Asthma is an obstruction to the outflow of air that is at least partially reversible. Diagnosis of asthma is established in older children and adults by pulmonary function testing; however, there is no infant testing counterpart available at this time.
Outside of a suggestive history, the best assessment tool to see if your infant or toddler meets the definition of asthma symptoms is to assess the response to asthma medication, such as a bronchodilator. That is, does the inhaler or breathing treatment make your infant better within 30 minutes? The improvement may only last 3-4 hours, but if there is improvement in 30 minutes, it is a response.
While many physicians think that infants cannot get asthma, the fact is, they can. Asthma symptoms to watch for in this age group include cough with activity and severe cough with upper respiratory infections that last longer than the nasal symptoms; e.g., nasal symptoms that last for a week and coughing that lasts for two to three weeks.
For infants, a cough that begins between midnight and 4:00 a.m. is considered an asthma symptom until proven otherwise. Other signs of asthma also include coughing, wheezing or rapid breathing that improves with inhaler or breathing treatment. Coughing is much more common in infants than wheezing. Wheezing is related more to asthma conditions.
One of the most common causes of asthma symptoms in children five years old and younger is a respiratory virus. In fact, viral infections are the most common cause of acute asthma episodes in infants six months old or younger. Although both adults and children experience respiratory infections, children have more of them and some preschool children are plagued with viral infections. At least half of children with asthma show some sign of it before the age of five, frequently when they are sick.
Many children in this age group have symptoms only when infection is present and not between infections. Of the children who have problems only with infection at age two, 75 percent have no asthma symptoms and test normally for lung function by age six. However, those children with recurrent wheezing episodes who have other allergic disorders (such as nasal allergies, eczema or food allergies) are more likely to have persistent asthma.
If your child is diagnosed with asthma, creating an Asthma Action Plan can help you and other caregivers monitor symptoms and know what to do if an asthma attack does occur. It’s also a good idea to fully understand what triggers asthma so you can create an asthma-safe home and improve the quality of indoor air your family breathes.
If you’re unsure whether your child’s symptoms are caused by asthma or something else, take them to your pediatric allergist or doctor right away.