Have you noticed your child wheezing? Is your baby or toddler always coughing? If so you may be wondering if they’ve got asthma, or whether it’s something else, such as a cold or chest infection.
Getting an asthma diagnosis for children under five can be difficult and may take a long time. But the good news is you can keep your child safe and well with the help of your child’s GP and support from Asthma UK.
It’s difficult to say for sure what causes asthma and the causes vary from child to child. But evidence suggests that children are more likely to get asthma if:
- they were born early (premature), especially if they needed help with their breathing
- they had a low birth weight
- their mother smoked during pregnancy
- they also have eczema or allergies
- there’s a family history of asthma, eczema, hay fever or other allergies (known as ‘atopy’)
- they are exposed to second hand cigarette smoke or pollution
- they’ve had repeated bouts of bronchiolitis or croup as a baby or toddler
The usual asthma symptoms to look out for are:
- difficulty breathing
- a tight, sore feeling in their chest (children often describe this as 'chest hurting' or 'tummy ache').
What else could asthma-like symptoms mean?
The typical symptoms of asthma can be the same as for other illnesses or conditions, which is one reason why diagnosing children can take so long. For example:
- a cough can also be a symptom of a cold or virus and is very common in small children because their airways haven’t yet developed fully.
- young children can sometimes wheeze (a whistling sound in the chest) when they have a cough, cold or viral infection – it doesn’t mean it’s asthma. Babies have small airways so being wheezy is very common in children under 3.
- it’s quite common for babies and toddlers to get croup, which can keep coming back. Cough is a key symptom of croup. It can also make your child’s breathing sound noisy.
- bronchiolitis can affect babies and toddlers and has similar symptoms to asthma.
Getting a GP’s appointment is an important first step if you’re worried about your child’s symptoms. The GP can begin to work out what’s causing them, and will be looking out for any patterns to their symptoms, for example, if they are always worse at certain times or in certain situations. It’s unlikely that you’ll come away with a clear asthma diagnosis at this point, because diagnosing asthma can take time.
At the first appointment your child’s GP will probably:
- listen to your child’s chest to find out if there are any wheezy sounds.
- ask about your child’s symptoms and triggers and how often your child has them
- ask lots of questions about your child and their family history
- talk to you about asthma tests your child will need to do to confirm a diagnosis
If you can, try filming your child when they’re coughing and wheezing. This can be useful if your child’s not having any symptoms during the appointment. Asthma nurse specialist Debby Waddell says: "It can be hard for a parent to explain the kind of cough or wheeze their child has. What really helps me is to see a short video clip of the child when they’re having symptoms.”
If your child is well and not getting symptoms, the GP might suggest monitoring your child without treatment for a while to see if symptoms come back.
If your child is having symptoms, the GP will try a low dose of asthma medicine to see if it makes a difference to your child. This is known as a ‘trial of treatment’.
Preparing for your child’s GP appointment
It can be helpful to write a list of questions and anything you’re worried or unsure about – this will help you make the most of your appointment. You might find it useful to think about the following:
Your child’s health history
- Is asthma in the family?
- Is hay fever or eczema in the family?
- Was your child premature (born early)?
- Has your child had any chest infections, croup or bronchiolitis?
Your child’s symptoms
- How often does your child have symptoms?
- Are symptoms worse at night?
- Have you noticed your child’s symptoms are triggered by things like cold weather or pets?
- Are your child’s symptoms worse when they have a cold?
Where you and your child live
- Is your child ever around cigarette smoke?
- Is there any damp or mould at home?
- Do you live on a main road?
- Do you have to walk along a main road to take your child to school or nursery?
Going by your child’s symptoms and history your GP may say your child has ‘suspected asthma’. If this is the case your child might be given inhalers and you’ll be able to work together with your GP towards a clear diagnosis.
But it’s very common, if your child is young, to come away with less clear diagnoses, for example: ‘childhood wheeze’, ‘viral wheeze’, ‘needing inhalers’, ‘bronchiolitis’, or just ‘a virus’. When you’re hoping for a clear way forward this can be worrying and frustrating.
“It is frustrating for parents, and for me, that it isn't always easy to diagnose asthma. There are no routine tests that can 100%prove or disprove asthma so we have to be patient and observe how the symptoms change over time, and with any treatments given.” Dr Andy Whittamore, Asthma UK’s in-house GP.
Although most children develop asthma symptoms under the age of 5, it is difficult to give them a clear diagnosis of asthma, which is frustrating for many parents, and for GPs. This is because very young children are not able to do the tests that help confirm asthma so don’t be surprised if you need regular visits to your GP at this stage.
Before you leave the appointment the most important thing you can do is to make sure you know what to do to keep your child safe when symptoms get worse.
Caring for babies and children is already challenging, but if they have symptoms like cough or wheeze and aren’t sleeping well, it’s even harder.
We’re here to help, even when your baby or toddler doesn’t yet have a confirmed asthma diagnosis.
- Call our Helpline
- Get tips, advice and alerts by following us on social media
- Share your concerns with others on Facebook or Twitter
- Read about other parents with similar experiences
Last updated July 2017
Next review July 2020