Childhood asthma is the same disease as adult asthma—long-term airway inflammation with periodic symptom flare-ups that cause breathing problems. About seven million American children under age 18 have asthma, making it one of the most common chronic childhood disorders. Childhood asthma is the top cause of missed school days and children’s emergency room visits.

What happens in asthma is the same for children and adults: inflamed airways narrow, preventing free movement of air in and out of the lungs. This narrowing is caused by:

  • Swelling of the lining of the airways
  • Tightening of the muscle around the airways
  • Secretion of too much mucus in the airways

Childhood Asthma Symptoms

  • Wheezing (a whistling sound when exhaling), considered a classic symptom of asthma
  • Shortness of breath
  • Frequent bouts of coughing, often at night (disturbing sleep—this is sometimes the only asthma symptom) or in the early morning
  • Longer-than-usual time recovering from a cold or the flu
  • Chest tightness and/or pain
  • Dark under-eye circles
  • Fatigue
  • Irritability

If your child has any symptoms (particularly wheezing) that may indicate asthma, contact your pediatrician or family doctor as soon as possible.

The way asthma affects children can range from mild to severe. Some may have only mild symptoms that occur from time to time or only after physical activity (this is called exercise-induced asthma, or EIA). They may be able to breathe normally for weeks or months between flare-ups. Others may have asthma so severe that, unless properly treated, it can be incapacitating and even life-threatening.

Symptoms of an asthma attack may include:

  • Severe wheezing or coughing
  • Visibly using abdominal muscles to force breathing
  • Widened nostrils when inhaling
  • Having to stop to catch his or her breath when talking
  • Being short of breath even when not particularly active
  • Rapid pulse
  • Sweating
  • Blue lips, face or fingernails
  • Difficulty walking or talking
  • Severe confusion or drowsiness
  • No improvement after using rescue (quick-relief) asthma medication—a condition known as status asthmaticus

Childhood Asthma Complications

Worsening asthma can cause serious complications, including:

  • Severe asthma attacks requiring emergency care or hospitalization
  • Permanent airway narrowing
  • Missed school days or getting behind in schoolwork
  • Fatigue and disturbed sleep
  • Symptoms that interfere with activities such as playing or sports

There’s no cure for asthma, although some children eventually outgrow it.