Pediatric asthma; Asthma - pediatric

Breathing problems are common. They can include:

• Shortness of breath
• Feeling out of breath
• Gasping for air
• Having trouble breathing out
• Breathing faster than normal

When breathing gets very hard, the skin of the chest and neck may suck inward.

Other symptoms of asthma in children include:

• Coughing that sometimes wakes the child up at night; it may be the only symptom
• Dark bags under the eyes
• Feeling tired
• Irritability
• Tightness in the chest
• Wheezing, a whistling sound made when breathing, that may be more noticeable when the child breathes out

The type and pattern of your child's asthma symptoms may vary. They may occur often or only when certain triggers are present. Some children are more likely to have asthma symptoms at night.

With proper treatment and a team approach to managing asthma, almost all children with asthma can live a normal life. However, poorly controlled asthma may lead to missed school, problems playing sports, missed work for parents, and many visits to the doctor's office and emergency room.

Asthma symptoms usually occur much less often or disappear as the child gets get older. However, if the child’s asthma is not well controlled, it can lead to permanent changes in lung function.

Asthma can rarely be a life-threatening disease. It is important for families to work together with health care professionals to develop a plan to care for the child.

Call your health care provider if you think your child has new symptoms of asthma. If your child has been diagnosed with asthma, call the doctor:

• After an emergency room visit
• When peak flow numbers have been getting lower
• When symptoms are more frequent and more severe and your child is following the asthma action plan

If your child is having trouble breathing or having an asthma attack, seek medical attention immediately.

Emergency symptoms include:

• Difficulty breathing
• Bluish color to the lips and face
• Severe anxiety due to shortness of breath
• Rapid pulse
• Sweating
• Decreased level of alertness, such as severe drowsiness or confusion

A child who is having a severe asthma attack may need to stay in the hospital and be given oxygen and medicines through a vein (intravenous line or IV).

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.

Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics. 2009 Mar;123(3):e519-25.

Bush A, Saglani S. Management of severe asthma in children. Lancet. 2010 Sep 4;376(9743):814-25.

Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.

McMahon AW, Levenson MS, McEvoy BW, Mosholder AD, Murphy D. Age and risks of FDA-approved long-acting beta-adrenergic receptor agonists. Pediatrics. 2011;128(5):e1147-1154.