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If you notice your child often struggling to catch their breath when running, playing sports, or exercising, they may have asthma. Asthma is a common chronic lung disease and usually starts in childhood. Some 5.1 million kids under age 18 have asthma.

Trouble breathing, coughing, and chest tightness are some of the main symptoms of asthma in kids. There is no cure for asthma, but there are good treatments to help control it.

Asthma is a long-lasting medical condition. It requires treatment to prevent symptoms from happening and manage them when they happen.

Left untreated, asthma can cause severe symptoms known as an asthma attack, also called an exacerbation. These symptoms can be very severe and, in certain cases, can lead to death.

What Is Asthma?

Asthma happens when the airways — the tubes carrying air in and out of the lungs — become inflamed and swollen. This swelling causes the tubes to narrow, closing the airway and making it difficult to breathe. Swelling can be present even in kids that don’t report many symptoms.

Common symptoms of asthma in kids

If your kid has asthma, they may have one or more of these symptoms:

• Shortness of breath. They may say they can’t breathe in or can’t breathe out.
• Tightness or pain in their chest. They may say that it feels like something is squeezing their chest. Or that it feels heavy, like someone is sitting on it.
• Coughing. They may cough more during the daytime or at night, which can get in the way of sleeping. They may also cough up mucus. Some kids with asthma may have a cough that lasts up to three weeks after getting a cold.
• Wheezing. When they breathe out, it sounds like a whistle or squeak. Some 4 out of 10 kids who wheeze with a cold or other illness are later diagnosed with asthma.

Common asthma triggers

Triggers are things that cause asthma symptoms. Each kid can have different triggers, but some common ones include:

Physical activity or exertion

A teacher may notice that your child’s asthma kicks in during or after exercise. This might happen during or after gym, recess, sports, or playground activities.

Allergens

It’s common for kids with asthma to have environmental allergies, including allergies to plants like grass or weeds. These allergens can cause coughing, wheezing, or shortness of breath.

More than 80% of school-aged kids with asthma are sensitive to indoor allergens, according to a 2019 review in the Journal of Allergy and Clinical Immunology.

Indoor allergens are in homes or schools. These can include mold, dust mites, mice, rats, cockroaches, pet saliva, dander, or fur.

Infections

Respiratory infections can trigger asthma attacks. Colds, the flu, COVID-19, RSV, and other respiratory infections can trigger asthma symptoms. It’s vital to stay up to date with vaccinations, including yearly flu vaccines and COVID-19 shots and boosters.

Getting the flu or COVID-19 shot won’t prevent your child from getting these infections. The vaccines reduce how severe the viruses can be. A vaccine could be the difference between managing an illness at home and needing to go to the hospital.

Strong emotional reactions

Intense bouts of anger, crying, or laughing may trigger asthma symptoms.

Poor air quality

Poor air quality can cause asthma symptoms to flare. Common sources of indoor air pollution include:

• Tobacco smoke.
• Marijuana smoke.
• Aerosols from electronic cigarettes and vapes.

Kids should avoid aerosols and smoke as much as possible. Smoking or vaping in a different room won’t protect your child; stopping exposure is best. But if a loved one isn’t ready to quit, they should smoke or vape outside.

Common sources of outdoor pollution are particles in the air and ozone. Particle pollution is highest near major roadways and can be higher around industrial sources. Ozone tends to be highest in the afternoon on warmer days.

The CDC recommends that kids get at least 60 minutes of daily physical activity. But, kids should avoid exercising on busy roadways if possible. If it’s not possible to avoid busy roadways, avoid exercising during rush hour.

Parents can check the air quality by visiting airnow.gov or using the AirNow app. Talk to your doctor if you notice your child has worse asthma symptoms after playing outside during yellow air quality days.

Very cold air

Icy outdoor or indoor air, such as in a hockey rink, can further tighten or narrow your child’s airways. Wearing a scarf when in cold air can be helpful.

When to Call Your Doctor?

If you think your child has asthma, talk to their doctor. That’s the first step in helping control asthma and prevent attacks. Their doctor may run tests, such as lung function tests, to better check for asthma.

If your child gets a diagnosis of asthma, their doctor will make an asthma action plan. This plan tells you:

• What to do every day when your child is well to prevent asthma symptoms.
• What to do if your child has asthma symptoms.

Symptoms of An Asthma Attack

An asthma attack is when symptoms flare or suddenly get worse. Asthma attacks can sometimes be severe and may need emergency treatment at the hospital.

According to the Asthma and Allergy Foundation of America, half of kids with asthma don’t have it under control.

Forty-four percent have one or more asthma attacks each year. An asthma attack can be a scary experience. Treatment can help reduce the number and seriousness of asthma attacks.

When to call 911?

Call 911 if your child has any of these happen during an asthma attack:

• If their symptoms are not controlled.
• If they are unable to speak in full sentences.
• They have severe chest pain.
• They show signs of confusion, drowsiness, or anxiety.
• Their skin or lips turn blue or have a blue tint.
• They have a fast heartbeat.

In general, parents and caregivers should trust their instincts. If you think your child is struggling, seek care as soon as possible.

Is Your Child At Risk of Asthma?

Asthma is the most common chronic disease in kids. According to the 2019 review, it affects nearly 9% of kids in the United States. Asthma can cause major problems, such as missed school days, emergency room visits, and being in the hospital.

It’s unclear exactly why someone gets asthma. Many factors can increase a kid’s risk of developing asthma, including if they:

• Breathed in second-hand cigarette smoke as a baby or young child.
• Are around indoor aerosols from smoking or vaping.
• Have had one or more severe viral infections that affected their breathing.
• Have a parent with asthma. Having a mother with asthma especially raises their risk.
• Have allergies to things in their environment, such as pollen, pet dander, or mold.
• Are obese. This increases the risk of asthma and makes symptoms worse.
• Had a low birth weight.
• Are around air pollution.

Loved ones can control some of these risk factors, like exposure to indoor aerosols during and after pregnancy.Asthma is also more common in some minority groups, due to historically exclusionary or racist policies.

Asthma can sound frightening. But it shouldn’t control your child’s life.

With the right treatments, no one should be able to tell the difference between a child with asthma and a child without. Your child’s doctor can help them manage their disease so they can live a healthy and active life.