Asthma is a chronic inflammatory disease that affects the lungs. In a child with asthma, the airways are very sensitive, meaning the lungs may be inflamed or irritated even though they don’t look like anything is wrong. The degree and severity of airway inflammation with asthma varies over time.

The winter months can be especially challenging for children with asthma. They may be sensitive to colds or viral infections. Additionally, certain weather conditions and particles in the air can also make asthma symptoms worse. Ongoing exposure to these substances can continue to increase airway inflammation as our bodies’ defense mechanism tries to help.

Asthma can be serious and even life-threatening. Unfortunately, we don’t have a cure for asthma but the symptoms can be treated and kept under control so kids can lead healthy, active lives.

Symptoms of asthma are different for each child and vary with frequency and severity.

Nighttime symptoms can be a warning sign. A cough may be the first and sometimes only asthma symptom. Other warning signs may include wheezing, difficulty breathing or shortness of breath, tightness in the chest or decreased ability to exercise.

During an asthma attack, the airways become narrower due to the muscles around the airway tightening and the inner lining of the airways becomes swollen and irritated, which makes breathing difficult.

In the United States, roughly one out of every 10 children have asthma. In some U.S. communities, rates are as high as 25%. Asthma is one of the main reasons children miss school and can cause hospitalizations.

The number of children with asthma has been rising worldwide. The number of illnesses caused by asthma may also be increasing in some parts of our country despite the reasons remaining unknown. However, we do know that many things can affect whether a child develops asthma. For example, family history of allergies, asthma, respiratory infections, and exposure to irritants, allergens, tobacco smoke or other air pollutants.

Some children with asthma may also have other allergic diseases, including eczema, food allergies and nasal allergies or allergic rhinitis. This connection is sometimes called the allergic march/triad or atopic march because the conditions often develop over time after each other, starting in infancy. If other doctors are caring for these conditions, it's important that care is coordinated.

The goal of asthma treatment is to prevent or reduce symptoms so children can be kids and be able to do what they want to do on a daily basis. It's important to prevent emergency department visits and hospital stays caused by asthma attacks. The best way to do this is to know and control asthma triggers and provide asthma medicine as planned by your primary care provider or an asthma specialist.

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Clinton Dunn, MD, FAAP, is a board-certified pediatrician and allergist/immunologist who practices in the Hampton Roads Virginia area. He is a member of the American Academy of Pediatrics (AAP) and the AAP Section on Allergy and Immunology. His clinical interests focus on atopic dermatitis, asthma, food allergy and applying high quality evidence-based medicine for the improvement of pediatric allergic/immunologic diseases.

Addie Dodson, MD, FAAP, is a board-certified pediatrician and currently completing her fellowship in pediatric pulmonology at Children's Hospital Los Angeles. Dr. Dodson is a member of the AAP Section on Pediatric Pulmonology and Sleep Medicine. She currently serves as the section's executive committee fellow-in-training liaison. Dr. Dodson's clinical interests within pulmonology are growing while she continues in her fellowship, but she has special interests in asthma, use of technology to improve practice, medical education and advocacy.

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