How to spot an asthma attack in your child

In the UK, over 1.1 million children have asthma. Asthma attacks are unpredictable and can vary in both severity and duration. Mindful Mum lists the most common triggers of asthma, how to spot an asthma attack in a child and when to call for medical attention.

How do I spot an asthma attack in a child?

An asthma attack may vary in both severity and length of time. Asthma attacks in children are unpredictable, although they are often worse at night or with exercise.

Signs a child may have asthma include:

feeling breathless
wheezing (there may be a whistling sound when your child breathes)
coughing (particularly at night)
tight chest

Signs asthma is getting worse and that you need to contact your GP, include:

a drop in peak expiratory flow rate (used by GP’s and given to parents to test at home)
an increased pulse rate
an increase in wheezing
feeling agitated, or restless

Signs an asthma attack is severe and needs immediate medical attention by calling 999, include:

the symptoms will get worse quickly
difficulty breathing and talking
a racing pulse
lips and/or finger nails may turn blue
the skin around the chest and neck may tighten
the nostrils may flare as the child tries to breathe

Download Signs of Asthma in Children to print and take with you.

Watch video on how to recognise symptoms of asthma in your child.

The video includes a real family’s experience of asthma in a six month old baby and a seven year old child.

How do I spot asthma in a very young child or toddler?

Diagnosing asthma in very young children can be difficult because ‘wheezing’ can be a common problem (one in seven) in children during their first five years. Many of these children will not go on to have asthma in later childhood, so your doctor may not want to use the term ‘asthma’ at this stage.

If your child is under the age of two, it is even more difficult to tell if they have asthma. There are a number of different wheezing illnesses, including acute bronchiolitis, ‘wheezy bronchitis’, as well as asthma, which can make your baby wheezy.

What are the common triggers of asthma?

The bronchi (lung airways) of children with asthma are more sensitive than those of children without the condition, and certain substances, or triggers, can irritate them.

Common triggers of asthma in children include:

infections, such as viral infections and some cases bacterial infections
house dust mites
animal fur
pollen
tobacco smoke
cold air
chest infections
emotional or stressful situations
some painkillers such as aspirin or ibuprofen (see note below)
food containing sulfites, such as concentrated fruit juice, jam, shrimp, and many processed, or pre-cooked meals

NB: Medicines, especially some painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), the most well known of which are aspirin and ibuprofen. Please note children who are under 16 years of age should not be given aspirin.

Can exercise cause asthma?

Sometimes, children with asthma find that their symptoms are made worse through physical exercise. This is known as exercise-induced asthma and is usually the result of poor asthma control.

What treatment is given to a child who suffers from an asthma attack?

During your child’s assessment, a personal asthma plan will be created which will help your child to recognise the initial symptoms of an attack. It will include how they should respond and when they should seek medical attention.

Treatment typically involves taking one or more higher doses of their reliever medicine.
If admitted to hospital, your child may be given a combination of oxygen, and beta2-agonists and steroids, to bring their asthma under control.
Your child’s personal asthma plan will need to be reviewed so that the reasons for the asthma attack can be identified and avoided in future.

What happens during an asthma attack?

Asthma affects the airways of the lungs (the bronchi) and causes them to become inflamed and swollen. The bronchi are small tubes that carry air in and out of the lungs. When the bronchi become irritated, they narrow, the muscles around them tighten, and there may be an increase in the production of sticky mucus, or phlegm. Your child may find breathing difficult, their chest may feel tight, and they may experience wheezing and coughing. The severity of asthma symptoms differ from child to child – from mild to severe. However, the narrowing of the airways is usually reversible, either naturally, or by using medicines.

Are some children more susceptible to asthma than others?

Asthma in children is more common among boys than girls. Children who develop asthma at a very young age are more likely to ‘grow out’ of the condition as they get older. During the teenage years, the symptoms of asthma will disappear in approximately three-quarters of all children with the condition. However, asthma can return in adulthood. If the childhood symptoms of asthma are moderate to severe, it is more likely that the condition will return later in life.

How is asthma diagnosed?

Your GP will normally be able to diagnose asthma by asking you about your child’s symptoms, examining their chest, and listening to their breathing. They will want to know about your child’s medical history and whether there is a history of allergic conditions in your family. Your GP will also want to know about the circumstances surrounding the onset of your child’s symptoms, such as when and where it happened, because this could help to identify the possible trigger(s) of their asthma.

For more in depth information on asthma symptoms, causes, diagnosis, prevention and treatment see the NHS Direct page – Asthma in Children.

Click on guide for print version of How to Spot Asthma In A Child.