Diagnosing and managing asthma in children younger than five years old can be challenging. However, especially lookout for the condition in children whose families have a history of it, as well as other allergies. Additionally, children are also at risk of the condition if their mother smoked during the pregnancy.
Primary symptoms of asthma in infants and toddlers result in wheezing and cough, but can also include the following:
- Shortness of breath
- Fast breathing
- Working harder to breathe
- Persistent coughing
- Coughing spells that often happen during play or exercise, at night, in cold air or while laughing and crying
- Lack of energy during play and pausing to catch their breath during activities
- Chest retractions (seesaw motions in their chest)
- Difficulty in sleeping because of coughing or breathing problems
- Tight neck and chest muscles
- Difficulty sucking or eating
- Feeling tired or weak
- Cyanosis (tissue color changes on lips)
- Trouble eating or grunting while eating (in infants)
- Failure to gain weight
What factors can trigger or worsen asthma symptoms in babies?
Similar to other asthma sufferers, symptoms in infants can be triggered or worsened by certain factors. Identifying these triggers can help your child better control their condition.
Asthma symptoms in babies can be triggered or worsened by these factors:
- Colds or other respiratory infections
- Allergens, such as dust, pet dander or pollen
- Mold infestation in the house
- Physical activity or exercise
- Feeding (in infants)
- Change in the seasons
- Exposure to cigarette smoke or other airborne irritants
- Strong emotional reactions, such as crying or laughing
- Gastrointestinal reflux
- Changes or extremes in weather
- Viral infection in the lungs
What are the patterns of asthma symptoms in babies?
The severity and patterns of asthma symptoms may vary by the child; however, the most common patterns resemble the following:
- Exacerbation of symptoms at night
- Short episodes of coughing and wheezing between a symptomless period
- Repeated or chronic symptoms with episodes of worse wheezing and coughing
- Seasonal changes based on prevalent infections or allergy triggers
When should you consult a doctor?
In most cases, symptoms of severe asthma require immediate medical assistance, so be on the lookout for the following signs:
- Stopping in the middle of a sentence to catch a breath
- Using abdominal or neck muscles to breathe
- The abdomen sinks under their ribs when they try to get air
- Chest and sides that pull in as they breathe
- Severe wheezing
- Severe coughing
- Trouble walking or talking
- Blue lips or fingernails
- Increasing shortness of breath with decreased wheezing
- Enlarged nostrils
- Fast heartbeat
- Sweating more than usual
Is it asthma or something else?
Asthma symptoms may be similar to the symptoms of other illnesses or diseases. If you are unsure whether your child has asthma or another condition, consult your doctor.
Some of the diseases that have symptoms similar to asthma include:
- Bronchiolitis (an inflammatory bronchial reaction in young children and infants)
- Croup (upper airway infection that blocks breathing)
- Acid reflux
- Pneumonia
- Upper respiratory viruses
- Aspiration
- Inhaled object
- Epiglottitis (a potentially life-threatening condition that occurs when the epiglottis is inflamed)
- Cystic fibrosis (an inherited life-threatening disorder that damages the lungs and digestive system)
- Conditions leading to weaker lung development, such as prematurity
What is the difference between childhood asthma and adult asthma?
The main difference between childhood and adult asthma is the severity. As infants have a much smaller airway than adults, even a mild bronchial swelling can lead to a severe reaction. Tightened, inflamed airways and extreme mucus can easily block the flow of air, which makes it extremely hard for the baby to breathe.
Respiratory infections are often the first trigger to cause an asthma attack in a child. The child will continue to experience symptoms even after the infection has been treated. Hence, parents should closely monitor their child suffering from a respiratory infection for symptoms of asthma.
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Asthma and Allergy Foundation of America. Asthma in Infants. https://www.aafa.org/asthma-in-infants/
Mayo Clinic. Treating Asthma in Children Under 5. https://www.mayoclinic.org/diseases-conditions/childhood-asthma/in-depth/asthma-in-children/art-20044376
Trivedi M, Denton E. Asthma in Children and Adults-What Are the Differences and What Can They Tell us About Asthma?. Front Pediatr. 2019;7:256. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603154/
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