Asthma in children — symptoms, diagnosis and treatment

Symptoms of asthma in children

Asthma symptoms vary somewhat from child to child, and they can change with the child's age. In the youngest children, coughing and wheezing predominate, while older children and adolescents more often describe chest tightness and shortness of breath during physical activity.

The most common symptoms are recurrent coughing — especially at night or in the early morning — wheezing or wheezing, shortness of breath during play and exercise, and a feeling of pressure or tightness in the chest. Many children with asthma also cough violently when they have colds, and coughing episodes can last significantly longer than in other children.

An important signal is if the child consistently avoids physical activity, quickly becomes short of breath, or cannot keep up with peers in play and sports.

Causes of asthma in children

Asthma occurs when the airways are chronically inflamed and overreact to various triggers. The exact cause is not fully known, but a combination of hereditary predisposition and environmental influences play a central role.

Children with parents who have asthma, allergies or eczema are at 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 two conditions.

The most common triggers in children are respiratory infections, pollen, house dust mites, animal dander, tobacco smoke and cold air. Physical exertion is a particularly common trigger in school children and may be the only symptom in some — this is called exercise-induced asthma.

Examination and diagnostics

Diagnosis of asthma in children requires a combination of a thorough medical history, clinical examination and lung function testing. In children under six years of age, diagnosis is primarily clinical, as lung function testing is difficult to perform reliably in this age group.

In older children and adolescents, pulmonary function testing — a measurement of lung capacity and airflow — is a central part of the evaluation. The test measures how quickly and how much air the child can blow out and provides an objective picture of whether airway resistance has increased.

If allergy is suspected as a triggering factor — which is frequent in children with asthma — the evaluation is supplemented with allergy testing in the form of skin prick tests or specific blood tests. It is always an individual medical assessment which testing is relevant for the individual child.

Treatment of asthma in children

The treatment of asthma in children is always tailored to the severity of the disease and the child's age. The goal is to achieve good symptom relief, prevent exacerbations, and ensure that the child can participate normally in everyday activities — including sports and play.

Treatment is broadly divided into two types: preventative treatment and reliever medication. Preventive treatment — typically an inhaled steroid — is taken daily and reduces inflammation in the airways over time. Reliever medication, usually a short-acting bronchodilator, is used for acute symptoms and provides rapid relief.

In children with allergy-induced asthma, allergy testing may be relevant to consider as part of long-term treatment. It is also important to identify and, as far as possible, reduce the child's exposure to the factors that trigger the symptoms.

Inhalation technique is crucial for the effectiveness of the treatment. In the youngest children, a nebulizer or spacer is used, while older children can gradually learn to use the inhaler directly. A thorough introduction to correct technique is an important part of the treatment process.

When should you seek medical attention?

If your child has 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 the child is frequently ill with respiratory symptoms that take a long time to resolve, or if they consistently avoid physical activity.

In the event of acute deterioration with pronounced shortness of breath, rapid breathing or visible use of accessory muscles when breathing, the child should be seen urgently — contact your doctor, the emergency room or the emergency room.

Asthma in children at Charlottenlund Private Hospital

At Charlottenlund Private Hospital, our pediatrician offers a thorough evaluation of children with suspected or known asthma. We conduct a systematic assessment of the child's symptoms and medical history, and supplement this with lung function testing and allergy testing after individual assessment.

If the child needs a comprehensive assessment of asthma in combination with allergies or eczema, we collaborate across specialties internally at the hospital. The hospital is located in Charlottenlund north of Copenhagen and is easily accessible from all over North Zealand and Copenhagen.

Experience and skills at Charlottenlund Private Hospital



At Charlottenlund Private Hospital, children with asthma are assessed and treated by pediatric specialists. Lung function testing and allergy testing are included after individual assessment, and the course can be organized interdisciplinary when asthma occurs together with allergies or eczema. You will find an overview of all departments on our department page.

Sources:

- Danish Paediatric Society: Asthma in children – nationwide clinical guideline (2023).