Asthma in Infants and Very Young Children

Asthma is a disease in which the airways become blocked or narrowed. These effects are usually temporary, but they cause shortness of breath, breathing trouble, and other symptoms. If an asthma attack is severe, a person may need emergency treatment to restore normal breathing. Although asthma can cause severe health problems, in most cases treatment can control it and allow a person to live a normal and active life.

How is asthma in very young children different from adult asthma?
Infants and toddlers have much smaller bronchial tubes than older children and adults. In fact, these airways are so small that even small blockages caused by viral infections, tightened airways, or mucus can make breathing extremely difficult for the child.

Asthma symptoms can look like symptoms of other illnesses or diseases. Croup, bronchitis, epiglottis, cystic fibrosis, pneumonia, bronchiectasis, upper respiratory tract viruses, gastroesophageal reflux, congenital abnormalities, or even a foreign body inhaled by the child all have some of the same symptoms as asthma.

Diagnosing asthma in very young children is difficult. Since they are not able to communicate, they cannot describe how they are feeling.

Signs of asthma in a baby or toddler include noisy breathing or breathing increased 50 percent above normal; wheezing or panting with normal activities; lethargy or disinterest in normal or favorite activities; difficulty sucking or eating; and crying sounds softer, different.

How is asthma diagnosed in babies and toddlers?
Diagnosing asthma in very young children is difficult. Since they are not able to communicate, they cannot describe how they are feeling. To help the pediatrician make a correct diagnosis, parents must provide information about family history of asthma or allergies and the child’s overall behavior, breathing patterns, and responses to foods or possible allergy triggers. Lung function tests are very hard to do with young children. Instead, the physician may see how the child responds to medications to improve breathing. Blood tests, allergy testing, and X-rays may be done to gather additional information. Using all this information, the doctor then can make the best diagnosis.

How is asthma treated in very young children?
Babies or toddlers can use most medications used for older children and adults. The dosage, of course, is lower, and the way the medication is given is different. Inhaled medications are preferred because they generally act more rapidly to reduce symptoms and produce fewer side effects.

Medications to treat asthma symptoms in infants and toddlers are usually given in a tasty liquid form or with a nebulizer. A nebulizer is a small machine that uses forced air to create a “medication mist” for the baby to breathe through a small facemask. Nebulizer treatments take about 10 minutes and are given several times each day until symptoms decrease. Although a nebulizer treatment is gentle, babies and young children often are frightened by the mask and fight the treatment at first.

Some toddlers are able to use an inhaler containing asthma medication with a spacer and mask attachment. A spacer is a small tube that holds the medication released by the inhaler fitted into it. The device allows children to breathe in the medication at their own speed.

Most people with asthma, including very young children, use a combination of medications, depending on severity and frequency of symptoms. Work with their healthcare providers to develop an asthma care plan for your child.

Can a child outgrow asthma?
Once someone develops sensitive airways, they remain that way for life, although asthma symptoms can vary through the years. As a child’s airways mature, he or she is able to handle airway inflammation and irritants better, so asthma symptoms may notably decrease. There is no way to predict which children may experience greatly 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 medications on hand (and up-to-date), even if symptoms are rare.

Tips for Parents
When a very young child has a chronic illness, parents can feel stretched to their limits as they try to manage. Get regular check-ups to help reduce your anxiety. Teach your toddler or preschooler to tell you when they are not feeling well.

It’s important to learn the warning signs for increasing asthma in infants and toddlers. Develop an asthma management plan with your child’s physician. Make sure the plan provides guidelines to follow if asthma symptoms get worse.

Follow your asthma care plan every day! Don’t alter from the plan until you consult your healthcare provider. Even if your child’s symptoms are gone, stick with the plan until you discuss changes with the doctor.

Above all, don’t let your child’s asthma become the focus of your relationship. If you use good healthcare practices to manage your baby’s or toddler’s asthma, you’ll be able to think less about asthma and enjoy your child more.