Asthma in Infants and Toddlers

Why It's Different 

What Is Asthma?
What Causes Asthma in Children under 5?
Symptoms: If It Looks Like Asthma …
10 Ways to Reduce Asthma Triggers in Younger Children
What If My Infant or Toddler Has Asthma?

About 6 percent of children under age 5 in this country have asthma; that’s about 1.2 million children.

Many first experience symptoms, such as wheezing, before their first birthday. Asthma treatment for infants, toddlers, and other children under 5 differs from that of older children and adults. Left untreated, asthma in these very young patients can lead to scarred lungs that cause lifelong breathing problems. That makes it critical to pay attention to asthma symptoms in infants and toddlers early. This article focuses on what parents need to know.

What Is Asthma?

Asthma is a disease in which the narrowing or blockage of airways results in difficulty breathing. It is not curable, but it is manageable. Most children with asthma live healthy, active lives once they get the disease under control.

When we breathe, air travels through a tube, called the trachea or the windpipe. From there, it flows into a series of smaller tubes called bronchi. These bronchi branch off into even smaller tubes called bronchioles. It is in the bronchi and bronchioles that asthma goes to work.

In a person who has asthma, allergens cause the normal passage of air through the airways to go haywire. When an allergen comes into contact with these airways, the tissue inside the bronchi and bronchioles becomes inflamed. At the same time, the muscles on the outside of the airways narrow. Mucus then enters the airways, causing them to swell. This causes the muscles on the outside to narrow further. This makes it even more difficult to breathe. 

For infants and toddlers, the effects are magnified because their airways are smaller. 

What Causes Asthma in Children under 5?

Experts are not sure.

Research does reveal a few clear connections:

  • History of asthma or allergies in the family
  • Hay fever
  • Frequent respiratory infections
  • Cigarette smoking during pregnancy or exposure to secondhand smoke after birth
  • Eczema
  • African American or Puerto Rican
  • Low birth weight
  • Living in a low-income environment

Knowing possible causes and symptoms of asthma can help parents recognize when it’s time to take a young child to the doctor for diagnosis.

Symptoms: If It Looks Like Asthma …

If it looks like asthma, it’s probably asthma, right? Not necessarily. Many symptoms that mimic asthma turn out to be something completely different. Only a diagnosis by your doctor can confirm that your child’s symptoms are asthma. Here’s what to look for in young children:

  • Wheezing is when your child’s breathing sounds like whistling. Not everyone who wheezes has asthma, and not everyone who has asthma wheezes. Still, wheezing in a young child is not normal. Pay attention to it.
  • Rapid breathing might signal that your infant is having problems catching his or her breath. When an asthma attack strikes, children can’t breathe in deeply, so they compensate by breathing in and out more often. These rapid short breaths are a desperate attempt to pull in more air. If your child’s breathing does not return to normal quickly, it’s time to get to the doctor or the hospital if medication is not working. 
  • Crying sounds different when your infant is experiencing difficulty breathing. It’s subtle, but the crying is softer than normal.
  • Eating is difficult or slowed, or your baby can’t suck. Breathing problems interfere with the ability to suck. If your infant has problems nursing or finishing a bottle, breathing problems could be the reason.
  • Chronic coughing is typical of asthma sufferers who experience trouble breathing while lying down, especially in bed at night. Toddlers in the midst of an asthma attack tend to tire easily and begin coughing while playing. They can’t suck in enough air to maintain their energy level.

For many children under age 5, respiratory infections are the culprit when it comes to asthma attacks. In infants 6 months old and younger, respiratory infections caused by viruses are the leading cause of serious asthma attacks. If your child frequently experiences coughing throughout the night or has colds that linger, respiratory infections might be the cause. Visit the doctor and find out.

10 Ways to Reduce Asthma Triggers in Younger Children

Environmental factors play a major role in triggering asthma for many younger children. Here are 10 things you can do to help control common asthma triggers:

  1. Wash all bedding in hot water every week.
  2. Enclose the mattress, box springs, and pillows on your child’s bed inside allergen-proof covers. This keeps out dust mites, cockroach droppings, pet hair and dander, and other allergens that drift into kids’ bedrooms. 
  3. Keep pets out of the bedroom. If your child is allergic to pets, you might have to bar them from the home.
  4. Only allow your child to have stuffed animals that can be washed.
  5. Don’t allow smoking anywhere in your home. There is no corner that smoke won’t reach.
  6. Use only area carpets that you can wash. Avoid wall-to-wall carpeting.
  7. Vacuum often, at least every week. Use a HEPA filter. Buy disposable masks, and have your child wear one while you are vacuuming and after to give the dust particles stirred up time to settle.
  8. Dust weekly. Many children are very allergic to dust particles. Have your child wear disposable masks as discussed in the last point.
  9. Breast-feed. There is evidence that protectors in mother’s milk help some infants and toddlers battle allergies and prevent eczema that may trigger asthma attacks.
  10. Monitor your child’s foods for signs of allergic reactions. Allergies are believed to trigger most asthma. Pay particular attention to dairy, shellfish, wheat, eggs, soy, and nuts.

Mold is another frequent trigger of asthma. Inspect your home for signs of mold. This is more likely if there have been leaks or other water damage in your home. Often, you can smell mold. Seek professional help in diagnosing and getting rid of mold if you suspect this problem.

What If My Infant or Toddler Has Asthma?

First, know that getting diagnosed is a major step. Diagnosis brings with it medication and an asthma action plan that will give you and your young child the tools needed to manage this disease. With asthma under control, your infant or toddler is likely to live a normal, active life doing the things that other children can do. 

With active management of asthma, your child will be able to sleep nights, avoid the need for emergency medical care, play sports, and, when it’s time, go to school every day.

Related:

Learn more about allergic asthma and common asthma triggers in children.

Pediatric Asthma Care at EPFMC

Pediatric Asthma Clinic at EPFMC

Pediatric Asthma Clinic Case Manager Felix Dominguez

Asthma Action Plans