Asthma is a very common chronic disease that affects 1 in 12 children under the age of 17 in the United States. Asthma attacks are caused by inflammation in your airway — usually from an allergen or irritant — resulting in swelling, chest tightness, and narrowing of the airway. Asthma attacks leave you struggling to breathe and can be life-threatening if left untreated.

Among the more than 6 million young children diagnosed with asthma, 3.8 percent are under the age of 4, and 50 percent to 80 percent of children with asthma experience symptoms by the age of 5.

For a parent, watching your baby struggle to breathe can be both frightening and upsetting. Fortunately, many treatments are available to relieve your child’s asthma symptoms.

Asthma Symptoms

Asthma is a disease of the airway, so the condition’s most common symptoms involve trouble with breathing, shortness of breath, and getting enough oxygen. Babies and young children have difficulty communicating how they feel, so you need to look for visual clues that a child is struggling to breathe.

Asthma doctors list the following symptoms as warning signs that your baby may be having breathing problems:

• Fast breathing
• Belly breathing (exaggerated belly movements while breathing)
• Nostril-flaring while breathing
• Skin being sucked in between the ribs while breathing
• Panting during normal activities
• Wheezing (whistling sounds during breathing)
• Continuous cough
• Difficulty eating or sucking
• Unusual sleepiness, such as at times when they are usually alert and awake
• Changes in skin color (blue or gray coloring in lips, face, and nails)
• Chest gets bigger
• Cries are softer and shorter

Asthma and breathing problems in infants can be especially dangerous because of their lung size. The tiny airways can get blocked by even small amounts of mucous, leaving babies more vulnerable to lung failure.

Be on the alert. If you notice any of the above breathing symptoms, seek medical care from an emergency room or pediatrician right away. For babies, breathing difficulties can escalate from a few symptoms to a severe asthma attack in a matter of minutes. However, with prompt treatment, asthma attacks are controllable.

Causes of Asthma in Infants

Although the exact causes of asthma are currently unknown, respiratory infections are the most common triggers of asthma symptoms in small children. Since infants have much smaller lungs and airways than adults, they are more prone to mucus blockages or inflammation, leading to an asthma attack. A family history of asthma, allergies, or eczema increases a child’s risk of getting asthma.

Common Asthma Triggers in Infants

Medical research has shown a number of risk factors (also known as triggers) that can induce asthma symptoms in babies, children, and adults.

Knowing what triggers asthma symptoms in your child is important, so you can eliminate, or minimize their exposure. “I was born with asthma,” said a MyAsthmaTeam member. “I have been dealing with it all my life. I’m always cautious of the things I do and eat that can trigger an attack.”

The following are some of the most common triggers of asthma in babies.

Environmental Factors

Allergens found in the environment can trigger inflammation in airways and cause asthma symptoms. Risk factors in the environment can include:

• Dust mites
• Pet dander
• Pollen
• Mold
• Cockroaches
• Rodents
• Air pollution
• Changes in weather (dry wind, cold air)
• Smoke in the air and cigarette smoke
• Wood fires
• Chemicals
• Charcoal grills

Other Health Conditions

Your child may develop other health conditions that can trigger asthma symptoms and cause breathing difficulties, including:

• Food allergies
• Gastroesophageal reflux disease (GERD)
• Viral infections
• Respiratory infections (e.g., colds, flu, pneumonia, sinus infections)
• Rhinitis (inflammation in the nose)

Strong Emotions

Babies use crying, laughing, facial expressions, and body movement to express their needs and emotions. Excessive crying or even common breathing changes from anger, fear, or excitement can trigger asthma in some infants and children.

Diagnosing Asthma in Infants

Typically, a doctor will diagnose asthma in older children and adults by:

• Reviewing current symptoms
• Completing a physical exam
• Discussing family and medical history
• Performing a lung function test
• Taking a chest or sinus X-ray

Diagnosing asthma in infants is a little different. Children younger than 5 are usually not given a lung function (or breathing) test. Instead, a doctor will conduct a physical exam and review the child’s family and medical history.

If an infant is experiencing breathing problems, a doctor may give them medications with Albuterol or Levalbuterol, which helps relax the airway. If the medication causes the breathing to improve, the child may have asthma.

Many other health conditions — including bronchitis, croup, acid reflux, and pneumonia — have the same symptoms as asthma, which can make diagnosis tricky. Before rendering a diagnosis, an asthma specialist will usually wait for the child to have a few episodes of wheezing with illnesses or to exhibit persistent symptoms when they are not sick.

“My son was diagnosed with bronchitis when he was 2 months old,” a MyAsthmaTeam member explained. “We were in and out of the hospital three times a year. He is now 3, and they are finally calling it asthma.”

Can a Child Outgrow Asthma?

It’s possible for an infant to outgrow asthma as their lungs mature and they build tolerance to inflammation and irritants. Approximately 50 percent of children outgrow their asthma symptoms when they reach their teens; however, it can return when they are adults.

Treatments for Babies With Asthma

Infants can take the same types of asthma medications as children and adults. However, they are administered at a lower dose, either using a nebulizer (breathing machine) or in liquid form. There are several common treatments, both fast-acting (for immediate relief) and for long-term control

Fast-Acting Medications

• Nebulizer treatment — This approach entails turning the liquid form of Albuterol into a mist that is inhaled via face mask. People of all ages can use a nebulizer to get relief from asthma symptoms in about 10 minutes.
• Inhaler — Infants can get symptom relief from an Albuterol inhaler with a spacer (similar to a valved holding chamber) and mask. With proper technique, this combination can give the same level of relief as a nebulizer — and the baby is able to breathe in the medication at their own pace.

Long-Term Control Medications

Fast-acting medication will help your child through the acute phase of an asthma attack. However, a doctor may prescribe a daily medication to help control your child’s asthma symptoms for the long term.

Here are some common daily medications for infants:

• Inhaled corticosteroids, such as Uceris (Budesonide) or Flovent Diskus (Fluticasone), act as an anti-inflammatory to reduce swelling and mucus in the airway to decrease daily asthma symptoms and control flares when they occur.
• Leukotriene modifiers, such as Singulair (Montelukast), are taken by mouth to help decrease lung inflammation that can cause asthma symptoms.
• Combination inhaled corticosteroids and long-acting albuterol inhalers, such as Symbicort (Budesonide/Formoterol) and Advair Diskus (Fluticasone propionate/Salmeterol), are typically only given to older children and adults who have moderate to severe asthma symptoms.

Asthma Action Plan

If your infant is diagnosed with asthma, the doctor or pediatrician should create an asthma action plan to help you manage your child’s asthma at home. The plan provides a clear, easy-to-read template that outlines exactly what medications and actions to take when your child presents certain asthma symptoms.

You should consider sharing the asthma action plan with friends, family members, and child care workers so they have guidance to follow should an emergency occur in your absence. When your child enters a school setting, the action plan can function as an emergency-response plan for teachers to follow in case of an asthma attack at school.

Tips for Managing Your Baby’s Asthma

Caring for an infant with asthma can be scary, exhausting, and worrisome. However, creating a management plan with your doctor and sticking to it can help reduce that stress and anxiety. The following are some useful asthma management tips:

• Administer medications on time and as prescribed.
• Identify and avoid all triggers that cause asthma symptoms in your child.
• Make sure your baby receives an annual flu vaccine.
• Use an asthma diary to help document asthma symptoms.
• Know the early signs of an asthma attack so you can seek treatment before it worsens.
• Understand severe asthma symptoms and when to seek immediate emergency care.
• Educate caretakers on early and severe asthma symptoms that require immediate action. Go over the asthma action plan and give them a copy.

Find the Support You Need

As you are navigating your infant’s asthma diagnosis, you are not alone. By joining MyAsthmaTeam — the social network people with asthma and their loved ones — you gain a community of members who share encouragement and reassurance. Members offer support and tips to overcome barriers to treatment and can be a safe sounding board to express your feelings, triumphs, and frustrations.

Do you have an infant or young child diagnosed with asthma? Share your experiences below in the comments or post on MyAsthmaTeam. Your story could help someone facing the same challenges.