The common symptoms of asthma in children include:

• feeling breathless,
• wheezing (there may be a whistling sound when your child breathes),
• coughing (particularly at night), and
• tight chest.

The severity and duration of the symptoms of asthma tend to be highly variable and unpredictable, and they are often worse during the night, or with exercise. You should be aware of any signs of worsening symptoms in your child. These may include:

• a drop in peak expiratory flow rate (see the ‘diagnosis’ section for more information),
• an increased pulse rate,
• an increase in wheezing, and
• feeling agitated, or restless.

If you notice that the children’s symptoms are getting worse, do not ignore them – contact your doctor, or asthma clinic.

Symptoms of a severe asthma attack in children include:

• the symptoms will get worse quickly,
• difficulty breathing and talking,
• a racing pulse,
• lips and/or finger nails may turn blue,
• the skin around the chest and neck may tighten, and
• the nostrils may flare as the child tries to breathe.

Although there is no single known cause of asthma in children, there are several factors that may contribute to your child having the condition.

These include a genetic predisposition (having something in their genes that makes it more likely that they will develop asthma), diet, and the environment.

Known risk factors for the development of asthma in children include:

• a family history of asthma, or other related allergic conditions (known as atopic conditions) such as eczema, hayfever or allergic conjunctivitis),
• developing another atopic condition,
• being exposed to tobacco smoke, particularly if the child’s mother smoked during pregnancy,
• being born prematurely, and
• being born with a low birth weight.

Asthma triggers

The symptoms of asthma can be triggered by external factors, such as those described below.

• Infections of the airways and chest. Upper respiratory infections, affecting the upper airways, are often caused by viruses, and they are a common trigger of asthma. In some children, fungi, bacteria, and parasites may also be responsible for infection.
• Allergens, such as pollen, dust mites, and animal fur, or feathers.
• Airborne irritants, such as cigarette smoke, chemical fumes and atmospheric pollution.
• Medicines, such as the class of painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), the most well known of which are aspirin and ibuprofen. Children who are under 16 years of age should not be given aspirin.
• Emotional factors, such as stress, or laughing.
• Foods containing sulphites. Sulphites are naturally occurring substances found in some food and drink. They are also sometimes used as a food preservative. Food and drink that are high in sulphites include concentrated fruit juice, jam, shrimp, and many processed, or pre-cooked meals. Although certain foods may trigger the symptoms of asthma, it is very rare for diet to actually cause the condition

What happens during an asthma attack

The symptoms of an asthma attack begin when something triggers a biological process called inflammation. Inflammation is one of the ways that your body’s immune system helps fight off infection.

If your body detects an infection in your lungs, it will start the process of inflammation. White blood cells will be sent to the site of the infection to destroy it and prevent it spreading. These blood cells cause the airways to swell and produce mucus.

If your child has asthma, their airways are very sensitive to the effects of inflammation. As a result, too much mucus is produced and the airways swell more than they should. Also, as a response to the inflammation, the muscles surrounding the airways begin to contract, making the airways narrower and narrower.

The combination of excess mucus, and the swelling and then narrowing of the airways, makes breathing difficult and produces the wheezing and coughing that is associated with asthma.

Related articles

1. Asthma in children
2. Treating asthma in children – the essential guide
3. How to find out if your child has asthma
4. Reducing the risk and complications of asthma in children
5. Inflamed airways – Bronchitis
6. Respiratory tract infection — Bronchiolitis
7. Cough
8. Croup infection
9. Chronic obstructive pulmonary disease

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