Exercise-Induced Asthma in Children

What is exercise-induced asthma?

Asthma is a chronic (long-lasting) lung disease in which the lining of the airways of the lungs is often swollen or inflamed. It causes wheezing, coughing, shortness of breath, and chest tightness. Exercise-induced asthma is a form of asthma that some children have during or after physical activity.

How does it occur?

When a child has asthma, the muscles around the airways tighten and the lining of the airways swells and produces thick mucus. This causes the airway to narrow and makes it harder to breathe. This breathing difficulty is called an asthma attack. In exercise-induced asthma, this can occur:

  • during or after vigorous physical activity
  • when the air is cold
  • when the humidity is very low or high
  • when there is a lot of air pollution
  • when there are a lot of allergens in the air.

For many children, running or bicycling in the cold air may trigger symptoms. Crying and temper tantrums may also trigger an asthma attack in very young children.

What are the symptoms?

The symptoms of exercise-induced asthma include:

  • wheezing (a high pitched whistling sound heard during breathing)
  • coughing with exercise
  • shortness of breath
  • chest tightness
  • fatigue
  • new or increased reluctance to participate in vigorous play or activities requiring physical exertion

How is it diagnosed?

Your healthcare provider will ask about your child's history of breathing problems during or after exercise. He or she may ask your child to run on a treadmill or to exercise outside the office. After that the healthcare provider will then listen to your child's lungs with a stethoscope to check for wheezing after the exercise.

Your healthcare provider may give you a small device called a peak-flow meter. This measures the fastest speed your child can blow air out of his lungs after a deep breath. During a bout of exercise-induced asthma, the peak flow measurement will decrease from your child's normal measurement.

How is it treated?

Exercise-induced asthma can be successfully treated with medicine. The kind of medicine usually tried first is an inhaled bronchodilator such as a short-acting beta2-agonist. This is also called a "quick relief medicine." Examples of these medicines are albuterol and pirbuterol. They work fast to relax the muscles of the airways. They prevent tightening of the muscles around the airways (bronchospasm) caused by exercise, cold air, and air pollutants. This kind of medicine is used to treat acute asthma attacks. They may be given 15 minutes before exercise to people with exercise-induced asthma in order to prevent symptoms.

Other preventative medicine, such as cromolyn, may be prescribed. This can be taken 15 minutes before exercise or exposure to cold air or allergens to prevent symptoms. Cromolyn can help prevent exercise-induced asthma, but will not help like albuterol or pirbuterol will after your child has started wheezing.

How can I take care of my child?

If your child has exercise induced asthma, let coaches, teachers, or others who supervise your child's activities know what to do to help your child. Exercise and other physical activities do not routinely need to be avoided. If your child is recovering from a viral illness and needs a few days to fully recover, he may need to avoid gym class or sports for a short time. Your child can usually avoid symptoms by using a quick-relief medicine 15 to 30 minutes before exercise. If your child takes a quick-relief medicine before exercise and does not recover quickly from asthma symptoms, repeat the dose after exercise is stopped. If your child regularly has a lot of symptoms with exercise even after using a quick relief medicine, talk with his healthcare provider.

Some children have more symptoms during strenuous activity in cold, dry air. During the winter your child may need to exercise indoors or wear a mask when exercising outside. Wearing a mask warms the air before your child inhales it. You may also need to be aware of conditions such as air pollution or allergens such as dust or pollen.

Doing warm-up exercises before a vigorous workout may help prevent an exercise-induced asthma attack.

When should I call my child's healthcare provider?

Call IMMEDIATELY if your child:

  • has severe wheezing
  • is having trouble breathing
  • has wheezing that has not improved after the second dose of asthma medicine
  • has a peak flow rate of less than 50% of the personal best.
Written by Pierre Rouzier, MD, for RelayHealth.
Published by RelayHealth.
Last modified: 2009-01-09
Last reviewed: 2008-12-29
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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