Information for parents

Photo of a mother and her son
PantherMedia / Phovoi R.

Many children and teenagers have : About 5 to 10 out of 100 young people are affected. It's perfectly normal for parents to worry about this problem. But can be managed with medication and other measures.

If a child has , their family's daily life doesn't need to be turned upside down. It's important for the child to learn to manage their disease on their own. As parents, you can help keep the under control by getting good treatment. And you can encourage your child to accept their illness, and help them live as normal a life as possible.

How can I tell whether my child has asthma?

It's difficult to diagnose in small children. Colds and infections in the of the lungs () are common in this age group. The cough caused by these viral infections is sometimes accompanied by slight whistling or rattling noises. It can be difficult to tell the difference between and early signs of in young children. Asthma-like symptoms in bronchitis tend to become less common as children get older, though.

A doctor can do specific breathing tests with your child to find out whether is causing the symptoms. Lung function tests such as peak flow measurement or spirometry can be used to see if your child's lungs are working properly, and whether air that has been breathed in can flow freely through their (lung airway passages). These tests only work with the child's help, so they are usually only suitable for somewhat older children.

Can you "grow out of" asthma?

Asthma is a chronic (long-lasting) condition in many people. But not everyone who has as a child will also have it later on as an adult. Nobody knows why that is. It's also not known whether a particular treatment can help children “grow out of” the disease.

Asthma comes and goes in phases, so your child might have long symptom-free phases. Sometimes the symptoms disappear completely after puberty. But even when this happens, the airways are usually still sensitive, and certain triggers still make them become narrower, causing symptoms.

So doesn't necessarily keep getting worse – especially if you get the right treatment. Asthma can also be very mild or moderate. Severe is rare in children.

My child has asthma – what do I need to know?

If a child has moderate or severe , it can be quite a burden for the family. Seeing your child struggle to breathe properly can be worrying or even frightening. And it's sometimes difficult to keep up the treatment. Small children often don't understand why they have to take medication regularly. Having to deal with a chronic disease can be very demanding for children, who would prefer to have the kind of carefree childhood some of their friends have.

If you are the parent or guardian of a child who has , there are several things you can do to make it easier for them to cope with the disease. The goal is to relieve the symptoms as much as possible and to help the child have a fairly normal life. One thing you can do is help your child to take medicine properly. It's also important to try to make sure that he or she feels “normal” amongst friends, family and neighbors, and at school. Many children don't know how to deal with the at first. They may feel embarrassed and try to keep it a secret. Many children also tend to constantly worry about attacks. Supportive parents are then a great help.

If you can make sure that your child grows up in a smoke-free environment, you can protect them from a major cause of . Cigarette smoke damages your child's lungs and makes symptoms worse. There are various treatments that can help make quitting a bit easier for you or other family members.

There are also patient education courses designed to teach parents and children how to manage asthma. These courses are offered for different age groups so that they are appropriate for the child's stage of development.

How can asthma medications help my child?

Two groups of medications are used in the treatment of :

  • Controller ("preventer") medication: These medications reduce the inflammation in the of the lungs, which prevents symptoms over the long term. Controllers usually have steroids in them, and are generally used every day – even if the child doesn't have any symptoms.
  • Reliever ("rescue") medication: These medications quickly open up the airways and relieve acute symptoms. They help your child during an attack, but may also be used to help prevent an attack, for instance before doing physical exercise.

The medication options will depend on how well the symptoms can be managed. In mild , people usually only need to use medication when they have acute symptoms. More severe symptoms can generally only be kept under control by using one or several medications every day.

In children who have allergic , a treatment known as allergen-specific immunotherapy may also help relieve the symptoms. This kind of therapy takes several years and can make a child less sensitive to the allergy-related triggers.

Can asthma medications harm my child?

If the doctor recommends that their child take corticosteroids, many parents worry about possible side effects. For people with severe , though, attacks are much more dangerous than the side effects of controller medication. Most medications, including corticosteroids, can be inhaled. When inhaled as a spray or powder, these drugs have far fewer side effects than when used as tablets or injections.

There are concerns that long-term use of corticosteroids in children could impair their growth. But steroid inhalers are very unlikely to permanently affect children's height. Research has shown that they grow a little more slowly in the first year of treatment, but develop normally after that. This suggests that they grow to the same final adult height as other children with who don't inhale corticosteroids. Still, to be on the safe side, young patients are usually only prescribed the lowest possible doses of steroids and, if possible, only steroids which are inhaled.

How can I protect my child from asthma triggers?

Asthma is sometimes triggered by substances in the air that also irritate the airways of people who don't have , such as perfumes, smoke and other pollutants. These substances can cause severe symptoms in people with . Other substances and environmental conditions that are normally harmless – like dust, pollen, animal fur or temperature fluctuations – sometimes irritate the airways of people who have , leading to an overreaction.

To protect your child, you need to know what triggers their . It can help to observe what things and situations make their symptoms arise or get worse. But it's important not to exaggerate. Wrongly assuming that something is a trigger can lead to unnecessary restrictions. Precautions that might protect your child, but also prevent them from doing everyday things – like meeting up with friends, following their interests, and going to kindergarten or school – could do more harm than good.

Animal fur can trigger allergies. If your child has an allergic reaction to a beloved pet, you could try keeping the pet in a separate part of your home or washing it more often. Sometimes that doesn't help. You may then have to find a new home for it. But it's only a good idea to take these measures if you know that your child's symptoms flare up when they come into contact with animals. Avoiding pets hasn't been proven to prevent .

Asthma is a complex disease. Trying to avoid triggers may not be worth the effort and sacrifices involved for your child. For example, it's almost impossible to completely avoid all dust mites. Individual measures hardly make a difference. But combining different measures may help – for instance, cleaning the floor with a wet rag, using a dust-mite-proof mattress cover, regularly washing the child's bedding at more than 55°C (130°F), and removing any "dust traps" such as upholstered furniture and rugs.

In most cases, as long as children use their controller medication properly, triggers no longer have an effect.

What needs to be considered when doing exercise?

If a child has , it doesn't mean that they can't play with friends, or do sports at school or in a sports club. Physical activities are a major part of daily life for many children and teenagers who have .

Getting a lot of exercise is important for a child's physical development. Exercise and sports can even have an extra benefit for children who have . They can improve the performance of their lungs and their general level of fitness. Exercise and sports can also reduce the frequency of attacks. Asthma should be treated (or “controlled”) in a way that makes it possible for the child to play and participate in sports at any time. You can talk with the doctor about whether it's a good idea for your child to use medicine before doing strenuous physical activities, to prevent symptoms that are caused by physical exertion (exercise-induced ).

It's difficult to say for sure whether certain types of sports are better for children with . But swimming, for example, is probably less likely to trigger exercise-induced asthma than winter sports are. This is mainly because cold, dry air tends to set off attacks. The air around indoor swimming pools is warmer and more humid. The main thing is that your child enjoys the type of sport that he or she does.

By the way, a lot of top athletes have . Knowing about some of those athletes could help encourage your child.

Can my child go on school trips?

A child who has will also want to do everything that other children do, including going on school trips or to summer camps. It is important that teachers, friends and your child are all well-informed about , and know how to prevent attacks and what to do in emergencies. That will help your child to deal with difficult situations when you aren't there too.

If your child has allergic , you probably won't be able to prevent him or her being exposed to triggers on school trips. You can talk with the doctor about whether it would be a good idea for your child to use steroids on school trips to prevent . A child who already uses controller medication regularly may forget about it while on a school trip. Then it can help if the adults accompanying your child are informed and can remind them, or – if symptoms occur – ask them whether they took their medication regularly.

Always carrying their treatment and emergency plan on them, with information about the disease and the medication they need, will make it easier for people to help your child in an emergency.

What can I do to help my child during puberty?

Puberty can be a time of conflict for all parents and their children. It is then often difficult for teenagers with to follow the specific rules and demands associated with managing their condition.

Teenagers with generally tend to take their symptoms less seriously than their parents do. But it is the other way around when it comes to quality of life: Parents often underestimate how much their teenage children feel limited by their treatment.

The topic of smoking can be especially tricky. If their friends smoke, even quite confident teenagers may also pick up the habit. Then it can be difficult to make it clear that smoking is especially bad for someone who has .

Puberty is commonly a time when many young people try out a lot of things, including things that they know aren't good for them. Researchers call this “adolescent risk behavior.” There is that this behavior is particularly common in young people who have chronic illnesses. This means that young people with may be even more tempted to start smoking than other people their age, even though it would be more harmful for them. Their family can influence whether or not they start smoking, though.

You can't protect your child from every type of harm they might expose themselves to. But if you manage to carry on talking openly with them, and perhaps with their friends too, it could help them and give them more self-confidence.

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IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on November 30, 2017
Next planned update: 2021

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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