What is asthma?

Asthma is a chronic inflammatory disease of the lungs and airways — the tubes that bring air into and out of the lungs. If your toddler has asthma, these airways are irritated and swollen, and this can affect his ability to breathe.

It's important that you work with your toddler's healthcare provider to prevent and treat asthma attacks. With the right medications, education, an asthma action plan, and regular medical follow-up, most asthmatic children do just fine.

What happens during an acute asthma attack?

If your toddler has an acute asthma attack, the lining of his airways will become even more inflamed and produce more mucus. Then the muscles around his airways will tighten and his breathing tubes will narrow. He may breathe rapidly, cough, or wheeze (make a whistling sound) as his breath is forced through the narrowed airways. You may notice your toddler's nostrils flare or the skin around his ribs suck in with each breath.

Listen: Wheezing

Won’t play? Click here.

If left untreated or there's a delay in seeking medical attention, asthma attacks can be deadly. As soon as you notice symptoms of an attack, promptly give your toddler the "quick-reliever" medicine prescribed by his doctor. (If you don't have any emergency medicine, call 911 or take your child to the closest emergency department.)

Once the medicine opens his breathing tubes, the symptoms should subside. If the symptoms persist or get worse, call 911 or take your child to the emergency department right away.

What do allergies have to do with asthma?

Exposure to allergens such as dust mites, cockroaches, mold, pollens, or animal dander can trigger or worsen symptoms in some children with asthma. This is referred to as allergic asthma. Seasonal allergies to outdoor pollens (also called hay fever) won't usually be a problem until your child is 4 or 5, because it can take that long to develop a sensitivity to them. Allergies to dust mites, mold, or animal dander may develop earlier in life, though.

About 75 to 80 percent of children with asthma also have significant allergies. If your toddler has asthma and you know or suspect that he has allergies, you may want to take him to an allergist for further evaluation and treatment to help prevent asthma attacks.

Are there other triggers?

Yes, other possible triggers include cold air, viral infections (such as the common cold), tobacco smoke and other air pollutants, or just plain running around. In fact, if your toddler often coughs and wheezes after a romp on the playground, he may have what's called exercise-induced asthma.

How common is asthma in children?

Asthma is the most common serious chronic childhood disease, and it's the third most frequent cause of hospitalization in children under 15 years of age. Asthma affects 6.5 million children in the United States today. Fifty to 80 percent of children with asthma develop symptoms before they're 5 years old.

How can I tell whether my toddler has asthma?

You'll need your doctor's help. Asthma can be difficult to diagnose in children younger than 2, because conditions other than asthma can cause wheezing or wheezing-like sounds. In fact, viral respiratory infections are probably the most common cause of wheezing in babies and young children.

However, if your toddler coughs frequently and has allergies or eczema, and your family has a history of asthma and allergies or eczema (especially if you and your partner both have them), there's a good chance that your toddler has asthma. His symptoms are likely to be worse at night.

Your child's doctor will examine your toddler and take a careful history, including a family health history, to help make a diagnosis.

How do you treat asthma?

If your toddler has asthma, you'll want to work with his doctor to develop a strategy for preventing and dealing with asthma attacks. First you'll want to figure out what triggers the attacks and then do your best to help your child avoid those triggers. Some children have attacks only when they have a cold, for example, while others have attacks after coming into contact with an allergen or an irritant like cigarette smoke.

Sick child with caring mom
Children's Symptom Guide

Is it serious? Find out fast

Stopping an asthma attack
Your doctor will probably prescribe one or more drugs for your toddler. Drugs known as quick relievers or rescue inhalers are used to stop an asthma attack. These fast-acting medications relieve the spasms in the airway, making breathing easier. Quick-reliever drugs such as albuterol are administered using either a nebulizer machine or a metered-dose inhaler (MDI).

A nebulizer is an electric or battery-powered machine that turns liquid medicine into a mist that your toddler can breathe into his lungs through a mask. Nebulized breathing treatments usually take about ten minutes.

An MDI is a small aerosol can that's inserted into a long tube called a holding chamber or spacer, which has a mask or mouthpiece attached to it. The albuterol is sprayed into the holding chamber and then inhaled by your child as he breathes through the mask. This type of breathing treatment can be given in less than a minute.

The choice of a nebulizer or a metered-dose inhaler depends mostly on which device is easiest for you and your toddler to use. In general, they are equally effective in getting the medicine into your toddler's lungs to stop an asthma attack.

Preventing an asthma attack
Drugs known as controllers are used to prevent asthma attacks. These include inhaled steroids, which can help reduce inflammation and swelling and prevent your toddler from wheezing. You would give your toddler daily inhaled steroid medicine using either an MDI or a nebulizer, depending on the steroid prescribed by his doctor.

A chewable nonsteroid pill called a leukotriene antagonist is another option for decreasing inflammation and swelling. Your child's doctor will recommend the type of daily controller medicine that's best for your child's asthma.

If your toddler's asthma proves difficult to control, his doctor may refer him to an asthma specialist.

You'll want to make sure that any sitters or daycare providers responsible for your toddler's care are familiar with his condition and know how to treat an asthma attack.

What can I do to prevent my child from developing asthma?

There's nothing you can do to fully prevent your toddler from developing asthma if it's in his genes. And you won't know whether your child will be asthmatic until he shows persistent symptoms, such as wheezing and constant coughing. That said, you may be able to minimize the severity of your child's symptoms or delay the onset of his asthma until he's older (and his lungs are bigger and stronger) if you do the following:

  • Limit his exposure to dust mites: Encase your child's mattress in an impermeable cover, remove carpeting and plush toys from his room, use blinds instead of heavy fabric drapes, and wash his bedding once a week in hot water.
  • Keep your toddler away from secondhand smoke. Cigarette smoke isn't technically considered an allergen, but it does irritate the lungs.
  • Limit his exposure to air pollution. Air pollutants such as ozone can irritate the lungs and cause breathing problems in people with sensitive respiratory tracts. Check your local newspaper or radio for reports on the Air Quality Index, and consider keeping your toddler indoors on days when the air quality is poor.
  • Avoid using a fireplace or wood stove. Although the warmth and coziness are inviting, the smoke may irritate your child's respiratory system.
  • If your child has developed an allergy to your family pet, keep the pet outside if you possibly can. Of course, depending on your pet's disposition and your living situation, this won't always be possible.
  • Reduce mold in your home. Install exhaust fans or open the window in the kitchen when cooking and the bathroom when showering, for example. Use an air conditioner or dehumidifier, if necessary, to keep the humidity level between 35 and 50 percent. Repair leaks, which can cause mold growth behind walls and under floors, and clean moldy surfaces using soap and water. Make sure damp or wet clothing or surfaces are dried as soon as possible to prevent mold growth.

Can my child be cured of asthma?

There's no cure for asthma, although some asthmatic children who wheeze only when they have colds or upper respiratory tract infections outgrow the tendency to wheeze over time. In general, asthma is thought to be a lifelong condition, although the frequency and severity of symptoms may change as your toddler grows.

Close medical follow-up and appropriate treatment will enable your child to manage his asthma as he gets older so he can run, swim, and play like other children. Most children with asthma grow up to be healthy adults.

Asthma can be frightening for both you and your child, but remember, you're not alone. You may be surprised to learn how many families are dealing with asthma. Share your concerns about your child's asthma with other parents in the BabyCenter Community .