What causes childhood asthma?

Researchers continue to learn what causes asthma. It is not fully understood. The following things play a part:

• Genetics. Asthma runs in families.

• Allergies. Some allergies are more common in people with asthma. Allergies also tend to run in families.

• Respiratory infections. Infants and young children who have some respiratory infections are more likely to have long-term lung problems.

• Environmental factors. Irritants, such as pollution and allergens, are known to cause asthma.

What causes asthma symptoms to get worse (flare-ups)? 

Triggers are those things that cause asthma symptoms to get worse or cause asthma flare-ups. Each child has different triggers. A very important part of asthma management is identifying triggers and then trying to stay away from them. Asthma triggers may include:

• Allergens, such as pollen, dust, and pets

• Upper respiratory infections, such as colds or the flu

• Inhaled irritants, such as from smoking, e-cigarettes, or secondhand smoke

• Certain weather conditions, such as cold air

• Exercise or physical activity

• Emotions, such as crying, laughing, or yelling

Do children outgrow asthma?

How asthma will affect a child throughout their lifetime varies.

• Many children with asthma can live normal lives. Staying away from triggers and following a treatment plan will help.

• Many infants and toddlers may wheeze when sick with a viral illness, such as cold or flu. But most of these children don't get asthma later in life.

• Some children may have fewer asthma symptoms as they get older. But others may still have symptoms as teens or adults.

Asthma Action Plans

An Asthma Action Plan helps you manage your child's asthma. It tells you what symptoms to watch for and what to do in an emergency. Create an Asthma Action Plan with your child's healthcare provider. The provider should review and update the plan at routine office appointments. Share the Asthma Action Plan with your child's caregivers, school, coaches, and family members.

If my child has asthma, can they take part in sports and activities?

Exercise, such as long-distance running, may trigger a flare-up in many children with asthma. But with correct management, a child with asthma can fully take part in most sports. Aerobic exercise actually improves airway function by strengthening breathing muscles. Some tips for exercising with asthma include:

• Teach your child to breathe through the nose and not the mouth. This helps to warm and humidify the air before it enters the airways.

• During cold weather, have your child wear a scarf over their mouth and nose to warm inhaled air.

• Give your child asthma medicine before exercising, as recommended by their healthcare provider. If your child is not already on controller medicine and they exercise daily, the provider may recommend daily controller medicine.

• Have your child carry their quick-relief inhaler medicine.

• Make sure your child's coach or school staff know about their asthma and how to help in an emergency. Give them a copy of your child's Asthma Action Plan.

Asthma and school

Some children with asthma may need to take their medicines during school hours. It's important that you and your child work with the healthcare provider and school staff to meet your child's asthma treatment goals. Laws about students carrying rescue inhalers vary by state. Make sure you understand the laws. Make sure that your child knows when and how to use their inhaler. For the best asthma care for your child at school:

• Meet with teachers, the school nurse, and other relevant school staff to tell them about your child's condition, special needs, and asthma management plan. Give them a copy of your child's Asthma Action Plan.

• Educate school personnel on your child's asthma medicines and how to help during an asthma flare-up.

• Ask school staff to treat your child as normal as possible when the asthma is under control.

• Before starting a physical education class or a team sport, make sure the teacher or coach understands that exercise can trigger asthma symptoms.

• Talk with teachers and school administrators about indoor air quality, allergens, and irritants in the school.

• Make sure of your child's emotional well-being by reassuring that asthma doesn't have to slow them down or make them different from other children.

Controlling asthma through the years

Be honest with your child about asthma. As your child grows, remember that independence is an important goal. Children with asthma don't want to be different. But they need guidance and supervision.

• Toddlers. This age group relies completely on the parents. These children understand little about asthma. The most important factor with this age group is to try to make medicine time fun. But you must also stress the importance of taking the medicines. Let children help in any way possible.

• School-age. These children are more able to understand asthma. They should be taught about their medicines and how to stay away from their triggers. They should begin to watch their own symptoms.

• Teens. Teens may resist taking long-term (chronic) medicines. They also don't like restrictions and don't want to be different. Involve teens in every part of asthma management. They should help with goal setting and help decide which medicines work best. An asthma care contract can be used. It should allow for teen self-care while allowing overall parental supervision.

Having asthma doesn't mean having less fun than other teens. It is important for your teen to tell their friends about their triggers.

Always talk with your child's healthcare provider if you or your child has questions or concerns.

Online Medical Reviewers:

• Deborah Pedersen MD
• Jessica Gotwals RN BSN MPH
• Rita Sather RN