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Diagnosis Asthma In Children – Symptoms

Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalization.

Recognizing asthma symptoms

Asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. Making a diagnosis of asthma in children may be difficult because episodic respiratory symptoms such as wheezing and cough are also common in children who do not have asthma especially in those younger than 3 years. Children with asthma experience symptoms when the airways tighten, inflame, or fill with mucus.
A diagnosis of asthma in children especially in younger age group can often be made based on largely on symptom patterns and on a careful clinical assessment of family history and physical findings.
Common asthma symptoms include:

  • Cough due to asthma is non-productive, recurrent and/or persistent, and is usually accompanied by some wheezing episodes and breathing difficulties. Allergic rhinitis may be associated with cough in the absence of asthma. A nocturnal cough (when the child is asleep) or a cough that occurs with exercise, laughing or crying, in the absence of an apperent respiratory infection, supports a diagnosis of asthma.
  • Wheeze is the most common symptom associated with asthma especially in children younger than 5 years old. Wheezing that occurs recurrently, during sleep, or with triggers such as activity, laughing, or crying, is consistent with a diagnosis of asthma.
  • Shortness of breath or loss of breath (typically manifested by patterns of activity limitation). Breathlessness that occurs during exercise and is recurrent increases the likelihood of the diagnosis of asthma.
  • Chest tightness, pain, or pressure
  • Rapid breathing.
  • Feelings of weakness or tiredness

Physical activity is an important cause of asthma symptoms in young children. Young children with poorly controlled asthma often avoid from strenuous exercise to avoid symptoms, but many parents are unaware of their children’s activities.

Still, not every child with asthma has the same symptoms in the same way. The child may not have all of these symptoms, or he or she may have different symptoms at different times. Your child’s asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another.
Some children with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms every day. In addition, some children may only have asthma during exercise or asthma with viral infections like colds.
Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild asthma symptoms to help you prevent severe episodes and keep asthma under better control.

When to see a doctor

Take your child to see the doctor as soon as possible if you suspect he or she may have asthma. Early treatment will not only help control day to day asthma symptoms, but also may prevent asthma attacks.

Bring your child to see the doctor if you notice:

  • Coughing that is constant, intermittent or seems to be linked to physical activity
  • Wheezing or whistling sounds when your child exhales
  • Shortness of breath or rapid breathing
  • Complaint of chest tightness
  • Repeated episodes of suspected pneumonia

Asthma can be worse at night, so listen for coughing during sleep or coughing that awakes your child. Crying, laughing, yelling or strong emotional reactions and stress also trigger coughing or wheezing.

Know the Symptoms of an Asthma Attack

An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors – bronchospasm, inflammation, and mucus production – cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities.

Even if your child has not been diagnosed with asthma, seek medical attention immediately if he or she has trouble breathing. Although episodes of asthma vary in severity, asthma attacks can start with coughing, which progresses to wheezing and labored breathing.


    1. Ministry Of Health Malaysia. Clinical Practise Guideline For Management Of Childhood Asthma 2014.
    2. Global Strategy for Asthma Management and Prevention: Global Initiative for Asthma (GINA) (updated 2012).
    3. Asthma and Allergy Foundation of America. Asthma overview-diagnosis.
Last Reviewed : 4 November 2015
Writer : Dr. Noor Hafiza bt. Noordin
Accreditor : Dr. Norzila bt. Mohamed Zainudin