Childhood Asthma: What Parents Need to Know

Symptoms of Childhood Asthma

Common symptoms include:²

• Repeated coughing
• wheezing or a whistling sound when breathing
• shortness of breath
• chest tightness or discomfort
• coughing during or after physical activity
• coughing or wheezing at night
• becoming unusually tired during play or exercise

Younger children may not be able to explain that their chest feels tight or that breathing feels difficult.

Parents may instead notice that the child stops running, wants to be carried, becomes tired more easily, or avoids activities they previously enjoyed.³

Sometimes cough is the most noticeable symptom. Pay particular attention when coughing repeatedly occurs at night, during exercise, or whenever the child develops a respiratory infection.²

Does Wheezing Always Mean Asthma?

No.

Children can wheeze for reasons other than asthma, particularly during respiratory infections. A single episode of wheezing does not by itself confirm that a child has asthma.²

Doctors therefore look at the overall pattern: whether symptoms keep returning, when they occur, what seems to trigger them, whether they affect sleep or physical activity, and what is found during medical assessment.

If coughing, wheezing, or breathlessness repeatedly returns, it is worth having the child assessed rather than assuming that every episode is simply another cold.

Childhood Asthma in Dubai and the UAE

For families living in Dubai and the UAE, it can be useful to observe whether environmental conditions affect the child's symptoms.

Dust, airborne irritants, cigarette smoke, respiratory infections, indoor allergens, and outdoor air pollution are among the exposures that can worsen asthma symptoms in susceptible children.¹,²

This does not mean that children with asthma should routinely remain indoors.

Instead, observe your child's individual response. If dusty or poor outdoor air conditions repeatedly coincide with coughing, wheezing, or breathing difficulty, it may be sensible to reduce prolonged strenuous outdoor activity during those periods.

During very hot weather, adequate fluids and choosing more comfortable times for outdoor activity can also make physical activity easier.

The aim is to adapt, when necessary, without unnecessarily restricting normal childhood activities.

What Causes Childhood Asthma?

There is usually no single reason why one child develops asthma.

The exact causes are not fully understood. Asthma involves airways that are more sensitive and prone to inflammation, and both inherited tendency and environmental exposures can contribute.²

For parents, an important distinction is:

The factors involved in developing asthma and the things that trigger asthma symptoms are not necessarily the same.

A child may have asthma as an underlying condition but experience symptoms mainly when exposed to particular triggers.

Understanding those triggers is usually more useful for everyday care than trying to identify one single “cause” of the child's asthma.

What Can Trigger Asthma Symptoms in Children?

Common asthma triggers in children include respiratory infections, dust mites, pollen, mould, animal dander, cigarette smoke, air pollution, physical activity, weather changes and strong emotional reactions such as prolonged laughing or crying.²,³

But triggers differ between children.

Trying to eliminate every possible trigger is neither practical nor necessary. Instead, look for patterns that repeatedly occur in your own child.

Does coughing appear whenever your child catches a cold?

Does wheezing repeatedly occur during running or sports?

Do symptoms become worse in a dusty environment or during a particular season?

Does exposure to smoke, strong fragrances, or another irritant repeatedly lead to symptoms?

A simple symptom record can sometimes help. Note when symptoms occurred, what the child was doing, whether they had a respiratory infection, and whether there was an unusual environmental exposure.

Over time, repeated patterns can become easier to recognise.

Childhood Asthma and Respiratory Infections

Colds and other respiratory infections commonly trigger or worsen asthma symptoms in children.²,³

Some children are comfortable between illnesses but begin coughing or wheezing whenever they develop a respiratory infection.

If this is your child's usual pattern, learn what the early stages of an infection-associated asthma episode look like.

For one child, the first sign may be nighttime coughing. Another may start wheezing. A younger child may simply become less active or appear unusually tired.

Good everyday infection-control habits such as regular handwashing are sensible, particularly when respiratory infections are circulating at school or within the family.

More importantly, knowing your child's usual response to respiratory infections can help you recognise when their breathing pattern is beginning to change.

How Is Childhood Asthma Diagnosed?

There is no single blood test, X-ray or scan that by itself confirms childhood asthma.

Diagnosis begins with the pattern of symptoms and the child's medical history. When the child is old enough to perform reliable breathing tests, objective lung-function testing can provide additional evidence.⁴

The healthcare professional may ask:

• How often does your child cough or wheeze?
• Do symptoms come and go?
• Are they worse at night?
• Do they occur during exercise?
• Do colds repeatedly trigger breathing problems?
• Are there periods when the child is completely well?
• Are sleep, school, or physical activities affected?
• Is there a personal or family history of asthma or allergies?

The child is also examined, and other possible explanations for the symptoms may need to be considered.⁴

Spirometry and Lung Function Testing

Children who are able to perform the test reliably may have spirometry.

Spirometry measures how much air a child can breathe out and how quickly the air can be expelled. Testing may also be performed before and after an inhaled bronchodilator to see whether airflow changes significantly.⁴,⁵

A peak flow meter is a simpler handheld device that measures how quickly air can be blown out. In selected children, it can also help monitor changes in lung function over time.⁴

Asthma varies, so a child's lung-function test may sometimes be normal when the child is feeling well. When symptoms strongly suggest asthma, but initial testing is inconclusive, testing may be repeated or other investigations considered.¹

Depending on the situation, these can include exercise or airway challenge testing, fractional exhaled nitric oxide (FeNO) or allergy testing. These tests are not necessary for every child.⁴,⁵

Diagnosing Asthma in Younger Children

Asthma can be more difficult to confirm in preschool children because they may not be able to perform reliable spirometry and because wheezing with respiratory infections is common at this age.³,⁵

The healthcare professional therefore relies more heavily on the child's symptom pattern, frequency of episodes, triggers, medical and family history, examination, and how symptoms develop over time.

Sometimes the diagnosis becomes clearer only after observing the child over a period of time.

Parents can help by keeping a simple record of coughing, wheezing, nighttime symptoms, breathing difficulty, respiratory infections, and possible triggers.

How Is Childhood Asthma Monitored?

Monitoring asthma is not simply about counting severe attacks.

Modern asthma monitoring considers both current symptom control and the child's future risk of significant flare-ups or poor lung function.¹

For families, this can be translated into a few practical questions.

• Symptoms: Are coughing, wheezing, or breathlessness becoming more frequent?
• Sleep: Is coughing or breathing difficulty waking the child?
• Activity: Can the child run, play, and participate in sports comfortably?
• School: Is asthma contributing to repeated absence or difficulty participating in normal school activities?
• Flare-ups: Are significant episodes becoming more frequent or requiring urgent medical assessment?
• Lung function: In children who can perform reliable testing, are objective measurements remaining satisfactory over time?
  
  Healthcare professionals may also use age-appropriate asthma-control questionnaires to track symptoms and their effect on daily life.¹,³
  
  Symptoms and lung function do not always tell the same story. This is one reason periodic assessment can remain useful even when a child appears relatively well.

What Does Good Asthma Control Look Like?

For a parent, good asthma control should be visible in everyday life.

A child whose asthma is well controlled should generally be able to:

• sleep without frequent asthma symptoms
• attend school normally
• run and play
• participate in age-appropriate physical activity
• complete normal activities without frequent coughing or wheezing
• have few significant asthma flare-ups
• avoid repeated urgent or emergency visits¹,³

This gives families a much more useful way to judge progress than simply asking:

“Has my child had an asthma attack recently?”

If the family is repeatedly changing sleep, school, exercise or normal activities because of asthma, that information should be discussed during medical review.

Childhood Asthma at School

Asthma can affect school attendance, physical activity and participation in everyday school life.⁶

The school should therefore know that your child has asthma.

Appropriate staff should know:

• what your child's usual symptoms look like
• what tends to trigger symptoms
• whom to contact if breathing becomes troublesome
• where the child's asthma action plan can be found⁶

The warning signs may not look identical in every child.

One child may wheeze. Another may repeatedly cough, become unusually quiet, or struggle to participate in physical education.

Good communication between parents, school staff, and the child's healthcare team can help the school respond appropriately when symptoms occur.⁶

What Is an Asthma Action Plan?

An asthma action plan is a written, personalized plan prepared with the child's healthcare professional. It helps parents, caregivers and school staff recognise changes in asthma and know what action has been advised.³,⁶

Many plans use green, yellow and red zones to make changes in asthma easier to recognise.³

The plan should be readily available rather than stored away with old medical records. An appropriate copy should also be available to regular caregivers and the school.

As children become older, they can gradually learn to recognise their own symptoms and understand their action plan.

Can a Child with Asthma Exercise and Play Sports?

Asthma should not automatically prevent a child from being physically active.

Children benefit from being able to run, play, and participate with their friends. Well-controlled asthma should generally allow normal physical activity.¹,³

Parents should pay attention if exercise repeatedly causes:

• coughing
• wheezing
• unusual breathlessness
• chest discomfort
• repeated stopping
• avoidance of activities the child previously enjoyed

Children naturally become breathless during vigorous exercise. Breathlessness alone does not necessarily mean that asthma is worsening.

The more useful question is whether your child's response is repeatedly different from usual or limits what they can comfortably do.

A child who repeatedly sits out because of coughing, wheezing, or breathing difficulty should be medically reviewed rather than routinely excluded from sports.

Caring for a Child with Asthma

Everyday asthma care is largely about awareness, preparation, and maintaining normal healthy routines.

Learn your child's usual pattern. An early change may be nighttime coughing, coughing during exercise, symptoms appearing with a cold, or a noticeable reduction in normal activity.

Focus on triggers that repeatedly affect your child rather than trying to remove every possible asthma trigger.

Keep the child's home and car free from cigarette smoke. Tobacco smoke and other airborne irritants are recognized asthma triggers.²

If dust appears to be relevant, concentrate cleaning efforts on areas where the child spends the most time, particularly the sleeping environment.

Persistent dampness or visible mould should be addressed by identifying and correcting the source of moisture where possible.

Strong perfumes, incense, room sprays and cleaning fumes may bother some children. If a particular exposure repeatedly coincides with symptoms, reducing that exposure is reasonable.

Encourage adequate sleep, sufficient fluids, regular meals and age-appropriate physical activity.

As children grow, help them learn to recognise meaningful changes in their breathing and tell an adult when something feels different.

The purpose is not to make a child anxious about asthma. It is to help the child and family recognise patterns, reduce relevant exposures and maintain as normal a childhood as possible.

When Should You See a Doctor for Childhood Asthma?

Arrange medical assessment if you suspect that your child may have asthma or if an established asthma pattern changes.²

Reasons for review include:

• repeated coughing or wheezing
• frequent nighttime symptoms
• breathing problems disturbing sleep
• difficulty keeping up during normal play
• recurrent symptoms during exercise
• repeated breathing problems with respiratory infections
• increasing school absence
• significant flare-ups becoming more frequent
• symptoms increasingly affecting normal activities
• uncertainty about whether the symptoms are actually asthma

A child who regularly cannot sleep, attend school, exercise or participate normally because of breathing symptoms deserves reassessment.

Periodic review can also be useful when the child appears well, particularly when longer-term asthma control and lung function are being monitored.¹

How to Identify an Asthma Emergency in a Child

Severe asthma attacks can be life-threatening and require urgent medical attention.³

Seek urgent medical attention if your child:

• is struggling seriously to breathe
• is gasping for air
• cannot speak normally because they need to stop for breath
• is pulling in strongly around or below the ribs while breathing
• has pronounced flaring of the nostrils
• becomes unusually drowsy, confused or difficult to respond to
• develops a blue or grey colour around the lips or face
• appears to be deteriorating rapidly³

Follow the child's emergency asthma action plan if one has been provided.

Parents know how their child normally looks and behaves. If breathing appears frightening, unusually difficult, or substantially different from previous episodes, do not wait for every possible warning sign to appear before seeking emergency assessment.

If symptoms appear severe or potentially life-threatening, seek emergency medical care.

Childhood Asthma: What to Remember

Childhood asthma does not look exactly the same in every child.

Learning your child's individual pattern is more useful than memorising long lists of symptoms and triggers.

Notice whether asthma is affecting sleep, school, exercise or normal daily activities.

Modern asthma assessment combines the child's history and symptom pattern with objective lung-function testing when the child is old enough to perform it reliably. In younger children, careful assessment and observation over time become particularly important.¹,⁵

Monitoring matters just as much as diagnosis. Good asthma control should be reflected not only in fewer severe episodes, but also in normal sleep, school attendance, physical activity and everyday life.¹

Identify triggers that actually matter to your child. Keep the child's environment smoke-free. Encourage normal activity rather than unnecessary restriction. Make sure school and regular caregivers understand the child's asthma and have access to the child's asthma action plan.⁶

Most importantly, recognise changes from your child's usual pattern. Increasing symptoms, declining activity, repeated nighttime problems or significant breathing difficulty should not simply become accepted as part of having asthma.

References

1. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention, 2025.
2. Mayo Clinic. Childhood asthma — Symptoms & causes.
3. Mayo Clinic. Treating asthma in children ages 5 to 11. This is particularly useful for symptoms, asthma control, activity, action plans, and emergency warning signs.
4. National Heart, Lung, and Blood Institute (NHLBI/NIH). Asthma — Diagnosis. This supports spirometry, peak expiratory flow, and bronchodilator-response testing.
5. Mayo Clinic. Childhood asthma — Diagnosis & treatment. This is useful for diagnosis in younger children, allergy assessment, and additional investigations.
6. Centers for Disease Control and Prevention (CDC). Managing Asthma in Schools.

Medical disclaimer: This information is intended for general patient education and awareness. It should not be used to diagnose a health condition or replace individual medical advice. If you are concerned about your child's breathing or general condition, seek assessment from an appropriately qualified healthcare professional.