Asthma is a chronic (long-term) inflammatory disease of the airways. Inflammation can narrow the airways and make breathing harder. About 47.2% of children under five years of age experience an asthma episode (1). Asthma may also cause hyperactive airways where the baby’s airways are more sensitive to irritants and allergens. It may lead to an overreaction of airways to minor irritants.
Read this post to know about the types, causes, symptoms, diagnosis, treatment, and management of asthma in babies.
Types Of Asthma In Infants
Asthma can be of various types depending on the cause and onset. The following types of asthma are commonly seen in infants (2).
1. Allergic asthma
Allergic asthma in babies is triggered by allergens, including pet dander, dust mites, and pollen. Approximately 80% of people with allergic asthma can have related conditions such as eczema, hay fever, and food allergies. Avoiding asthma triggers and prescription of daily preventive medications are recommended for allergic asthma. Seasonal asthma is also a type of allergic asthma since it occurs at times when the triggers, such as cold climate or pollen, are increased in the environment.
2. Non-allergic asthma
Non-allergic asthma, also called non-atopic asthma, is not related to any allergy triggers, and it is less common than allergic asthma. The exact causes are unknown, and it often leads to severe symptoms. Babies with non-allergic asthma require prescription medicines to relieve symptoms.
Signs And Symptoms Of Asthma In Babies
Asthma symptoms can be difficult to recognize from other respiratory symptoms in babies. Signs of asthma in babies can range from a lingering cough for days or weeks to sudden breathing emergencies. Babies with allergic asthma have breathing problems when they are exposed to triggers.
Common signs and symptoms of asthma in infants may include (3):
- Cough, especially night coughs
- Wheezing or whistling sound from airways
- Fast breathing
- Breathing troubles
- Frequent colds
- The skin around the chest and neck pulls tightly during breathing
Babies can have one of the above-listed symptoms or many of them at a time. These symptoms may often make you think that the baby caught a cold or bronchitis. However, frequent and recurring respiratory symptoms are commonly associated with asthma.
Causes Of Asthma In Babies
The exact cause of asthma is still unknown. Several reasons are believed to contribute to asthma. The following factors may increase the risk of asthma in babies (4).
- Genetic factors may cause asthma in some babies. A positive family history of asthma, eczema, and allergies in parents, siblings, and grandparents may increase the risk of developing asthma.
- Maternal smoking in pregnancy is suggested to increase the risk. Maternal smoking may affect a baby’s lung development and functions, potentially increasing the risk of asthma.
- Premature babies may have increased asthma risk due to an underdeveloped immune system.
- Exposure to environmental factors, including airway irritants and air pollution, may increase the risk in some babies.
- Respiratory viral infections can trigger asthma attacks in some babies. They may have symptoms that persist beyond infection.
Is Asthma In Infants The Same As Adult Asthma?
The severity of asthma varies in babies and adults. Babies have smaller airways than adults. It means mild swelling in the airways can result in severe asthmatic symptoms. Excess mucus due to immune reactions can also block the airflow and make it harder to breathe. Asthma symptoms in babies may require emergency medical care if parents are not equipped with medications (inhalers) to open airways. However, symptoms can be intermittent in most babies.
In adults, asthma symptoms may not be severe as in babies due to well-developed airways. However, most adults have persistent symptoms requiring daily treatment. Asthmatic symptoms are more easily identifiable in adults than babies.
Complications Of Asthma In Babies
Babies may develop complications if the asthma is not well-controlled. This may include (5):
- Airway damages
- Severe asthma attacks
- Increased emergency room visits and hospitalizations
Asthma requires a proper management plan to prevent a recurrence. If it persists beyond infancy to childhood, asthma can negatively impact schooling and other activities.
When To See A Doctor?
It is recommended to seek emergency medical help if your baby has life-threatening allergic reactions and wheezing. Cyanosis (blue lips and face), passing out or fainting, or wheezing after eating certain foods, medications, or bee sting may also require emergency room care (6).
Worsening of symptoms and breathing troubles also require immediate medical care. You may contact doctors during office hours for asthma plans and other queries related to medications or change of medications.
Diagnosis Of Asthma In Babies
An asthma diagnosis is challenging in infants and toddlers since they cannot explain the symptoms. It is not usually possible to do lung function tests in babies. Medications can improve breathing problems in babies with asthma. Thus, the response to medications helps to confirm the diagnosis.
Babies with suspected asthma are often referred to pediatric allergists or pulmonologists (lung specialists) for detailed testing and treatment. Chest X-rays, blood tests, and allergic tests are often done to include and exclude the diagnosis of underlying causes and other conditions.
Treatment For Asthma In Babies
Asthma medications are usually given in inhaled forms. You can give the medication using an inhaler with a spacer and mask or by a nebulizer as prescribed. Medications used to treat asthma may include (7):
- Bronchodilators: These are medications providing quick relief by opening the airways. Proventil, Xopenex HFA, and Ventolin are examples of bronchodilators.
- Inhaled corticosteroids: These are used for long-term asthma control to reduce airway inflammation and lower asthma symptoms. Flovent, Pulmicort, Asmanex, or Qvar, are often prescribed for long-term management.
- Leukotriene modifiers: This medication is also used to reduce airway inflammation and asthma symptoms. Singulair is a commonly prescribed leukotriene modifier.
A mix of medicines is often prescribed depending on the frequency and severity of asthma symptoms in babies. Dosage and administration may vary depending on age and other factors. You may obtain a prescription from a pediatrician to treat asthma in babies. Over-the-counter medications are not recommended for asthma treatment.
Ways To Manage Asthma In A Baby
Many parents can be stressed if the baby has a chronic illness, such as asthma. The following coping tips may help to reduce stress in parents (8).
- Learn about asthma and know your baby’s asthma symptom patterns.
- Know the warning signs of increasing severity of asthma.
- Develop an asthma action plan (asthma care plan), including what to do when the symptoms are worse and when to get emergency care with the pediatrician.
- Stick to the asthma action plan even if the symptoms disappear. Change the plan only after consulting the doctor.
- Develop an emergency action plan if the baby has severe asthma episodes requiring hospitalizations.
- Know from your doctor what hospitals provide care for infant asthma, and be sure that it is covered in your health plan.
The following measures from parents and caregivers can help to reduce the severity of asthma in babies.
- Know and avoid possible triggers
- Avoid smoking near baby
- Avoid dust mites, pests, and molds at home
- Avoid pollen exposure. Choose non-allergic indoor plants and houseplants
- Follow asthma management plan and prescribed medications as per recommendations
Avoiding triggers and proper treatment could help the baby recover and breathe normally. Although asthma is not a life-threatening condition, inadequate care can affect the quality of life. Seeking admission in a hospital where your baby’s regular pediatrician is available can be more convenient for you since they already know the details and easily give follow-up care.
Can A Baby Outgrow Asthma?
Sensitive airways can stay for a lifetime. However, asthma symptoms may change when the baby grows since the airway can handle irritants and inflammation better than before. Half of the babies outgrow asthma during their teenage years, but asthma symptoms may appear in their late 30s or early 40s (8).
The exact cause of these changes is not known. New triggers may cause symptoms anytime in one who has asthma. Although symptoms are not present, parents are recommended to keep quick-relief medications and update the asthma action plans if the baby has asthma.
Other Conditions Similar To Asthma
A few conditions may seem like asthma and its complications in babies.
- Acid reflux
- Birth defects
- Cystic fibrosis
- Upper respiratory tract infections
- Airway obstruction due to object inhalation
Some of the signs and symptoms of these conditions can be similar to asthma. A detailed evaluation by a healthcare provider is required to differentiate these diseases or conditions from infant asthma.
Although asthma is a life-long condition, this can be well-managed with a proper asthma action plan and treatments. Sticking to prescribed treatments and follow-ups can reduce the incidence of emergency visits and hospitalizations. You may also take necessary steps to avoid exposure to triggers and respiratory infections in babies.