Asthma in Babies

Asthma is a chronic condition of the airways in the lungs. Diagnosing asthma in babies is nearly impossible because of their small size, which makes it difficult to measure their lung function. Also, symptoms like coughing and wheezing may be related to the baby's environment or caused by other illnesses. Fortunately, children with asthma can have normal growth and development.

This article outlines some of the symptoms of asthma, conditions that mimic asthma, causes, diagnosis, and possible treatments.

Symptoms of Asthma and Similar Conditions in Babies

Babies may experience some or all of the following symptoms related to asthma:

• Rapid breathing
• Difficulty breathing (signs include nostril flaring and exaggerated belly movements)
• Panting when sitting or playing
• Wheezing
• Coughing
• Difficulty sucking or eating
• Being less active or growing tired
• Discoloration of fingertips or nail beds (grayish or whitish on darker skin and bluish on lighter skin)

To pick up on signs of asthma in your baby, pay attention to what they sound like when they're sleeping or resting. Gurgles and squeaks are normal, whereas wheezing and coughing are not.

Causes and Risk Factors

There are numerous causes and risk factors (also called triggers) for asthma and diseases that mimic asthma, including:

• Allergies: These can range from pet dander allergies caused by proteins in skin and hair to environmental allergies like grass or pollen.
• Acid reflux: A sign of acid reflux is spitting up after eating.
• Being formula fed: Breastfeeding may prevent or delay asthma, although this has been debated in scientific literature.
• Environmental factors: These can include exposure to smoke (whether in utero or in the home), mold in the home, or pollutants in the home or area where you live.
• Food allergies: Food allergies may be a cause if the baby is old enough to eat solid foods.
• Gender: Boys have a higher rate of asthma than girls.
  
• Respiratory infections: Frequent respiratory infections can increase the risk of asthma.
• Race: Black, Latinx, and Native American people have a higher rate of developing asthma than White people.
• Low birth weight: Babies with a low birth weight may not have fully developed lungs.

A family history of asthma is also a significant risk factor for a child developing the condition.

Knowing your child's triggers can help you and your healthcare provider determine a diagnosis of asthma or a different condition. You can also monitor and track symptoms at home so you know when to seek medical attention.

Diagnosis

Asthma cannot truly be diagnosed in babies, because they are too small for standard lung function tests. Further, most babies have some wheezing when they have the common cold or some other virus. Babies who have structural abnormalities sometimes wheeze, which mimics asthma symptoms.

After a study of toddlers with wheezing episodes, the asthma predictive index (API) was developed in 2000 as a way to predict if children would develop asthma when they reached school age. The API tests for certain infections, skin conditions, allergies, and a family history of asthma. It continues to be used around the world as a predictor of asthma.

In addition to the API, a healthcare provider will likely examine a baby by watching them breathe and listening to their heart and lungs with a stethoscope.

Typically, breathing tests are practically impossible to conduct on a baby, so the provider can learn more through blood tests, allergy testing, or X-rays of the chest to see the lungs and heart. Most kids aren't able to be diagnosed with asthma until around age 5, when they are big enough to follow directions for breathing tests.

Treatments

Medication options are available to reduce inflammation, open airways, and help your baby breathe better.

Medicines may vary depending on the severity of the asthma. Some common medications include:

• Anti-inflammatory drugs: Drugs such as Singulair (montelukast) treat allergies and asthma.
• Bronchodilators: These medications help open up the airways. Types include albuterol sulfate (ProAirP, Proventil, and Ventolin), which are quick-relief medicines that open up airways immediately.
• Corticosteroids: This form of treatment calms inflammation. Brands include Flovent, Pulmicort, and Asmanex.

Treatments like bronchodilators and corticosteroids work well and quickly.

Infants may also be prescribed treatments using breathing machines called nebulizers that deliver medicine to the lungs by turning liquid into a breathable mist. A mask holds the nebulizer in place so that the baby gets the full dose.

Asthma may go a way for a while, but it is likely to come back. Some people end up having seasonal asthma, while others have it all the time. Having medications on hand in case of emergency asthma attacks is one way to manage this condition.

Coping

Dealing with a chronic illness can be stressful, but there are support groups that may be helpful.

The American Lung Association has a group called Living with Asthma, as does the Asthma and Allergy Foundation of America. Each has members who understand what it's like to live with this kind of condition and may offer tips and tricks to help your child live well with asthma.

Summary

Asthma is a chronic lung condition. It can affect babies, but it can't be truly diagnosed until around age 5. It can be mistaken for other conditions like the common cold, so tracking symptoms and their duration can help your pediatrician decide next steps. Medications are commonly prescribed to treat asthma and open the baby's airwaves.

A Word From Verywell

Having a baby with breathing difficulties is frightening. But remember that you know your baby better than anyone and will know if something isn't right with their sleeping, eating, and fussiness levels. If you notice any signs of wheezing, reach out to your healthcare provider to discuss your concerns. Effective medications are available to offset symptoms.