and bronchodilators as prescribed by a healthcare provider. With proper management, children with asthma can lead active, healthy lives, but they require ongoing care and an asthma action plan to handle potential flare-ups and reduce the impact of the condition on their daily activities. Asthma symptoms in children might sometimes be mistaken for other respiratory issues, 

Asthma is one of the most common chronic conditions among children worldwide. Asthma in children is a significant health concern in India, where environmental factors and limited access to healthcare in some areas can exacerbate the condition.

Types Of Asthma In Children

While asthma symptoms can vary from child to child, doctors classify asthma into different types based on the frequency, triggers, and underlying causes of symptoms. Here’s an overview of the main types of asthma in children:

1. Intermittent Asthma

  • Description: Symptoms appear only occasionally, typically fewer than twice a week. The child may experience mild symptoms that don’t interfere much with daily activities.
  • Triggers: This type is often triggered by specific factors, such as colds, exercise, or allergens (like pollen or pet dander).
  • Symptoms: Shortness of breath, wheezing, coughing and feeling of tightness in the chest. These symptoms may flare up briefly and subside.
  • Treatment: Inhalers or bronchodilators may be prescribed to manage sudden symptoms.

2. Persistent Asthma

Persistent asthma is further divided into mild, moderate, and severe types, depending on the frequency and intensity of symptoms.

  • Mild Persistent Asthma
    • Description: In this type of asthma symptoms can be seen more than twice a week.
    • Symptoms: Periodic wheezing, coughing, and chest tightness that may interrupt sleep or activities occasionally.
    • Treatment: A daily controller medication, such as a low-dose inhaled corticosteroid, may be prescribed to reduce inflammation.
  • Moderate Persistent Asthma
    • Description: Symptoms occur daily and may interfere with daily activities.
    • Symptoms: Frequent wheezing, coughing, and difficulty breathing, especially at night.
    • Treatment: A medium-dose inhaled corticosteroid or combination therapy (inhaled steroid and long-acting beta-agonist) is often used to manage symptoms.
  • Severe Persistent Asthma
    • Description: Symptoms occur multiple times a day and severely limit the child’s daily activities.
    • Symptoms: Persistent wheezing, coughing, and shortness of breath that may require frequent emergency care.
    • Treatment: High-dose inhaled corticosteroids, combination inhalers, and sometimes oral steroids. Severe cases may need additional asthma medications.

3. Exercise-Induced Asthma

  • Description: Symptoms occur during or after physical activity, commonly in sports or activities that require continuous movement, like running or swimming.
  • Symptoms: Shortness of breath, wheezing, and coughing triggered by exercise.
  • Treatment: A bronchodilator or quick-relief inhaler taken before exercise may help prevent symptoms. Some children may also need long-term control medication if they have underlying asthma.

4. Allergic Asthma

  • Description: Triggered by allergens, such as dust mites, pet dander, mould, pollen, or certain foods.
  • Symptoms: Wheezing, coughing, and difficulty breathing, often accompanied by other allergic reactions like runny nose or itchy eyes.
  • Treatment: Management includes avoiding allergens, taking antihistamines, using inhalers for symptom relief, and sometimes using allergy shots (immunotherapy) if the allergens are known and unavoidable.

5. Cough-variant asthma

  • Description: Characterized mainly by a chronic cough rather than the typical wheezing or shortness of breath associated with asthma.
  • Symptoms: Persistent dry cough, especially at night or after exercise. This type is sometimes mistaken for other conditions like chronic bronchitis.
  • Treatment: Inhaled corticosteroids and bronchodilators are typically prescribed. A proper asthma diagnosis is essential since symptoms overlap with other respiratory conditions.

6. Nocturnal Asthma

  • Description: Symptoms worsen at night, leading to disrupted sleep.
  • Symptoms: Coughing, wheezing, chest tightness, and shortness of breath during the night or early morning.
  • Treatment: Adjusting medication schedules, using long-acting bronchodilators or corticosteroids before bedtime, and managing any sleep-related issues can help.

7. Non-Allergic Asthma

  • Description: Not triggered by allergens; instead, triggers can include cold air, respiratory infections, smoke, pollution, and stress.
  • Symptoms: Similar to allergic asthma, with wheezing, shortness of breath, and coughing, but not linked to specific allergens.
  • Treatment: Avoiding known triggers and using prescribed inhalers or bronchodilators to control symptoms.

Each child’s asthma is unique, and effective management requires a personalized approach that considers their specific symptoms, triggers, and lifestyle. Parents should monitor asthma symptoms in children closely, as these can worsen during cold weather or allergy seasons. Paediatricians or pediatric allergists often recommend creating an asthma action plan, which outlines daily management steps, preventive measures, and emergency actions to manage symptoms effectively. 

8. Bronchial Asthma 

Description: Bronchial asthma in children is a chronic inflammatory condition affecting the airways in the lungs. In children with asthma, the bronchial tubes, which carry air to and from the lungs, become overly sensitive to certain triggers, such as allergens (like dust mites, pet dander, pollen), respiratory infections, physical exertion, and environmental irritants (such as smoke or pollution).

When these triggers are encountered, the bronchial tubes react by inflaming and swelling, which narrows the airways and makes it harder for air to flow through. The muscles around the bronchial tubes may also tighten, further restricting airflow. Mucus production often increases during an asthma attack, adding another layer of obstruction in the airways. Managing bronchial asthma in children also involves identifying and avoiding known triggers, developing an asthma action plan, and regular follow-up with a healthcare provider to monitor symptoms and adjust treatment as needed. With proper management, most children with asthma can lead active and healthy lives.

Symptoms:  Symptoms can vary in severity and may be triggered by allergens, infections, exercise, or weather changes. Common symptoms in children include:

  • Frequent coughing – Especially at night, early morning, or during physical activity.
  • Wheezing –  a high-pitched whistling sound occurs while breathing out
  • Shortness of breath – a child may face difficulty in breathing.
  • Chest tightness – A feeling of tightness in the chest.
  • Difficulty in sleeping – Due to coughing or breathing discomfort at night.
  • Fatigue – Feeling tired or lethargic due to reduced oxygen and disrupted sleep.
  • Rapid breathing – Faster-than-normal breathing rate during an asthma attack.

If your child experiences these symptoms frequently or severely, consult a healthcare provider for assessment and management, which may include medications, inhalers, and lifestyle changes to control triggers.

Treatment: Treating bronchial asthma in children involves a combination of medications, lifestyle adjustments, and, in some cases, specialized therapies. Managing asthma symptoms in children often involves using inhalers, avoiding triggers, and sometimes adjusting daily routines. Medications for bronchial asthma in children can help control symptoms and reduce the frequency of asthma attacks. Here’s a breakdown of commonly recommended treatments:

1. Quick-Relief Medications (Rescue Inhalers)

  • Short-acting beta-agonists (SABAs): Like albuterol or levalbuterol, these provide rapid relief from acute asthma symptoms by relaxing bronchial muscles. They’re usually delivered via a metered-dose inhaler (MDI) or nebulizer.
  • Anticholinergics: Such as ipratropium bromide, are sometimes used in combination with SABAs for stronger relief during asthma attacks.

2. Long-Term Control Medications

  • Inhaled Corticosteroids (ICS): The most common long-term treatment for reducing inflammation in the airways, helping to prevent symptoms. Examples include budesonide and fluticasone.
  • Long-acting beta-agonists (LABAs): These are sometimes prescribed alongside ICS to help with long-term control but are usually not prescribed as stand-alone medications in children.
  • Leukotriene Modifiers: Such as montelukast, taken orally to help reduce inflammation and relax airways, especially beneficial in children with mild asthma or those triggered by allergies.
  • Combination Inhalers: These contain both ICS and LABAs and are helpful for children with moderate to severe asthma who need more consistent control.

3. Biologic Therapies

  • For children with moderate to severe asthma not responsive to standard medications, biologic therapies like omalizumab (for allergic asthma) or mepolizumab (for eosinophilic asthma) may be considered.

4. Immunotherapy (Allergy Shots)

  • If allergies are a major trigger, allergy immunotherapy (under medical supervision) can gradually desensitize the child to allergens over time.

5. Environmental and Lifestyle Modifications

  • Trigger Avoidance: Identifying and avoiding known asthma triggers like dust, smoke, pet dander, and pollen.
  • Use of HEPA filters and dehumidifiers: These can reduce dust mites and other allergens in the home.
  • Healthy Diet and Regular Exercise: Regular physical activity, as tolerated, can help lung function; warm-up exercises may help reduce exercise-induced asthma.

6. Asthma Action Plan

  • A detailed, personalized asthma action plan outlines daily management strategies, triggers to avoid, how to recognize worsening symptoms, and steps for managing an asthma attack.

7. Education and Support

  • Educating both the child and family about proper inhaler use, recognizing symptoms, and following the action plan can significantly improve asthma control and quality of life.

Causes Of Asthma In Children

Asthma in children is often triggered by a combination of genetic and environmental factors. Understanding the causes of asthma in children is crucial for effective prevention and management strategies.

1. Genetics and Family History

  • A child is more likely to develop asthma if there is a family history of asthma or other allergic conditions that can contribute to the causes of asthma in children and increase their risk.

2. Allergens and Environmental Triggers

  • Environmental factors, such as air pollution and mould, are important causes of asthma in children that parents should be aware of. Pollen, Dust Mites, and Mold: Exposure to indoor and outdoor allergens, including pollen, dust mites, mould, and pet dander, is a common cause.
  • Pollution and Smoke Exposure: Air pollution, secondhand smoke, and chemicals in household products can irritate the lungs and make asthma more likely.
  • Weather Conditions: Cold air and sudden temperature changes can trigger asthma symptoms in sensitive children.

3. Respiratory Infections

  • Viral respiratory infections, like the common cold or respiratory syncytial virus (RSV), can cause asthma symptoms or make existing asthma worse, especially in young children.

4. Physical Activity

  • Intense physical activity or exercise, especially in cold weather, can trigger asthma in some children (often called exercise-induced asthma).

5. Emotional Stress and Strong Emotions

  • Strong emotions, such as crying or laughing intensely, can cause breathing to become shallow and rapid, which may trigger asthma symptoms in children.

6. Exposure to Irritants

  • Children exposed to certain irritants, such as perfumes, cleaning products, or aerosol sprays, may have a higher risk of asthma flare-ups.

Understanding and managing these causes and triggers can help reduce asthma symptoms and improve the quality of life for children with asthma.

Diagnosis Of Asthma In Children

Diagnosing asthma in children can be challenging due to overlapping symptoms with other respiratory conditions, as they may not be able to accurately describe their symptoms, and other respiratory conditions can mimic asthma. Frequent coughing at night is one of the asthma symptoms in children that parents should be particularly mindful of. Diagnosing asthma in children may involve using lung function tests, especially for older children who can follow instructions well. Here’s a general outline of how asthma is diagnosed in children:

1. Medical History and Symptom Assessment

  • Symptom Patterns: Children with asthma may experience recurrent wheezing, coughing (especially at night or after exercise), shortness of breath, and chest tightness.
  • Triggers: A history of symptoms worsening with certain triggers (like exercise, cold air, allergens, or viral infections) can suggest asthma.
  • Family History: A family history of asthma, eczema, or allergic rhinitis can support the diagnosis.
  • Response to Medication: If a child shows improvement with asthma medications (like inhaled bronchodilators or corticosteroids), this response supports the diagnosis.

2. Physical Examination

  • The doctor will listen for wheezing or other signs of airway obstruction during breathing, though wheezing may not always be present between episodes.
  • Signs of other conditions that might mimic asthma (like nasal polyps or enlarged tonsils) will also be checked.

3. Lung Function Tests (if age-appropriate)

  • For children over 5 years old, spirometry can measure how well the lungs work.
  • Bronchodilator Test: Spirometry can be done before and after using a bronchodilator to see if the medication improves lung function, indicating reversible airway obstruction typical of asthma.

4. Exhaled Nitric Oxide (FeNO) Testing

  • FeNO testing can measure the level of nitric oxide in exhaled breath, which tends to be higher in children with allergic (eosinophilic) asthma.

5. Allergy Testing

  • Skin tests or blood tests for specific IgE antibodies may identify allergies that trigger or worsen asthma. Identifying allergens can help in managing asthma and avoiding triggers.

6. Trial of Asthma Medication

  • In cases where lung function tests are inconclusive, doctors may prescribe a trial of asthma medication (like inhaled corticosteroids or bronchodilators) for several weeks to see if symptoms improve. A positive response can help confirm the diagnosis.

7. Differential Diagnosis

  • Other conditions, such as viral bronchiolitis, foreign body aspiration, gastroesophageal reflux, or cystic fibrosis, need to be ruled out, as they may present with symptoms similar to asthma.

Asthma in children can evolve, so regular follow-up is crucial for monitoring symptoms and adjusting treatment as needed. Early diagnosis and management can significantly improve the quality of life and help prevent exacerbations.

What Is Crowdfunding? & How Can It Help Children Suffering From Asthma?

Medical crowdfunding is the practice of raising money online to cover medical expenses through donations. People often turn to crowdfunding to help pay for treatment costs, medications, and other health-related expenses that are not fully covered by insurance or government aid. Platforms like ImpactGuru allow individuals or families to create fundraising pages, where they share their stories and financial needs, and supporters can contribute directly.

For children with asthma, medical crowdfunding can be particularly beneficial in several ways:

  1. Covering Treatment Costs: Asthma medications, inhalers, and routine doctor visits can be costly. Crowdfunding helps families pay for essential treatments that ensure the child’s symptoms are well managed.
  2. Affording Specialized Equipment: Some children with severe asthma may need specialized equipment, like nebulizers or air purifiers, to manage their condition at home. These items can be expensive, but crowdfunding can make them accessible.
  3. Funding Alternative Treatments: Families may seek alternative or holistic therapies that are not covered by insurance but could improve the child’s quality of life. Crowdfunding can support these expenses.
  4. Supporting Emergency Costs: Asthma attacks can lead to emergency room visits and hospital stays. Crowdfunding provides a way to handle these urgent, often high-cost medical needs without creating financial strain.
  5. Raising Awareness and Community Support: Sharing a crowdfunding page raises awareness of asthma’s impact on children, which can lead to additional resources or support networks forming around the family.

Through medical crowdfunding, families with children suffering from asthma can access crucial funds for effective treatment, leading to improved management of the condition and a better quality of life. Crowdfunding platforms such as ImpactGuru help patients by giving them a reliable platform to raise money for critical treatments.

Conclusion

In conclusion, asthma in children is a complex, chronic condition that requires careful, ongoing management. Its varied triggers and symptoms necessitate a personalized approach to diagnosis and treatment. By using a combination of preventive measures, medications, and personalized asthma action plans, children with asthma can achieve better symptom control, allowing them to lead healthier, more active lives. Supportive tools like medical crowdfunding can also provide financial relief, making specialized treatments and emergency care more accessible to families in need. Through continued awareness, early diagnosis, and effective management, we can significantly improve outcomes for children living with asthma, fostering a better quality of life.