Asthma in children

Child-specific asthma guidelines should be used. Asthma in children is different from asthma in adults; adult or adolescent guidelines should not be extrapolated to younger age groups.

The prevalence of childhood asthma appears to have plateaued in many affluent countries, but it remains a significant cause of childhood morbidity and mortality.

Most children with asthma have mild intermittent asthma and do not require daily therapy. Minimum doses and medications for maximal control should be used in those who require preventive therapies. Therapy should be individualized.

A number of important differential diagnoses, and adherence and environmental issues should be considered when evaluating a child with suspected asthma, especially in very young children or when high doses of inhaled corticosteroids are required.

Asthma is a chronic respiratory disorder characterized by variable airway inflammation, airway obstruction, and airway hyperresponsiveness. These features interact to determine a patient’s clinical symptoms. While most asthmatic children have an intermittent symptom phenotype, a minority have persistent symptoms that reflect underlying chronic inflammation. In older children, this may lead to airway remodeling (permanent structural alterations of the airway wall) and a more severe asthma phenotype.

This topic covers the nonacute treatment of children up to 12 years, consistent with national and international guidelines. See Asthma in adults for information about the management of children ages 12 years and older.