By Staff
Asthma is one of the most common chronic conditions affecting children, yet it is often misunderstood. Symptoms can appear suddenly, showing up as a lingering cough or trouble breathing and then disappear just as quickly, leaving parents unsure of what’s going on.
“Early diagnosis is important for several reasons,” said University of Alabama at Birmingham School of Nursing Professor and Associate Dean for Access and Engagement Felesia Bowen, PhD, DNP, PPCNP-BC, FADLN, FAAN. “Diagnosing asthma early is important because it allows providers to help parents control symptoms like chronic coughing, wheezing and respiratory distress.”
As Chair of the Alabama Asthma CoalitionOpens an external link., Bowen emphasizes that with the right diagnosis and treatment plan, health care providers can help families manage symptoms and prevent them from becoming more severe. Untreated asthma can lead to a process called remodeling. This occurs when ongoing swelling in the lungs causes the airways to thicken, which may make treatments less effective or require higher doses to control symptoms, according to Bowen.
Bowen’s work also is supported by the Healthy Tomorrows Partnership for Children ProgramOpens an external link., a federal initiative through the Health Resources and Services AdministrationOpens an external link., reinforcing the importance of early diagnosis, education and consistent care. Bowen, who serves as President of the National Association of Pediatric Nurse PractitionersOpens an external link., is widely recognized for her leadership in pediatric asthma, health disparities and health equity.
Early warning signs of asthma in children
Asthma often first appears as a persistent cough. This cough is typically worse at night, early in the morning or when a child is running and playing.
“Other symptoms include wheezing without symptoms of a cold, as well as complaining of chest discomfort or pain,” Bowen said. “This happens when the muscles surrounding the airways tighten and squeeze the tubes that carry air in and out of the lungs, making it harder to breathe. Parents may also notice that their child is breathing faster or working harder to breathe.”
Because coughing and chest congestion can also occur with respiratory illnesses, asthma symptoms often are mistaken for a cold. However, asthma is not caused by a virus or bacteria, so children typically do not have a fever.
“Illnesses such as the common cold, COVID-19 or the flu are often accompanied by symptoms like sore throat, muscle aches, headache, sinus pain and fever and they usually improve within 7 to 10 days,” she said. “In some cases, a respiratory illness can trigger asthma symptoms. When this happens, the cough may continue or even worsen after the fever and other cold symptoms have gone away.”
Managing asthma after diagnosis
After a child is diagnosed with asthma, it is very important to follow the treatment plan prescribed by their health care provider. A common mistake parents make is stopping medication once their child’s symptoms improve.
“The symptoms improve because the medication is working, so stopping the medicine will cause those symptoms to come back,” Bowen said. “Every child’s symptoms are different and the medications, frequency of use and trigger avoidance information are individualized for that child. So even two siblings with asthma can have different treatments prescribed.”
Children with asthma should have regular appointments with their provider, not just visits when symptoms occur. Even if a child is not coughing or wheezing, they should still be seen regularly.
“It’s important to remember that children can have asthma symptoms anywhere and at any time,” Bowen said. “Some children are in daycare or school for most of the day, so there should be a treatment plan available for caregivers. These are called asthma action plans, and they provide instructions on how to care for the child when symptoms occur.”
Following an asthma action plan can help families avoid urgent care and emergency room visits.
“The plan is completed by providers and copies should be kept at home and at school, along with the child’s medication,” she added.
Asthma can be scary, especially during flare-ups but with proper treatment and monitoring, children can live active, healthy lives.
“There is no need to limit their activity,” Bowen said. “Children with asthma should be encouraged to play, spend time outdoors and participate in sports or other activities.”
Reducing asthma triggers at home
There are many environmental triggers for asthma but the most common in the home are secondhand smoke in the air and thirdhand smoke that lingers on clothing and surfaces. The source of the smoke, whether cigarettes, pipes or vaping, does not matter; all can trigger asthma symptoms.
“If a child has asthma, there should be no smoking at all in the home or in the car,” Bowen said. “Smoke lingers and can irritate the airways, causing them to tighten, swell and produce mucus.”
Other indoor triggers include dust, dust mites, pest droppings and strong odors from cleaning products and perfumes.
If a child is allergic to animals, continued exposure may worsen symptoms. If dust mites are a trigger, using allergen-protective mattress and pillow covers can help reduce exposure.