Pediatric Asthma: Symptoms, Manifestations, and Parental Guidance

Medically reviewed: 29, December 2023

Pediatric Asthma: what is it?

Asthma is a lung disease with irritation in the trachea which causes difficulty breathing and coughing. In an asthma attack, the airways are narrowed due to convulsions in the muscles of the trachea, swelling of the mucosa and mucous membranes in the respiratory tract. This can sometimes be heard as wheezing / wheezing. Pediatric asthma is a chronic disease that affects the airways in the lungs. It is one of the most common long-term diseases in children, but it can occur at any age. This article aims to provide a comprehensive understanding of early childhood asthma, its symptoms, manifestations, and what parents should pay attention to.

Pediatric Asthma warning: What Should Parents Pay Attention To?

Parents should be vigilant for signs of worsening asthma symptoms in their children. These can include:

There has been an escalation in coughing and wheezing, along with experiencing difficulties in breathing such as shortness of breath or rapid breathing. These respiratory issues have had a direct impact on one’s ability to carry out regular daily activities, making them more challenging to perform.

If parents become aware of any of these indications, it is crucial for them to promptly seek medical assistance.

It’s also crucial for parents to work with their child’s healthcare provider to develop an asthma action plan. This plan should outline what medications to take, what triggers to avoid, and what steps to take when asthma symptoms are worsening.

Pediatric Asthma in Infants, toddlers and school children

Infants and small kids have more frequent asthma symptoms than bigger children. There may be many causes of the symptoms in toddlers, and most grow from the disease before school age. Because of this, other names, such as asthmatic bronchitis, are also used for asthma symptoms in young children. However, it can be difficult to distinguish between the various asthma types, and the only thing that matters to the treatment is the frequency and severity of symptoms.

Why do children get asthma?

The main cause of asthma is inheritance from the parents.

Coldness is the factor that most often causes asthma symptoms in both small and bigger children.

Allergy is rarely the cause of asthma in toddlers, but is important in school age where approximately 2/3 also have allergies. Typically, it is allergic to pollen, fur animals, dust mites and fungi. All children in need of preventive asthma treatment should be tested for allergy regardless of age.

Tobacco smoke increases the risk of developing and maintaining asthma in children.

In addition to the above factors, however, you are not aware of the root causes of some children developing asthma and allergy. Therefore, today we can not safely prevent the diseases.

How does asthma affect children?

With both infants and school children, the following symptoms and signs are seen:

• Wheezing
• Persistent cough without simultaneous cold – The host is usually the worst at night, and when the child laughs and cries.
• Prolonged cough (for 2-4 weeks) in conjunction with colds and possibly recurrent pneumonia.
• Cough or wheezing, difficulty breathing after physical exertion. Possibly, the child has a reduced activity level because it avoids activities that give symptoms.
• Poor well-being (especially in small children).

How does asthma exacerbate?

Colds, allergies and tobacco smoke are the most important factors that maintain asthma and cause seizures.

In addition, physical exertion may often cause short-term asthma symptoms, but it is important not to treat asthma children from physical activity. If asthma is well-treated, asthma children may be physically active on an equal footing with other children.

Symptoms of Pediatric Asthma

Children with asthma may show various symptoms. These can include a decrease in energy levels while engaging in physical activities, accompanied by quick and heavy breathing. The individual may express discomfort or pain in their chest area. Audible wheezing can be heard when inhaling or exhaling. The child may also experience difficulty in breathing and may feel as if they cannot take in enough air. Additionally, there may be a sensation of tightness in the muscles of the neck and chest.

It’s important to note that these symptoms can vary from child to child and may not be present all the time.

Manifestations of Pediatric Asthma

Asthma in children manifests in episodes or attacks.

During an asthma attack, there is a noticeable inflammation and swelling of the lining of the airways, accompanied by a contraction and tightening of the muscles surrounding the airways. This combination restricts the flow of air, making it difficult for the individual to breathe properly.

Consequently, various symptoms arise, such as the distinct sound of wheezing, persistent coughing, a feeling of breathlessness, and a sensation of tightness in the chest. It is crucial to understand that not all children experiencing asthma will exhibit wheezing. In some cases, a persistent cough may be the sole indication of asthma, which can often lead to misdiagnosis or the condition being mistaken for recurrent bronchitis.

How does the doctor diagnose asthma in early childhood?

Little children (infants)

• The doctor looks at the symptoms of the child
• You can do an asthma medicine trial and if it helps, it confirms the disease
• You can also perform lung function measurement in the body box (hospital)

Children of a school age

• The doctor looks at the symptoms that child has.
• You can do a lung function measurement (spirometry).
• The child can go trough an exertion test.
• A specialist physician or hospital can perform an NO measurement of respiratory air.
• Some children can tell that they are having difficulty breathing while others describe their symptoms as chest pain.
• Doctor can test asthma medicine on the child and if it helps, it confirms the disease.

Previously, peak-flow measurement was recommended, but this is now used rarely, as the technique is too uncertain.

Asthma in children: future prognosis

About 20% of young children have asthmatic symptoms, 7% among schoolchildren and 4% in adults. That is, many grow from the disease during childhood.

The risk that the disease does not disappear is greatest if others in the immediate family have allergy. There is also greater risk in children with asthma and allergy and in children where asthma attacks are frequent and severe.

What can you do yourself?

Parents may be aware that the child is not exposed to an environment that can help maintain asthma, eg passive smoking and any allergies.

Asthma in children: finding the right treatment

It is important that children with asthma get medicine so that they can participate in play and sports on an equal footing with healthy children and avoid severe asthma attacks.

Symptomatic treatment for pediatric asthma

Symptoms are treated with airway expanding seizures (B2 agonists). In many children, treatment with seizure medication will be sufficient. The medicine is found as:

• Short-acting B2 agonists. The medicine should be given as an inhalation to be effective
• Long-acting B2 agonists. For example, can be used on days of sporting activities but should never be used as a regular daily treatment without concurrent preventive treatment. Only asthma specialists should print the treatment for toddlers.

Preventive treatment for pediatric asthma

In children where seizure medication is insufficient, treat with daily preventive medicine:

• Adrenaline (steroid) as inhalation. Adrenaline is the most effective asthma treatment and first choice for children with weekly symptoms, symptoms between colds that inhibit daily activities or wake up at night or frequent severe asthma attacks.
• Leukotriene-inhibiting pill an be used as an alternative to inhalation steroid in mild asthma. Can be tried by repeated cold-triggered episodes in small children. It is also used as a supplemental treatment for children in which inhalation steroid is insufficient.
• Long-acting B2 agonists as solid therapy in combination with inhalation steroid. Given to some children with severe asthma, but only after examination with asthma specialist.

In the absence of treatment, consider whether the medication is taken properly or if the medicine is empty (may be particularly difficult to evaluate by spray treatment).

As many young children grow from their symptoms or only have symptoms for some periods, it can be difficult to assess the treatment effect. Therefore, it is important that you, in consultation with your doctor, try medication breaks to assess whether the child still needs treatment.