Each one affects your child’s airways and the conditions seem to be connected. Genetics play a part too.² Parents with asthma often pass it on to their kids. The same is true of allergy.

Experiencing an asthma attack can be very scary for your child and for you, especially as they may not be able to describe what’s happening. Whether or not you or your partner have asthma, it’s helpful to have a reminder of what the condition looks like in children. Read on to find out more about the symptoms, causes and treatment options so you can help your little one breathe more freely.

Children with asthma have hypersensitive airways which can be easily irritated. Their bronchial tubes can swell and clog up with mucus, and their chest muscles may tighten. That causes breathing difficulties. Confusingly, kids also get a lot of respiratory infections, some of which can look like asthma.

Signs and symptoms of asthma in children affect their lower respiratory system and may include:

• Coughing: This can keep kids awake at night or bother them in the early morning when they wake up
• Wheezing: The whistling sound typically happens when they breathe out
• Difficulty breathing: You might see the skin on children’s neck tighten or their shoulders rise with the effort of catching their breath; breathing fast is another sign
• Tight chest: Kids don’t always know how to describe this feeling and often say they have a sore tummy instead

Your child’s experience of asthma will depend to some extent on what age they are.  Symptoms and triggers might shift.

This is when childhood asthma tends to start. Their airways aren’t fully developed so children are more affected by respiratory infections like bronchitis as well as colds. In fact, it’s often a virus that first sets off a child’s asthma symptoms and which causes their wheezing after that. But asthma is difficult to diagnose in younger kids so it’s often undiagnosed and untreated.

Asthma symptoms are now more likely to be allergy-related rather than due to a bug. Your child may show few signs normally but have a severe flare-up if they meet their trigger. Kids tend to play more organized sport at this age too and that can make them cough. Watch out for your child losing interest in physical activities, even just running around with friends.

Until now the risk of asthma has been higher for boys. It tends to even out at puberty and switches to girls afterwards. As well as wheezing and coughing, teens may get a tight chest. Many find it embarrassing to have to use an inhaler. So they may not use it, or at least not properly. And that can make the impact of asthma on their school and social life even greater.

But it is also quite common for symptoms to fluctuate in adolescence. It may only be temporary though and asthma can worsen again later in life.

A flare-up can happen slowly over several days or quite suddenly and it can be life-threatening. Your son or daughter might be listless and fractious. They might not talk or eat much because it’s a struggle to catch their breath. If they have an asthma inhaler, they’re probably using it more than usual but it isn’t helping.

Kids can panic when they’re having an asthma attack which tends to make their symptoms worse. What they need is a grown-up to be a calm protector even if you’re scared too. Persuade your child to sit up straight and try a few puffs of their inhaler again. In case of a very severe attack be ready to call 911 and seek immediate care.

Making a diagnosis of any kind is like putting a puzzle together. Your child’s doctor will need lots of different pieces of information. Before your appointment, think how you’ll answer questions like these:

• Is there a family history of allergy or asthma?
• Is there any pattern to when your child’s symptoms occur?
• Do they have other allergies or symptoms that could be allergic?
• Does your child take any medication or have you tried other remedies?
• Are they regularly exposed to secondhand smoke, high levels of air pollution, damp or mold?
• Was your child born very prematurely (23-27 weeks), with a low birth weight or by caesarian section?

The doctor may say your child needs some tests, either for asthma or for allergies if you haven’t done that before, or both.

It’s hard to test toddlers and younger children for childhood asthma because it usually involves blowing into a machine in a controlled way. Instead, the doctor may give you an inhaler for them to see if it helps their symptoms. Otherwise these are common tests kids may have:

• Breath test or lung function test: The medical name is spirometry and it’s a test that astronauts do too. A computer will measure how fast your child can blow into a tube and how much air they can hold in their lungs.
• Peak flow test: This also measures how fast your child can breathe out. But this time it’s with a handheld device you can take home. Kids need to use the peak flow meter for a few weeks to track their symptoms. It’s also a tool to help parents manage their child’s asthma.
• FeNO test: This checks the level of nitric oxide in your child’s breath, which tells the doctor if there’s inflammation in their airways. It also shows if asthma medication is working (or if your teen is taking theirs properly).

If your child has been diagnosed with asthma, the next step is to draw up an asthma action plan. You and your doctor will work on this together. Involve your child if they’re old enough. If not, they should still know that it’s there and can help any grown-ups looking after them.

The idea is to have all the information you need in one place. It will usually describe:

• Your child’s day-to-day symptoms and what an asthma attack looks like
• What medication they take when
• How to react to danger signals
• How to avoid asthma triggers, including allergens and particular situations

Take the asthma action plan along to medical appointments to make sure it’s always up to date.

1. Share your child’s asthma action plan with their nursery, daycare or school. Family members and the parents of your child’s friends may also find it helpful and reassuring to have a copy.

2. Learn how to use the peak flow meter to help prevent asthma attacks. Your child’s breathing can seem fine even as lung function worsens.

3. Think about how you’re going to talk to your child about their asthma. Choose simple language and maybe use one of their toys as a prop to help.

4. Make a star chart so younger children know when they should take their medication. Older kids can log the info in their mobile phone. The klarify app can help them keep track of possible asthma triggers such as air quality and pollen levels.

5. Teens may be more open to advice from adults who aren’t their parents. Encourage them to talk to the doctor or asthma nurse. Apart from anything else, it’s important they understand that cigarette smoke, vaping, alcohol and recreational drugs can all worsen asthma symptoms.

6. Make a note in your diary to book a flu shot to boost your child’s immune system over the winter.

Asthma medicines and dosage will vary depending how old your child is and whether their condition is mild, moderate or severe. Never give kids medication meant for grown-ups.

Toddlers and younger kids may only get symptoms and need relief when they catch a virus. There’s a pressurized type of inhaler suited to this age group because it delivers a precise dose. Kids can move on to the powder inhalers when they’re ready.

Follow the prescription carefully. Read and keep the patient information leaflet too. Medications should be safely out of the reach of kids they’re not meant for and in an easy place for those that self-administer to get them when they need to. Make sure you know how long your child’s inhaler will last for and keep a note of when they’re going to need a new one as many inhalers have metered doses.

If your child has allergic asthma, keeping contact with their allergens to a minimum will be part of the asthma action plan. Your doctor can also tell you what allergy medicines are right for your child to keep symptoms such as allergic rhinitis in check. That could be antihistamines, corticosteroids or maybe allergy immunotherapy.

Antihistamines and corticosteroids can act as short-term relief for allergy symptoms. The aim of allergy immunotherapy is to retrain the body not to see the allergy trigger as a threat. Asthma symptoms need to be mild-to-moderate and under control before starting allergy immunotherapy.

Childhood asthma is a serious respiratory disease that can be triggered by allergies and tends to run in families. Common symptoms include persistent cough, wheezing, trouble breathing, chest tightness and congestion.

There are a range of asthma and allergy tests kids can have. If the diagnosis is asthma, you and your doctor – and your child if they’re old enough – will draw up an asthma action plan. This helps you and anyone else who looks after your child manage their symptoms. They’re likely to need an inhaler. But if allergies are a trigger your doctor may also suggest allergy symptom relief such as antihistamines and corticosteroids. Or maybe your child is recommended allergy immunotherapy to retrain their immune system and reduce allergy symptoms.