The incidence of childhood asthma has increased steadily over the past 20 to 30 years. In addition, more and more infants are being identified as having asthma. Although asthma symptoms in adults are fairly straightforward, symptoms in infants can be more subtle. Add to this that babies can't verbalize when they are feeling asthma symptoms. Together, these issues make identifying symptoms of asthma in infants sometimes tricky, but knowing what to watch for can lead to a timely diagnosis.
Cough
By far the most common symptom of asthma in infants is a cough, which often is described as a short, productive-sounding cough. However, even though the cough often sounds productive, infants very rarely produce sputum when they cough. Cough due to asthma in infants occurs frequently at night. The pattern of cough is chronic, occurring more than two to three nights per week. A baby with a cough due to asthma--as opposed to a baby with a cough due to a simple cold--will improve with the administration of certain inhalation or nebulizer treatments that can be administered in a doctor's office.
Wheezing
True bronchial wheezing in infants with asthma does not occur as often as it does in adults with asthma. Many people have images of an older child or adult having a classic asthma "attack" with wheezing, prompting the use of an inhaler. Babies sometimes suffer from the same wheezing that causes those attacks, but parents of these babies describe hearing a high-pitched whistling noise when their baby breathes.
Parents may mistake other kinds of noisy breathing in infants for true bronchial wheezing. For instance, stridor, croup and nasal congestion can sound similar to wheezing. If a parent suspects that his infant is wheezing, it is important to have a physician evaluate the baby.
Shortness of Breath
Because babies can't tell us when they're feeling winded, it's important to watch for subtle signs that this may be the case. Infants with asthma who are having symptoms and are feeling short of breath often will flare their nostrils with breathing in an effort to increase their oxygen intake. They also will use their accessory chest and abdominal muscles to help them breathe. This appears as small indentations, known as retractions, between the individual ribs, above the collar bone or sternum and under the rib cage.
References
- "Pediatrics"; Trends in childhood asthma: prevalence, health care utilization, and mortality; LJ Akinbami, et al; August 2002
- "Primary Care: Clinics in Office Practice"; Pediatric Asthma; LJ Stewart; March 2008
- "Pediatric Clinics of North America"; Respiratory Noises: How Useful are They Clinically?; C Mellis; February 2009
