Asthma, asthma flare-ups, asthma attacks and asthma triggers

Asthma is a disease that affects the small airways in the lungs.

In people with asthma, it’s sometimes hard for air to get through these airways and into the lungs. People might wheeze, cough, feel tight in the chest and have mild breathlessness. This is called an asthma flare-up.

Sometimes people might also have severe breathing difficulty or go blue in the lips. This is called an asthma attack.

Asthma flare-ups and asthma attacks happen when people come into contact with asthma triggers. Asthma triggers cause inflammation in the airway passages or make existing inflammation worse. This inflammation causes the airways to narrow.

Triggers vary, but the most common is a viral infection, usually the common cold. Other triggers include allergens, exercise, weather changes, cold air, cigarette smoke, pollution and stress.

Asthma symptoms

Wheezing
An asthma wheeze can vary from mild to severe. Some people say it sounds like a high-pitched whistle.

Sometimes you’ll be able to hear your child’s wheeze easily, usually when your child is breathing out.

Asthma wheezing is typically worse first thing in the morning or at night when the air is cooler. Other times you’ll hear a wheeze after your child has done some exercise.

Coughing
Asthma coughing can vary from mild to severe.

You’re more likely to hear the cough at night, after your child has done some exercise, or when the weather is cold.

Sometimes your child might have a restless sleep or wake during the night because of the cough. Sometimes coughing, especially at night, is the only sign that your child has asthma.

Chest tightness
Your child might feel like something is squeezing or constricting their chest.

Breathing difficulty or discomfort
As wheezing, coughing or chest tightness gets worse, your child might also have difficulty breathing.

Breathing difficulties might stop your child from doing things like sport or other physical activity.

The severity and frequency of asthma symptoms vary a lot. Some children wheeze or cough only a few times a year when they have a cold, whereas others (a small minority) have some asthma symptoms every day.

Concerned about symptoms of asthma: when to see a GP

Take your child to see your GP if your child:

• has a wheeze, a cough or chest tightness that keeps coming back or gets worse, particularly when they exercise
• has difficulty breathing, which makes it hard for them to exercise or play as usual, or to keep up with other children
• isn’t sleeping well because of wheezing or coughing.

Diagnosing asthma

Your GP might be able to diagnose asthma by asking how severe your child’s symptoms are and how often your child has them. They’ll also look at your child’s medical history and examine your child.

If your child is aged over 5 years, doctors might also use breathing tests to help in the diagnosis.

Allergy testing can also help.

Asthma tests are often arranged by a paediatrician or respiratory specialist.

Categories of asthma

If your child is diagnosed with asthma, their asthma might be described as:

• infrequent intermittent asthma
• frequent intermittent asthma
• persistent asthma.

Infrequent intermittent asthma
With this kind of asthma, symptoms happen a few times a year, usually in association with a cold or other viral infection. Children with infrequent intermittent asthma might wheeze or cough for a few days when they’re having flare-ups and respond rapidly to treatment.

Between asthma attacks or flare-ups, children with infrequent intermittent asthma are usually in good health and lead healthy, balanced lives with no asthma symptoms.

Most children with asthma fall into this group.

Frequent intermittent asthma
Children with frequent intermittent asthma have several acute attacks each year, at least every 6 weeks.

Children with frequent intermittent asthma might have an intermittent cough or a wheeze or cough triggered by exercise.

Persistent asthma
Children with persistent asthma have symptoms at least once a week. Their symptoms can happen during the day or night.

This is the smallest group of children with asthma.

Every child with asthma needs an asthma action plan. Your child’s plan will say what medicine your child needs to prevent and minimise asthma symptoms. Read more about asthma treatment and management, including asthma action plans, reliever medicines and preventer medicines.

Causes of asthma

Children who have parents with asthma might get genes from their parents that make it more likely that they’ll get asthma too. If you, your child’s other parent or other family members have asthma, eczema, hay fever or allergies, there’s an increased chance your child will have asthma.

Also, if children are exposed to cigarette smoke in pregnancy, they have an increased risk of developing asthma in childhood.

Early in life, something switches on a child’s asthma for the first time. This might be:

• a viral infection
• an allergen like pollen, dust mites and animal dander
• something in the environment that irritates the child’s airways.

At this stage we don’t know how to stop asthma from developing.

Asthma is the most common chronic medical condition in children in Australia. It affects around 1 in 5 children.