Asthma in children - symptoms, diagnosis and treatment

Symptoms of Asthma in Children

Asthma symptoms vary considerably from child to child and may change as a child grows older. In younger children, coughing and wheezing are the most common symptoms, while older children and adolescents are more likely to describe chest tightness and shortness of breath during physical activity.

The most common symptoms include recurring coughing - particularly at night or early in the morning - wheezing or whistling sounds when breathing, shortness of breath during play and sports, and a feeling of pressure or tightness in the chest. Many children with asthma also experience severe coughing during colds, and these coughing episodes may last significantly longer than in other children.

An important warning sign is when a child consistently avoids physical activity, becomes breathless quickly or struggles to keep up with other children of the same age during play and sports.

Causes of Asthma in Children

Asthma develops when the airways become chronically inflamed and react excessively to various triggers. The exact cause is not fully understood, but a combination of genetic predisposition and environmental factors plays a central role.

Children whose parents have asthma, allergies or eczema have a significantly increased risk of developing asthma themselves. The condition often occurs as part of the atopic triad — asthma, allergic rhinitis and atopic eczema - and many children with asthma also have one or both of the other conditions.

The most common triggers in children include respiratory infections, pollen, house dust mites, animal dander, tobacco smoke and cold air. Physical exertion is a particularly common trigger in school-aged children and may be the only factor that causes symptoms in some children. This is known as exercise-induced asthma.

Examination and Diagnosis

Diagnosing asthma in children requires a combination of a thorough medical history, clinical examination and lung function testing. In children under the age of six, the diagnosis is primarily based on clinical assessment, as reliable lung function testing can be difficult to perform in this age group.

In older children and adolescents, lung function testing — which measures lung capacity and airflow - is a central part of the diagnostic process. The test measures how quickly and how much air a child can exhale, providing an objective indication of whether airway resistance is increased.

If an allergy is suspected as a trigger - which is common in children with asthma - the assessment may be supplemented with allergy testing, such as skin prick tests or specific blood tests. The appropriate tests are always determined through an individual medical assessment of each child.

Treatment of Asthma in Children

Asthma treatment in children is always tailored to the severity of the condition and the child's age. The aim is to achieve good symptom control, prevent asthma flare-ups and ensure that the child can participate normally in everyday activities, including sports and play.

Treatment is generally divided into two types: preventive medication and reliever medication. Preventive treatment - typically inhaled corticosteroids - is taken daily and gradually reduces inflammation in the airways. Reliever medication, usually a short-acting bronchodilator, is used to manage acute symptoms and provides rapid relief.

For children with allergy-triggered asthma, allergy assessment may be worth considering as part of long-term treatment. It is also important to identify and, wherever possible, reduce the child's exposure to factors that trigger symptoms.

Correct inhaler technique is essential for effective treatment. Nebulisers or inhalers with spacers are used for younger children, while older children can gradually learn to use inhalers directly. Thorough guidance on proper inhaler technique is an important part of the treatment process.

When Should You Seek Medical Advice?

If your child experiences recurring episodes of wheezing, coughing at night or shortness of breath during physical activity, they should be examined by a doctor. This also applies if your child frequently experiences respiratory symptoms that take a long time to resolve or consistently avoids physical activity.

If your child's condition suddenly worsens, with severe shortness of breath, rapid breathing or visible use of additional muscles to breathe, they need urgent medical attention. Contact your GP, the out-of-hours medical service or an emergency department.

Asthma in Children at Charlottenlund Privathospital

At Charlottenlund Privathospital, our paediatrician offers thorough assessments for children with suspected or diagnosed asthma. We carry out a systematic evaluation of the child's symptoms and medical history, supplemented by lung function testing and allergy testing where clinically appropriate.

If a child requires a combined assessment of asthma alongside allergies or eczema, our specialists collaborate across departments within the hospital.

The hospital is located in Charlottenlund, north of Copenhagen, and is easily accessible from across North Zealand and Copenhagen.

Experience and Expertise at Charlottenlund Privathospital

At Charlottenlund Privathospital, children with asthma are diagnosed and treated by specialists in paediatrics. Lung function testing and allergy testing are included where appropriate based on an individual medical assessment, and care can be coordinated across specialties when asthma occurs alongside allergies or eczema.

You can find an overview of all departments on our departments page.

Sources:

- Danish Paediatric Society: Asthma in Children – National Clinical Guideline (2023)