Asthma is a chronic respiratory condition that affects millions in the Unites States every day. Childhood asthma is the single-most prevalent chronic health condition in children, and the third-most common cause for juvenile hospitalization. According to a 2015 report by the CDC, 24.6 million Americans suffer from asthma, including 8.4% of all children and 7.6% of adults. Not only does it affect the daily lives of those afflicted, it can also be deadly if ignored or untreated. These cases vary greatly in severity and frequency of attacks. While often seemingly mild, asthma can be deadly. Knowing the potential causes and triggers of asthma and asthma attacks will help your child avoid damaging respiratory illness and discomfort.
The Global Initiative for Asthma defines it as “a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.” So, is it just a cough and a sore chest, or is it asthma? Let’s take a look at the most common symptoms of asthma in children to get a better idea.
Signs and Symptoms of Childhood Asthma
Unlike adult onset asthma, which usually displays persistent symptoms, childhood asthma is typically characterized by sporadic flare-ups. Symptoms of asthma in children can range from mildly inconvenient to deadly, so it is best to know what to look for when assessing whether or not your child has asthma. Only a doctor can provide the real answer, but most likely they will be looking for a combination of the following signs of asthma in children.
Wheezing, also called silibant rhonchi, is a long, continuous whistling stemming from the respiratory airways. It occurs when the bronchi in the respiratory tree are blocked and airflow is restricted to and from the lungs. Expiratory (breathing out) wheezing usually occurs when the airflow rate is diminished by 50% or less, whereas inspiratory (breathing in) wheezing commonly indicates the presence of physical blockages such as tumors and scarring that may interrupt the flow of air through the respiratory tree. Experiencing both expiratory and inspiratory wheezing may demonstrate a lack of sufficient oxygen intake and a lack of carbon dioxide expulsion. As such, wheezing is one of the main indicators of an asthma attack, and should be regarded seriously if the afflicted individual appears to be struggling to breath.
Yes, we all know what coughing looks and feels like, but do we know exactly why we do it? Coughing is a protective reflex that is predominantly utilized to expel foreign bodies, such as dust, bacteria, viruses, and excess phlegm from the respiratory airways. However, in those with asthma, coughing is usually a result of bronchial hyperresponsiveness, or a condition in which the muscles behind the bronchioles (the passageways by which air travels to the alveoli) contract without significant stimuli. It is not uncommon for coughing to be the sole symptom of an asthmatic individual. In this case, their asthma is considered “cough-variant asthma.” Those with asthma may also experience nocturnal (night-time) coughing, which may lead to insomnia and other complications.
Serious coughing fits may cause fainting spells due to the lack of oxygen entering the brain. As most asthmatic coughing is chronic, many patients will experience pelvic or abdominal hernias, fractured ribs, and costosternal syndrome, the inflammation of the cartilage that connects the ribs to the sternum.
Hyperactivity in the lungs, such as the overexertion of coughing fits and the extra effort involved in obtaining enough oxygen through blocked airways may cause chest tightness after an attack. This pain is similar to the pain of working out your chest at the gym. The tightness can also happen during the attack, though it will likely be overshadowed by the panic/adrenaline that often accompanies an asthma attack. Those who suffer very frequent asthma attacks may feel less chest tightness, as their muscles are accustomed to the strain that accompanies them.
Shortness of Breath
Shortness of breath, or dyspnea, is a state of discomfort that varies in severity and quality from person to person. It is most commonly described as the feeling of not being able to breathe adequately, the feeling of “air hunger,” or an “uncomfortable awareness of breathing.” Shortness of breath can be as psychological as it is physical, and may be brought about by the panic of suffering an asthma attack, as well as the increased effort of clearing oxygen through the bronchioles.
Symptoms of asthma in infants
Since an infant cannot describe their symptoms as an adolescent child can, it is especially important to monitor your baby’s breathing. Look out for signs of difficulty breathing, such as exaggerated movements in the chest and tummy, flaring nostrils, wheezing, and panting. Asthmatic infants may also display a pallid (pale) complexion, especially in the extremities. They may also have a stubborn cough and have difficulty breastfeeding or eating food.
Besides the obvious health risks of childhood asthma, its effect on children is more than the sum of its symptoms. Kids with asthma are less likely to participate in common socializing behavior like sports and active playing. While this may seem mild, the social and emotional growth, as well as physical conditioning that take place in the schoolyard is not to be underestimated. It is important to take steps to manage childhood asthma in order to make active playtime enjoyable, rather than burdensome or painful.
Another massive effect of childhood asthma takes place in the academic setting. In 2013, the US saw around 14 million school days lost to asthma complications, making it one of the leading causes of absenteeism in America.
These childhood asthma symptoms are the most common, but asthma can be accustomed by other symptoms as well. Now that we know what childhood asthma looks and feels like, let’s take a look at the causes and risk factors.
Childhood Asthma Causes
Unfortunately, if you or your partner have asthma, your child has a 300-600% greater chance of developing asthma than those without asthma in their bloodline. Researchers have found at least 30 phenotypic variations in DNA that contribute towards the likelihood of asthma, but our understanding of asthma heredity and how it affects the development of airway constriction is still incomplete. Along with asthma specific genes, links have been found between genetic predisposition towards atopy (standard allergies) and asthma. So if you or your child suffers from allergic symptoms such as hay fever, eczema, or hives, there is a much higher likelihood that they will develop asthma than those who do not.
Asthma can also occur in those who aren’t genetically predisposed. Common factors include air pollution, dust and dust mites, pet dander, and even cold air or wind. Occupational and behavioral stimuli such as chemical irritants in the workplace and tobacco smoking, as well as certain medications are far more likely to affect adults. However, close proximity to those industrial settings and secondhand tobacco smoke can play a huge part in childhood asthma development.
Children are more likely to develop asthma in combination with allergies than adults, whose asthma is usually triggered by hormonal and environmental factors. Asthma affects everybody differently, so knowing which factors contribute towards your child’s condition is the first step in avoiding chronic symptoms and acute exacerbations (asthma attacks).
Areas with the highest levels of pollution see the highest numbers of asthma. It is estimated that over half of all asthma cases in the US occur in areas with substandard air quality. Microbes, allergens, chemicals, and other commonly occurring indoor irritants play a role in the development of asthma and often trigger asthma attacks. Common irritants include:
- Pet Dander – Animal allergies, to cats in particular, are very commonly associated with adult onset asthma.
- Dust mites
- Chemicals – Phthalate esters, formaldehyde, and cleaning products.
Other medications can be a trigger too. Medical triggers can include medications like NSAIDs and beta-blockers as well as conditions like:
- Anxiety and Mood disorders
- COPD (Chronic obstructive pulmonary disorder)
- Obstructive Sleep Apnea
Occupational hazards can be a key factor. Factory workers, painters, construction workers, and many other blue collar jobs report higher numbers of asthmatic sufferers. Anywhere from 5-25% of asthma cases reported annually are caused by occupational factors. The risk of asthma is greatly increased in settings with:
- Wood and sawdust
- Flour (bakeries/food processing)
- Industrial adhesives
Do you think your child has asthma? Learn how it is diagnosed or information on asthma treatment and medication.
If you think you have symptoms of asthma, call or book online with PlushCare to set up a phone appointment with a top U.S. doctor today.