The signs of asthma in a baby or toddler include:
We still do not know what causes some people to get asthma. If a child has a family history of asthma or allergies, a specific allergy, or had a mother who smoked during pregnancy, they have a higher chance of getting asthma early in life.
A respiratory virus, an illness that occurs in the lungs, is one of the most common causes of asthma symptoms in children 5 years old and younger. Although both adults and children experience respiratory infections, children have more of them. Some preschool children get viral infections often. At least half of children with asthma show some sign of it before the age of 5. Viruses are the most common cause of acute asthma episodes in infants 6 months old or younger.
Infants and toddlers have much smaller airways than older children and adults. In fact, these airways are so small that even small blockages caused by viral infections, tight airways, or mucus can make breathing difficult for the child.
Asthma symptoms can look like symptoms of other illnesses or diseases. The following may have symptoms similar to asthma:
It is hard to diagnose asthma in infants and toddlers. Since they are not able to talk well, they cannot describe how they are feeling. A fussy baby could mean many things. Toddlers and preschoolers are often active, even with chest tightness or trouble breathing.
Parents should give the following information to their child’s doctor:
Lung function tests – often used to make a complete asthma diagnosis – are hard to do with young children. Instead, the doctor may see how the child responds to medicines to improve breathing. The doctor may order blood tests, allergy testing, and X-rays to get more information.
Using this information, the doctor can make the best diagnosis. Parents may need to take their child to a pediatric allergist or pulmonologist (lung specialist) for special testing or treatment.
Infants or toddlers can use most asthma medicines used for older children and adults. The dosage may be lower and the way the child takes it is different. Inhaled medicines work fast to make symptoms better and produce few side effects.
Medicines used to treat asthma symptoms in infants and toddlers are usually given in inhaled forms. Infants are usually treated with medicine given by a nebulizer or with an inhaler using a spacer with a mask. A nebulizer (sometimes called a “breathing machine”) is a small machine that uses forced air to create a medicine mist for the baby to breathe through a small face mask. Nebulizer treatments take about 10 minutes. A spacer is a small tube, or aerochamber, which holds the medicine released by the inhaler fitted into it. The inhaler/spacer device allows children to breathe in the medicine. Medicines given via inhaler with a spacer and mask work just as well as medicines given by a nebulizer. In some cases, the child might tolerate the inhaler with spacer and mask better.
Asthma is treated with several different medicines. Bronchodilators are quick-relief medicines (also called "rescue" or "reliever" medicines) that open up airways to relieve sudden symptoms. Controller medicines like inhaled corticosteroids, long-acting bronchodilators, combination medicines, or leukotriene modifiers taken for maintenance are used to calm swelling in the airways and keep asthma symptoms low. Many people with asthma, including infants and toddlers, are given a mix of medicines depending on how severe and how often they have symptoms. Work with your child’s doctors to develop an asthma care management plan.
This plan should include an Asthma Action Plan. An Asthma Action Plan is a document that tells you how to manage your child's asthma according to their symptoms. If your child does not have an Asthma Action Plan, work with their doctor to create one. Keep a copy close by at all times, and share with other people who care for your child, such as family, friends, and child care providers.
When a baby or toddler has a chronic illness, parents can feel stressed to their limits. Here are some coping tips:
Once someone gets sensitive airways, they may stay that way for life. This is the case even though asthma symptoms can change over the years. As a child gets older, they may be able to handle airway swelling and irritants better, so their symptoms may get better. About half of those children get asthma symptoms again when they are in their late 30s or early 40s. There is no way to know which children may have reduced symptoms as they get older. New triggers may set off symptoms at any time in people who have asthma. If your child has asthma, keep quick-relief medicines and their Asthma Action Plan on hand (and up to date), even if symptoms don’t happen often.
Medical Review December 2021 by Michael Pistiner, MD, MMSc, and Mitchell Grayson, MD