Signs of Asthma in Kids: How to Tell If Your Child Might Have Asthma and What to Do Next

Childhood asthma is a common medical condition. About 6.5% of children in the U.S. have asthma. It can cause breathing problems that interfere with school, sleep, and daily activities.

It can be difficult to tell if your child has asthma. Common things like colds, allergies, and bronchiolitis can cause symptoms similar to childhood asthma. If you’re wondering whether your child’s cough is a sign of developing asthma, keep reading. We’ll talk about how, when, and why children develop asthma, and what to do if you think your child has asthma symptoms. 

What are common symptoms and signs of asthma in kids?

Asthma causes inflammation in the airways of the lungs. Inflamed airways become swollen and filled with mucus, which makes it hard to breathe. So trouble breathing is the main symptom of childhood asthma. But trouble breathing can look different based on a child’s age.

Quiz: Could I have asthma?

What causes asthma to develop in children?

There’s no one single cause of asthma. But there are quite a few factors that could increase your child’s chances of developing asthma. Some of them include:

• Being born prematurely or with a low birth weight

• Having seasonal allergies (hay fever) or food allergies 

• Frequent respiratory infections

• Exposure to tobacco smoke or air pollution

Genes also play a role in whether a child develops asthma. Children are more likely to develop asthma if they have close relatives with asthma. 

So when does asthma develop in children? That’s a hard question to answer. Many children who go on to develop asthma start having symptoms by the time they are 3 years old. But many infants and toddlers have symptoms of asthma — like cough and wheezing — when they are sick but never go on to develop asthma. 

Common asthma triggers

Asthma triggers are things that can prompt inflammation in the airways. They “trigger” your child’s asthma to flare up, which can lead to an asthma attack. Not everyone with asthma has the same triggers. Things that can trigger an asthma attack in one person might not have any effect on another person. So it’s important to take note of what triggers your child’s asthma.

Some common asthma triggers include:

• Viral illnesses, like the flu, COVID or the common cold

• Tobacco smoke

• Wood smoke

• Pollen

• Pet and animal dander

• Mold

• Dust mites

• Cockroaches

• Weather changes

• Exercise and activity

• Pollution and poor air quality

When should you seek care if you think your child might have asthma?

Get medical care as soon as possible if you think your child has asthma. Your child’s healthcare team can diagnose asthma and other medical conditions that can cause symptoms similar to asthma, such as:

• Acid reflux 

• Lung infections like pneumonia

• Birth defects that affect the lungs

• Objects accidentally breathed in

• Lung conditions like cystic fibrosis  

If your child’s symptoms are caused by childhood asthma, treatment should be started as soon as possible. Asthma treatment is aimed at keeping lung inflammation at bay so that children are less likely to have asthma attacks. Children with asthma who get treatment have better lung health over their lifetime. They also have fewer asthma symptoms, which makes it easier for them to play, learn, and grow. 

How do you diagnose asthma in children?

Diagnosing asthma in toddlers and young children can be tricky because they can’t complete pulmonary function tests, which are used to check for signs of asthma. Many times, toddlers and children will be diagnosed with asthma based on their symptoms. 

Your child’s healthcare team will ask you questions about:

• Your child’s asthma symptoms (cough, wheezing, trouble breathing)

• When those symptoms appear (at night, in the early morning, during play or activity)

• How severe the asthma symptoms are

• Whether your child has other medical conditions

• Your family history of allergies and asthma

• Your home environment

How do you treat childhood asthma?

There’s no cure for asthma. But treatment will keep your child’s asthma symptoms under control and prevent asthma attacks. Treatment of childhood asthma symptoms differs depending on the child’s age.

Children often need two different types of asthma medications: 

• Long-term medications, which your child takes every day to prevent asthma attacks 

• Quick-relief medications or rescue medications, which your child takes when they have asthma symptoms 

Examples of long-term asthma medications include:

• Inhaled steroids like fluticasone (Flovent) and mometasone (Asmanex)

• Combined inhalers like budesonide / formoterol (Symbicort)  

• Oral medications like montelukast (Singulair) 

Experts recommend that most children with asthma who are over 5 years of age should use an inhaled steroid. Children younger than 5 years may need these medications if they have:

• A strong family history of asthma

• More than three wheezing episodes in a year

• Signs of asthma occurring more than every 6-8 weeks  

Quick-relief medications (or rescue medications) treat asthma attacks by opening swollen airways. Sometimes, a dose of these quick-relief medication is recommended before exercise or strenuous play. Examples include:

• Albuterol (ProAir)

• Levalbuterol (Xopenex)

Experts recommend SMART therapy for treating asthma. SMART therapy (which stands for “single maintenance and reliever therapy”) uses a combination inhaler for both long-term asthma control and quick relief. 

Having an asthma action plan can help you remember when to give your child which medication. This type of treatment schedule provides a game plan for how to manage and treat your child’s asthma symptoms, particularly when they have an asthma attack.  

What should I do if my child has an asthma attack?

An asthma attack — or asthma exacerbation — is what happens when asthma symptoms suddenly get worse. Anyone with asthma can have an asthma attack. 

During an asthma attack, general asthma symptoms like wheezing, trouble breathing, and coughing get worse. Depending on how severe the attack is, these symptoms can be mild or could require emergency treatment. 

Mild attacks can sometimes be managed at home with your child’s nebulizer or quick-relief inhaler. During an asthma attack, it’s best to use the inhaler through a spacer device, as your child may otherwise find it difficult to get the medication into their lungs. If your child doesn’t get better after these treatments, you should call a healthcare professional.

Severe asthma attacks should be treated like emergencies. Call 911 or take your child to an emergency room if you notice any of the following:

• Constant wheezing

• Starting to wheeze suddenly after being stung or bitten by an insect, eating or drinking a food or beverage, or taking a medication

• Severe trouble breathing, leading to blue lips, blue face, or passing out

• Inability to speak in full sentences

• Pulling in around the ribs and neck when trying to inhale (also known as retractions)

• Rescue inhalers not working after 15 or 20 minutes

Can you prevent asthma in your child?

Researchers don’t know the exact reason kids develop asthma. But they have noted kids more often develop it if:

• There’s a family history of asthma.

• They are frequently exposed to cigarette smoke, even before birth.

• They are exposed to a lot of air pollution. 

You can’t change your family’s medical history. And lowering exposure to air pollution can be tough, depending on where you live. But you can limit your child’s exposure to smoke. If you smoke, consider quitting. It will make you healthier and help your child avoid childhood asthma symptoms. 

If your child has asthma, there are things you can do to help prevent asthma attacks, such as:

• Keeping your child away from smoke

• Making sure your child isn’t around their asthma triggers

• Making sure your child gets a yearly flu vaccine

• Following an asthma action plan

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Written by:

Brian Clista, MD

Dr. Clista is a board-certified pediatrician who works in private practice in Pittsburgh, Pennsylvania. He previously served as a National Health Service Corporation Scholar in the inner city of Pittsburgh for 11 years.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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