Asthma in Children

Asthma symptoms in infants and young children 

 In young children, cough is often the only symptom of asthma.

Asthma symptoms generally include coughing, wheezing, and shortness of breath, but asthma symptoms vary widely among children. Some cough all night but are symptom-free during the day, while others seem to get frequent chest colds that just won’t go away.

Children have very small, narrow airways, and can wheeze when they have a viral infections. First episodes of cough, runny nose and fever that happen in cold and flu season (fall, winter and early spring) is likely not asthma. If your child has several more episodes of wheeze and cough, it is more likely to be asthma. The most common cause of asthma in infants and children under three years of age is a cold. Even after the cold is gone, asthma symptoms and airway swelling can last for several weeks. 

Diagnosing asthma in young children

Healthcare providers are often reluctant to give a diagnosis of asthma to infants and very young children because children often cough and wheeze with colds, chest infections like bronchitis, and other conditions responsible for asthma-like symptoms.

Since there is no diagnostic test available for children younger than six years of age, making a diagnosis in this age group is more difficult than in older children. Over the age of about six  it is possible for a child to have a spirometry test. This is a simple test that measures a child’s airflow through the large and small airways. Results reveal if the child’s airflow can be improved with medication. Reversibility of airway obstruction is a key feature of asthma. If administering a bronchodilator reverses airway narrowing significantly, the diagnosis is probably asthma.

Preparing for your child’s visit to your healthcare provider

During your appointment, your healthcare provider will conduct a physical exam and may order some tests, like x-ray, blood tests, allergy skin tests, and pulmonary function tests (PFTs).

The physician will take a detailed history of:

  • Family allergy/asthma, with emphasis on parents
  • Child’s allergy history – e.g. eczema
  • Child’s history of illness to date e.g. frequency of colds
  • Child’s symptoms: Severity, frequency and duration of symptoms. What brings an end to the symptoms for example if the child has a cold, do the symptoms disappear when the cold is over?
  • Child’s triggers: what have the parents observed with respect to exposures to allergens or irritants, such as smoke, perfume, infection or emotions

This information will help your healthcare provider understand your child’s pattern of symptoms.

What can you do if your child has been diagnosed with asthma?

If your child has just been diagnosed with asthma, know that you are not alone. Asthma Canada and your healthcare team have many resources available to you.

  • Start by learning as much as you can about the condition. Work closely with your child’s healthcare provider to monitor your child’s asthma symptoms. Ask questions and clarify any information you are unsure about.
  • Reach out to Asthma Canada’s FREE Asthma & Allergy HelpLine to speak with a Certified Respiratory Educator. 
  • Begin keeping a diary to keep track of what non-allergic triggers affect your child’s asthma. This will help you identify your child’s triggers, and develop strategies to avoid them.
  • Learn all you can about your child’s medications. This includes possible side effects of medication and the appropriate technique for administering medication.
  • Ask you healthcare provider about developing a Kids Asthma Action Plan. And Asthma Action Plan monitors asthma symptoms and has a written plan to follow when symptoms change.
  • Join Asthma Canada’s membership alliance (ACMA) to connect with other Canadians living with asthma or impacted by asthma.


How do I know if my infant or child has Severe Asthma?

If you are concerned that your infant or child’s asthma may be severe, observe their behavior for the indicators below and speak to your healthcare provider right away.

Observe your infant for any of the following indicators of Severe Asthma:

  • Sits up, refuses to lie down
  • Stops feeding
  • Audible wheezing
  • Pale or bluish-looking skin –anywhere
  • Irritable
  • Rapid breathing
  • Using accessory muscles of breathing-in, drawing of muscles at the neck when breathing – it may look like the skin is being tugged in. If you see this, your child must be assessed by a healthcare provider.

Observe your child for any of the following indicators of Severe Asthma:

  • Pale looking or bluish looking skin- anywhere
  • Breathless
  • Cannot walk or talk
  • Wheezing
  • Looks exhausted
  • Rapid breathing
  • Irritable
  • Peak flow less than 50% of personal best
  • Using accessory muscles of breathing-in, drawing of muscles at the neck when breathing – it may look like the skin is being tugged in. If you see this, your child must be assessed by a healthcare provider.