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Asthma: Age-by-Age Guide

Infants
It is very difficult to diagnose an infant with asthma, but in severe cases doctors may diagnose and treat babies (although he might call is reactive airway disease). Signs of asthma in a baby may include:

  • audible wheezing during normal activities
  • chronic cough
  • rapid breathing (normal respiration rates in newborns are 30-60 breaths a minute, breathing increased 50 percent above normal could indicate asthma)
  • rib retractions (the pulling in of the skin between the ribs)
  • difficulty sucking or eating
  • crying sounds that are softer and different than normal
  • recurring respiratory syncytial virus (RSV) may increase the risk of asthma later in childhood

The same medications used to treat older children are used in infants, only in smaller doses, and most often delivered via a nebulizer. Because babies spend up to 18 hours a day in their bedrooms, “asthma-proofing” that room is especially important.

Toddlers and Preschoolers
As babies transition into toddlers, some may outgrow wheezing as bronchial tubes mature. If your toddler develops or continues to experience some or all of the symptoms above, your doctor may be more willing to diagnose asthma. Additional signs your toddler or preschooler may have asthma might include:

  • Inability to keep up with playmates
  • Repeated episodes of wheezing or coughing triggered by specific things, i.e., a visit to a relative who has multiple cats, or a windy day on the playground
  • Seasonal allergies
  • Chronic sinusitis (sinus infections)

School Age
Most children are diagnosed at around age five or older when doctors are able to effectively administer lung function tests. In addition to the symptoms listed above, school-age kids have the language skills to describe their symptoms, like chest tightness and inability to draw a breath.

When parents develop an asthma management plan with their doctor, they should provide a copy to their child’s school as well. Each child’s plan will be different, depending on the type and severity of asthma and treatment, but most will include basics such as:

  • Permission to give ongoing/emergency medication
  • Details on when and how to treat symptoms (i.e. signs that your child needs rest, conditions that may require your child take indoor recess, when to administer regular medication or emergency treatment)
  • Asthma triggers  (i.e. the class hamster, cold, windy days, high pollen count)
  • Emergency contacts and phone numbers

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