Asthma in Childhood: Causes, Risk Factors, and How to Manage it

Asthma is the most common chronic lung disorder that is triggered by certain stimuli. It is characterized by an inflammation of the airways of the lungs, resulting in respiratory distress. The causative agents of this inflammatory response can be various allergens such as pollen, polluted air, animal fur or feather, nuts, and smoke.

Childhood asthma isn’t a different disease from asthma in adults, but children do face unique challenges. They are more susceptible to cold, infections, and allergies that can cause asthma. Asthma can have troublesome symptoms that can interfere with the regular schedule of your child.

It can keep your child panting and wheezing with a congested chest. In some children, unmanaged asthma can cause fatal asthma attacks. Asthma in children is a leading cause of missed school days, emergency department visits, and even hospitalizations.

Unfortunately, childhood asthma is incurable and it may progress into adulthood, but with proper treatment, you and your child can manage the condition and prevent any damage that can impair the functioning of your child’s lungs.

According to the Centers for Disease Control and Prevention, about 1 in every 10 children in the United States is asthmatic and approximately 25 million Americans suffer from asthma.⁽¹⁾

The American College of Allergy, Asthma & Immunology states that asthma is the most prevalent chronic illness in childhood, accounting for 13.8 million missed school days each year. It also accounts for 14.2 million lost work days for adults.⁽²⁾

Causes of Asthma in Children

The underlying cause of asthma in children is not completely known. However, any agent that can induce inflammation into the respiratory passages, entailing a hypersensitive response from the immune system, can play a major role. You need to keep a track of these causes to evaluate the allergies your child might be having.

Some factors that can lead to this condition are:

• Allergens such as peanut, milk, dust, mites, mold, pollen, and animal dander that can cause a hypersensitive reaction in your child’s body.⁽³⁾⁽⁴⁾
• Irritants such as chemicals, odors, cigarette smoke, air pollution, and smog, which when inhaled can cause damage to the respiratory system due to their toxicity.⁽⁵⁾⁽⁶⁾
• Changes in weather or exposure to cold temperatures, which can cause inflammation in the airways.
• Overexertion during physical exercise, which can facilitate an asthma attack.⁽⁷⁾
• Infections such as flu, pneumonia, bronchitis, and the common cold, which can have a profound effect on your child’s respiratory system. Such infections are likely to cause an inflammation of the airways, resulting in an asthma attack.⁽⁸⁾

Signs and Symptoms of Asthma in Children

Common signs and symptoms exhibited by children suffering from asthma include:

• Frequent, intermittent, or constant coughing
• A whistling or wheezing sound when exhaling
• Rapid breathing
• Chest tightness or congestion
• Chest pain, particularly in younger children
• Difficulty sleeping caused by shortness of breath, coughing or wheezing
• Delayed recovery or bronchitis after a respiratory infection
• Bouts of coughing or wheezing that get worse with a respiratory infection, such as the flu or cold
• Trouble breathing that may limit the child’s playtime
• Fatigue induced by poor sleep

Symptoms vary from child to child and may get worse or better over time. Also, your child may have only one of these symptoms or several of them.

Diagnosing Asthma in Children

Asthma in children can be diagnosed by evaluating the medical history, symptoms, and family history of your child. It is advised that you keep track of your child’s symptoms, such as when and how often they appear.

The doctor will conduct a physical examination and also look for signs of a possible allergy that might have triggered asthma. Various tests will be prescribed, including:

• Allergy test on the skin for possible triggers
• Blood tests (IgE levels)
• Chest X-ray
• A simple lung function test called spirometry

Based on the diagnosis, your doctor will draft an asthma action plan for you to follow. It will contain a detailed description of when and how to use the prescribed drugs and what to do when your child’s asthma gets worse. It will guide you to manage your child’s asthma.

Keep this copy in a common spot in your home. You can share a copy of this asthma action plan with your child’s school staff and caregiver to ensure his/her safety even when he/she is away from home.

Tips and Remedies to Deal with Asthma in Children

Here are 10 home remedies to relieve your child’s asthma.

1. Identify and Keep a Check on Asthma Triggers

It is important to be well aware of the causative factors that can trigger an asthma attack. This is only possible when you have recognized the symptoms your child is experiencing.

According to the American College of Allergy, Asthma & Immunology, asthma can be triggered by allergens such as pollen, dust mites, cockroaches, molds, animal dander, medications such as aspirin and acetaminophen, extreme weather conditions, exercise, stress, and irritants in the air such as smoke, chemical fumes, air pollution, and strong odors.⁽¹⁴⁾

A 2017 study published in the Nigerian Medical Journal found that exercise, fumes, dust, and respiratory tract infections (RTIs) were the recognizable triggers of asthma exacerbation and were seen more in preschool than in school-age children.⁽¹⁵⁾

What Should the Parents Do?

• You need to work with your child’s doctor to identify specific triggers that can engender an asthma attack in your child.
• Once you are aware of them, it becomes easy to make an asthma action plan on how you can help your child avoid allergies and improve his/her quality of life.
• Keep your acquaintance informed about your child’s problem to help manage his/her condition.
• As food allergies (the most common being peanuts, shellfish, eggs, and milk) can trigger asthma attacks, you need to keep an eye on what your child is eating. Instruct your child to avoid foods that can act as potential allergens, when eating out.
• Administration of allergy shots is advised for an unavoidable allergen to reduce the chances of a possible asthma attack.

2. Give Ginger Tea to Your Child

Ginger has been a part of every kitchen and its benefits are immense and far-reaching. Its potential use as a home remedy is attributed to its constituent compounds, namely, gingerols, shogaols, and zingerones.

It is believed that these compounds are associated with counteracting inflammation and pain similar to NSAIDs. Ginger is believed to be a potent bronchodilator and inhibits airway inflammation.

A 2008 study published in the Canadian Journal of Physiology and Pharmacology shows that ginger inhibits airway contraction and aids in treating respiratory illnesses such as asthma.⁽¹⁶⁾

According to a 2013 study published in the American Journal of Respiratory Cell and Molecular Biology, several compounds in ginger help relax the smooth muscle tissue in the airways, which is constricted during asthma attacks. However, further studies are still required.⁽¹⁷⁾

• Add 1 inch of ginger (grated) to a pot of boiling water. Simmer for 10 minutes, strain it, and allow the tea to cool. Add a few drops of honey. Give 2-3 cups of this ginger tea to your child daily.
• Prepare a nutritious mix of equal amounts of ginger juice, pomegranate juice, and honey. Give your child 1 tablespoon of this mixture two or three times a day.
• You can also give your child ginger candies.

3. A Warm Glass of Turmeric Milk

Turmeric is a well-known ingredient in Ayurvedic medicine. The healing properties of turmeric are attributed to its bioactive ingredient called curcumin.

Curcumin is an effective antioxidant and anti-inflammatory compound, which can help dislodge the mucus in the bronchial tubes and ensure proper airflow in the lungs.

In a 2014 study published in the Journal of Clinical & Diagnostic Research, researchers analyzed 77 patients with mild to moderate bronchial asthma. The results showed that curcumin capsules helped in improving the airway obstruction, which was evidenced by the significant improvement in the mean forced expiratory volume in one second (FEV1) values. It was concluded that curcumin is effective and safe as an add-on therapy for the treatment of bronchial asthma.⁽¹⁸⁾

• Mix 1 teaspoon of turmeric powder into 1 cup of milk and boil it. Allow it to cool a bit. Give it to your child twice a day.
• You can opt to give curcumin supplements to your child, only after consultation with your doctor.

4. Make Your Child Sip a Mild Honey Tonic

Honey is a natural source of antioxidants, amino acids, and various minerals including magnesium, manganese, and selenium. The ethereal oils and alcohol in honey help in clearing up the mucus accumulated in the bronchial tubes.

It soothes the mucous membranes in the airways and fights coughing and subsequent wheezing associated with asthma.

A 2014 study published in BMC Complementary and Alternative Medicine demonstrated that aerosolized honey was effective in treating and managing asthma in rabbits. It can be a potent treatment for asthma in humans, but future studies with a larger sample size are required to validate this finding.⁽¹⁹⁾

In a survey-based study published in Pediatrics, products composed of honey and silan extract were rated. The parents ranked the honey-based products higher than the silan extract products for the symptomatic relief of their children’s nocturnal cough and sleep troubles due to URI.⁽²⁰⁾

You can use these concoctions of honey to relieve your child’s asthma:

• Mix 1 teaspoon of organic honey into a glass of warm water. Give it to your child to drink two or three times a day.
• Also, mix ½ teaspoon of cinnamon powder with 1 teaspoon of organic honey. Give this mixture to your child right before bedtime.
• Boil 6-7 cloves in 1 cup of water. Let it simmer for 5 minutes. Cool the solution and add 1 tablespoon of honey. Give it to your child to drink two or three times a day.

5. Up Your Child’s Vitamin D Intake

Low levels of vitamin D have been reported in asthma patients.

A 2016 study published in the European Review for Medical and Pharmacological Sciences found that the frequency of vitamin D deficiency and insufficiency was higher in children with asthma than in the controls. The study suggested that lower levels of vitamin D are associated with poor asthma control and increased asthma severity.⁽²²⁾

A 2017 study published in Cureus reports that vitamin D is of particular interest in asthma, due to its immunomodulatory effects.⁽²³⁾

Another study published in the Lancet Respiratory Medicine in 2017 found that vitamin D supplementation reduced the rate of asthma exacerbations requiring treatment with systemic corticosteroids overall.⁽²⁴⁾

• An early morning sun bask at least 10 minutes a day will help your child’s body synthesize vitamin D.
• Enrich your child’s diet with foods fortified with vitamin D, such as orange juice, milk, yogurt, and almond milk.

6. Serve Your Child a Cup of Garlic Milk

Garlic contains vitamin C, which can potentially eliminate the congestion in the airways of the lungs. The antioxidant activity of garlic neutralizes free radicals and relieves the smooth muscles of the airways in patients with asthma.

The body’s immune system produces chemicals called histamine in extreme amounts when it encounters an allergen, causing inflammation. The anti-inflammatory action of garlic effectively reduces the levels of histamine produced in the body.

A 2008 study published in the Iranian Journal of Allergy, Asthma, and Immunology demonstrated that aged garlic extract has the potential to attenuate inflammatory features of allergic airway inflammation in a murine model.⁽²⁵⁾

1. Just boil 2 cloves of garlic in ¼ cup of milk.
2. Allow it to cool down to room temperature.
3. Give this milk to your child to drink once daily.

7. Regular Exercise may Benefit Your Child.

Exercise is a no-brainer when it comes to physical and mental well-being. Regular exercise can help regulate asthma by improving stamina. Exercise and physical activities play a pivotal role in enhancing the efficiency of lungs, which in turn improves breathing.

You can also keep a check on other secondary factors such as the immune system and weight. As long as your child is able to manage asthma well, physical activities will be beneficial for him.

Children diagnosed with asthma should be encouraged to do regular exercise to avoid the transition of asthma into adulthood. Exercise is associated with improved asthma control in adults.⁽²⁶⁾

Encourage your child to be active, as it is important for his/her overall growth. Regular physical activity can condition the lungs to work more efficiently, which helps reduce asthma symptoms.

A 2015 study published in the European Clinical Respiratory Journal considered it very important for an asthmatic child and adolescent to master exercise-induced asthma (EIA) and exercise-induced bronchoconstriction (EIB) to be able to participate in physical activities at an equal level with their peers. This is because moderate exercise works as a potential therapeutic tool for asthmatics.⁽²⁷⁾

A 2016 study published in the British Journal of Sports Medicine concluded that physical training improves cardiopulmonary fitness without changing lung function. It is not clear if the improvement in fitness translates into a reduction in symptoms or an improvement in the quality of life. Further studies are needed to analyze the effects of physical training in the management of asthma.⁽²⁸⁾

A study published in the Journal of Asthma provides new evidence that regular exercising among young adults improves their asthma control, thus suggesting it to be an important part of asthma self-management in clinical practice.⁽²⁹⁾

• Always ask your child to do a warmup before exercise and a cool-down period after.
• While exercising, ask your child to breathe through his/her nose instead of his/her mouth.
• Have your child always carry his/her relief inhaler for emergency situations.
• Make your child exercise inside on very cold or very warm days. If your child exercises outside, make him/her wear a mask or scarf over his mouth.
• Moderate to brisk walking, gentle biking, and spot jogging can be performed.
• Sports that involve short and intermittent periods of exertion can be well tolerated. These include golf, gymnastics, and racquet sports such as tennis and swimming.
• Don’t let your child exercise on days when the air is polluted with dust, smoke, pollen, or any allergens that might trigger his/her asthma attack.

8. Yoga can be Beneficial for Your Child

Yoga is an age-old alternative therapy that works on the technique of breathing and postures to strengthen and improve the capacity of the lungs by enhancing the flow of air.

According to the Global Initiative for Asthma Management (GINA), the breathing technique has been advised as an adjuvant therapy along with the standard medical therapy to have a synergistic impact on the health of the patient.

Several yoga poses have been identified with curative effects on the condition of the lungs. Hence, yoga can be helpful if your child suffers from exercise-induced asthma.

Pranayama, Anulom Vilom, and Kapaalbhaati are known to strengthen the lung capacity and improve the flow of air in the lungs. A 2009 study published in the International Journal of Yoga reported that breathing exercises (pranayama) help improve lung functioning and should be a regular part of asthma treatment.⁽³⁰⁾

Another study published in the Cochrane Library suggests that yoga has shown beneficial effects on the symptoms and quality of life in people with asthma, but there is some uncertainty pertaining to its effects on lung functioning and medication use.⁽³¹⁾

While there are different yoga poses for children suffering from asthma, there is one pose that children love to do. It is the Butterfly Pose (Baddha Konasana), which stimulates the heart and improves circulation in the entire body, including the lungs.

Do this yoga pose daily with your child to encourage him/her and soon you will notice the change in your child’s health.

To Do the Butterfly Pose:

1. Sit up straight with your legs spread straight out.
2. Bend your knees and bring your feet inward.
3. Place the soles of your feet together, about 6 inches away from your pelvis.
4. Hold your feet tightly with your hands.
5. Inhale deeply, pressing the thighs and knees down toward the floor.
6. Taking normal breaths, start flapping both legs up and down.
7. Start slowly and gradually increase the speed, continuing for 5 to 10 minutes.
8. Slow down and then stop.
9. Take a few long, deep breaths and slowly straighten your legs back out in front of you.

9. Keep the Air Quality in Check

One of the major triggers of asthma in the environment is the air that we breathe. Air pollution is one of those factors that should be legislated and regulated in order to improve the quality of air in our surroundings.

In fact, exposure to polluted air is widely responsible for a range of health effects related to the respiratory system. This increases the frequency of asthma attacks in asthmatic children and adults.

A meta-analysis published in PLOS One in 2017 provides evidence of the association between major air pollutants and moderate or severe asthma exacerbations.⁽³²⁾

A 2008 study by the National Institute of Allergy and Infectious Diseases raised questions about the current air quality standards and suggested that overall asthma management for children living in inner cities needs to include efforts to reduce exposure to air pollutants.⁽³³⁾

Avoid exposing your child to:

1. Extremely hot, humid weather
2. Poor air quality
3. Highly polluted areas

You must pay attention to the quality of air your child is breathing. The most effective ways to bring changes in the quality of air that your child breathes are as follows:

• Use an air conditioner in your child’s bedroom to lower indoor humidity and reduce airborne pollen from trees, grasses, and weeds that find their way indoors.
• Keep the windows and doors closed during pollen season.
• Consider installing a small-particle air purifier with HEPA filters in your ventilation system to improve the quality of indoor air.
• Ensure regular pest control to avoid exposure to mites and cockroaches.
• If you live in a damp climate, consider using a dehumidifier. You can also install exhaust fans in your kitchen, bathroom, and laundry room to avoid any mold growth.
• If possible, move to a location where your child can enjoy fresh, dry air.
• Avoid exposing your child to varying temperatures within a short time.
• Do regular cleaning to remove any dust and allergens in the vicinity of the child.
• Avoid using scented candles or room fresheners.

10. Make a Well Balanced Diet Plan for Your Child

Making well-informed choices in your child’s diet can play a significant role in reducing the distress caused by inflammation in the airways of your child.

Foods that are pro-inflammatory and can act as potential allergens should be avoided to curtail the severity and recurrence of the attacks in existing patients.

A balanced proportion of fiber, protein, antioxidants, and moderate amounts of monounsaturated (MUFA) and omega-3 PUFA should be included in the diet of the patient. This well-balanced diet is known to have a positive impact on asthma risk and asthma control.

• A diet abundant in fresh, organic fruits and vegetables is beneficial for asthma patients.
• Intake of high quantities of vitamin C and E, beta-carotene, flavonoids, magnesium, selenium, and omega-3 fatty acids is recommended for patients with asthma.⁽³⁴⁾ A study published in Nutrients concluded that a higher intake of fruits and vegetables has a positive impact on asthma control.⁽³⁵⁾
• Enrich the diet of your child with sufficient amounts of omega-3 fatty acids; good sources are salmon, tuna, and flaxseed. A study published in Allergology International highlighted the efficacy of omega-3 fatty acids in the amelioration of asthma and allergic diseases.⁽³⁶⁾
• Use herbs and spices such as sage, oregano, ginger, and turmeric in your culinary practices. These herbs and spices contain compounds that are anti-inflammatory in nature.
• Avoid processed and packaged foods that contain artificial additives and preservatives.
• Avoid milk and dairy products if your child is allergic to milk proteins or is lactose intolerant.
• Avoid serving meals rich in fats, as they increase inflammation of the airways and arrest the effects of common asthma medications.

When to Seek an Emergency Treatment?

Seeing your child in pain is probably one of the things you never want to witness. Parents should keep a check on their child in order to arrest the possibility of an attack. You should observe the breathing of your child. Seek emergency care if your child:

• Is pulling his/her chest and sides inward to breathe
• Is gasping for breath, sitting upright, and leaning forward
• Has widened nostrils when breathing in
• Has blushed skin with a tinge of blue
• Has to stop while talking in order to catch his/her breath
• Has rapid pulse
• Is sweating
• Has decreased the level of alertness
• Is using abdominal muscles to breathe, causing the abdomen to suck in
• Has problems sleeping due to shortness of breath

In Case of a Possible Asthma Attack

If your child shows symptoms associated with an asthma attack, do not panic. Guide yourself with the asthma action plan that was designed by your child’s doctor. Alternatively, you can follow these steps:

• Give your child his/her reliever medicine as prescribed.
• Help them to stay calm and sit up straight.
• Wait for 5 to 10 minutes.

Danger signs are; severe wheezing, coughing, shortness of breath, trouble walking and/or talking, and blue lips and/or fingernails. If the symptoms disappear on using the medicine, your child should be able to resume his/her work.

If symptoms persist or fail to improve or you are unsure of what action to take, contact emergency care and seek professional help immediately.

Seeing your child suffering from asthma can be very painful, as the symptoms can interfere with his/her health, everyday activities, sports, and school. All these factors can have direct consequences on your child’s physical, emotional, and mental growth.

Unfortunately, there is no cure for asthma, but with the right treatment and lifestyle changes, it is possible to keep the symptoms under control.

When to See a Doctor

Consult an allergist or immunologist if you notice symptoms suspected to be a flare-up of an allergy. Getting an early consultation can help you mitigate recurrent attacks and life-threatening complications. Make an appointment with your child’s doctor if you notice:

• Coughing that’s constant, intermittent, or exercise-induced
• Complaints of chest congestion
• Wheezing or whistling sounds when your child exhales
• Difficulty breathing
• Shortness of breath
• Recurrent bronchitis or pneumonia

Additional Tips

• Massage the chest with warm sesame oil to help loosen the phlegm deposited in the airways.
• Pour a few drops of eucalyptus oil in boiling water and let your child inhale its vapors. This will help open up any blockages.
• Obesity is a significant risk factor for developing asthma, so avoid giving your child a diet high in calories that can lead to weight gain.
• As food allergies (the most common being peanuts, shellfish, eggs, and milk) can trigger asthma attacks, you need to keep an eye on what your child is eating, especially when eating out.
• Smoking should be prohibited in the vicinity of the child. Exposure to passive smoke can increase the risk of an attack.
• It is recommended to avoid pets with furs and feathers if your child is allergic to dander.

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