Asthma in children: causes, symptoms, treatment

Asthma is a chronic respiratory disease that causes a feeling of shortness of breath and suffocation. In asthma there is hypersensitivity of the airways, the lungs overreact to certain stimuli. In the Netherlands, asthma is the most common chronic condition in children. What are the causes and symptoms of asthma, how can the condition be treated and what is the prognosis? Which sports are suitable for children with asthma?

Article content

  • Respiratory tract
  • Asthma
  • Causes of asthma
  • Symptoms of asthma
  • Complications of asthma
  • Diagnosis of asthma
  • Asthma treatment
  • Asthma prognosis
  • Limiting an asthma attack in children
  • Exercise if you have asthma
  • A vaccine against asthma (future)


Respiratory tract

The airways are the natural pathways through which air flows in and out of the lungs during breathing. The respiratory tract includes the nose, the nasopharynx, the airway and the bronchi.


A child with asthma may experience shortness of breath, coughing and wheezing during an attack. It is due to a narrowing of the airways. Asthma occurs in many children, approximately ten percent. More common in boys than in girls and it can also run in families. The airways are sensitive to certain stimuli and in response to the stimuli, the muscles around the airways contract. The mucous membrane lining the airways will change, it will swell and more mucus will be produced. This causes the airways to become narrower. More and more children are suffering from asthma, possibly due to allergies and other environmental factors.

Causes of asthma

Heredity plays a role, if both parents have asthma then the child has a greater risk of asthma. Other respiratory diseases increase the risk that a child will develop asthma-like symptoms later. Then you should especially consider respiratory diseases in the event of a premature birth. A respiratory reaction can also occur if a child is often in an environment where smoking occurs. In children under the age of five, you often see seizures triggered by a viral infection. This may also be the case in older children, but it can also be caused by allergic reactions to, for example, pollen, mold, dust mites, and pet flakes. Physical exertion can also be the cause, cold and dry air in particular can trigger an attack. It is not common, but food can also be the culprit, for example milk, eggs or nuts. There are other possible causes: emotions, certain medications (antibiotics, NSAIDs, aspirin).

Symptoms of asthma

  • Whistling or wheezing, this can start suddenly. It can get worse at night, but also when it is cold, or when the child is exercising.
  • A dry cough that is worse at night.
  • Shortness of breath.
  • A tight feeling in the chest.
  • In a severe attack, rapid breathing may occur, the chest wall may retract and speaking will become more difficult. If there is a low oxygen level in the blood, the tongue and lips may turn blue. This is also called cyanosis. In the event of such a severe attack, call your doctor or 911. A severe attack of asthma can be life-threatening.

Very young children may only suffer from a dry cough and no other symptoms. Older children may feel very tired because they do not sleep well at night. Children with asthma often suffer from other allergic conditions such as eczema and hay fever.

Complications of asthma

  • If air remains in the alveoli, they can stretch. The elasticity of the lungs will decrease (emphysema).
  • Someone with asthma suffers from bronchitis or pneumonia more often than other people.
  • It doesn’t happen often, but excessive coughing can cause tears in the pleura (around the lung). Air gets between the pleura (pneumothorax).


Diagnosis of asthma

The doctor will listen to the child’s chest with a stethoscope. An older child will probably need to blow on a peak flow meter to estimate lung function. The doctor may prescribe a bronchodilator medication. If the complaints are caused by asthma, they can improve significantly after using the medication. After establishing the diagnosis, an allergy test can be done via blood tests to see whether there are allergies that trigger asthma attacks.

Asthma treatment

It is important that a child can lead as normal a life as possible, and that is what the treatment is aimed at. Information will be given to the parents, including about medications and what to do if a child has a seizure. But the child itself must also receive the necessary information. It will also be necessary to consider what adjustments are needed in the environment to prevent attacks. As for the medications, there are two types of medications: preventive and rapid-acting. The preventive medicines prevent the production of substances that trigger allergic reactions, they counteract the inflammatory response and they reduce mucus production. The fast-acting medications are the most effective, they dilate the airways immediately and usually for a long time. They should be used as soon as symptoms are observed. To combat an asthma attack, the child or someone accompanying the child should always carry an inhaler with a bronchodilator. The child must also have an inhaler nearby at school. If the inhaler does not give good results, your GP or emergency room should be contacted. It is very important to always remain calm, this also has a good influence on the child. If a child experiences a severe attack, hospitalization may be necessary.

Asthma prognosis

A child with asthma can lead a relatively normal life. It is important to handle medications carefully and avoid factors that can trigger an attack. In almost half of children, asthma symptoms disappear before or around puberty. The complaints can return later in life. Every year, several children in the Netherlands die as a result of asthma, especially very young children. Usually because the symptoms are not properly recognized and treatment is started too late. It is also possible that an attack develops so quickly that one arrives at the hospital too late.

Limiting an asthma attack in children

  • No smoking in the house.
  • Use as a covering for floors: tarpaulin, parquet, laminate, tiles.
  • Preventing moisture in the home.
  • Do not keep furry animals as pets if the child is allergic to them.
  • Do not bring birds into your home if the child cannot tolerate them.
  • Dust with a slightly damp cloth.
  • Do not use strongly scented products such as air fresheners or perfume.
  • Use synthetic duvets, pillows and mattresses.
  • If a child is sensitive to pollen, keep the windows closed.


Exercise if you have asthma

  • Exercise is important for everyone, including those who have asthma. Besides diving with oxygen tanks, a child with asthma can practice any sport. However, one sport is more suitable than the other.
  • Athletics, football and basketball are sports that can cause the most problems.
  • More suitable are: swimming in an indoor and heated pool, gymnastics, cycling on flat terrain, walking and golf.
  • Tennis and volleyball are also suitable, there is a lot of running, but the efforts are intermittent.
  • Martial arts such as judo, karate and taekwondo are very suitable, as is fencing.
  • Diving with tanks is not recommended because of the pressure changes that occur and at a certain depth you cannot do anything against an asthma attack. If you suffer from shortness of breath, it is very difficult to perform the decompression actions.
  • During mountain sports such as cross-country skiing and skiing you have to deal with cold and dry air, which can be a problem.


A vaccine against asthma (future)

Allergic asthma is a severe reaction to certain stimuli. Attempts are being made to develop a vaccine that can prevent allergic asthma. Dendritic cells play an important role in allergic asthma, these cells are located in the lungs and are the gatekeepers of the body. They look for intruders and warn our immune system. In healthy people, the immune system does nothing when it comes to harmless substances, but if you have allergic asthma, the immune system does respond. You will then experience coughing, sniffling, wheezing, itchy eyes, shortness of breath and sneezing. It seems that if you come into contact with innocent intruders in your first years of life, you are protected against allergies later. Children who grow up on a farm and spend time in the stables as children almost never develop allergic asthma. Children who live in tropical areas also almost never get allergic asthma. It has also been found that when dendritic cells come into contact with allergic substances and at the same time with substances from innocent intruders, the immune system remains calm. There is no allergic reaction. This knowledge can be used to look for a vaccine (vaccination) that can prevent allergic asthma in children. There is still a long way to go before a vaccine is ready for allergic asthma.

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