What are some of the unusual symptoms of asthma in children?

One in twelve children has asthma in the United States, and it is the leading chronic illness in children. It is presently incurable, but there are medications that can prevent and treat flare-ups. Approximately 20 people die of asthma each day. It is more common in children than adults, and boys are more commonly affected than girls. African Americans are afflicted more often than whites.

A child does not have to be born with it. It may develop later in childhood as a result of exposure to mold or allergens like dust mite feces and cockroach feces. While wheezing is the most common symptom of asthma, not all children have that symptom. Some of the less common or more unusual symptoms might not even be associated with the lungs themselves, but are a consequence of low oxygen exchange between carbon dioxide in the blood traveling through the lungs. Difficulty breathing, shortness of breath are the most common symptoms. Here is the list of less common symptoms.

Change in appetite

Not being able to eat or finishing their food is one subtle sign of asthma that may be confused with other disorders associated with the gastrointestinal tract. If your child has a change in his or her eating patterns, they could have asthma. Likewise, abdominal or belly pain or nausea may be symptoms of nausea as a result of increased use of the abdominal muscles to breathe or lower oxygen content in the blood that supplies the stomach and brain.

Sore throat

Because asthma makes it hard for the child to get enough oxygen and exhale enough carbon dioxide with each breath, they breathe faster and harder, which can give them a dry, sore throat as more air must move past the tonsils.

Headache

People can get headaches as a result of asthma. It’s kind of like altitude sickness, which can cause headaches and nausea due to less oxygen content in the air. The headache can be global or worse in the forehead or base of the skull. The location or characteristics of the headache are not specific for asthma. If the headache does not resolve with fluids, food, or acetaminophen, then consulting a doctor is prudent.

Blue lips

People often associate blue lips with being cold, but blue lips can signal low oxygen content in the blood and would be especially worrisome if the weather is warm or hot.

Blue lips may be seen after swimming in cold waters. However, in that case, the child is usually shivering. Blue lips in normal ambient temperatures are concerning

Lethargy

Feeling tired and not wanting to do much of anything, and this is often associated with not wanting to go outside on hot, humid days or sitting around with no interest in activities that would normally entertain a child.

Trouble Talking

Some children cannot talk in complete sentences and have to stop to take in a breath or gulp before continuing. If your child pauses a lot while speaking, look for other signs that might suggest asthma.

Leaning forward and unable to lie flat

Children that cannot lie down for a nap or at bedtime or who are seen leaning forward may be having an asthma attack. This leaning maneuver improves airflow to the lungs due to the inflammation that builds up during an asthma attack. This inflammation releases enzymes and immune cells that increase the fluid content around and in the small air sacs. This fluid accumulates in any dependent region of the lungs, collapsing the sacs, which lessen oxygen exchange.

Using extra chest wall muscles

Besides abdominal muscles, chest wall muscles that wouldn’t normally be used to breath are in full gear. A child than raises their shoulders, sucks in their chest wall, and then exhales forcefully will look like their belly is bulging outwards at that time. Think of the Big Bad Wolf and Goldilocks when he tried to ‘huff and puff’ to blow the house down. 

Coughing up white or clear mucus

It’s not normal to cough up any mucus unless the person has a cold, influenza, bronchitis, or pneumonia. Coughing up clear or white mucus may be a sign of asthma.

Episode after swimming

Because humid air can trigger an asthma attack, so can swimming because of the high humidity and because of chlorine fumes. Any chemical with fumes can trigger an asthma attack as can vigorous exercise. Look for wheezing and cough after these activities or exposures to common household chemicals like bleach, ammonia, or aerosol cleaners. 

Nostrils flaring in and out

Before the asthma is severe, you might only see the child’s nostrils start to flare out and then collapse in as they breathe. You should not be able to see nostrils flare once the child is at rest. If the child is doing strenuous physical activities such as soccer, it would be normal for a few minutes of flaring, but it should resolve with resting.

Lack of wheezing 

Ironically, the lack of wheezing does not mean that the child is asthma-free. Lack of wheezing after a period of wheezing can mean that the child is severely ill and needs immediate attention in the emergency room. Of course, this would be an unlikely event in someone who has never been diagnosed with asthma.

Conclusion

Cough, chest tightness, and wheezing are the cardinal symptoms of allergies but be on the lookout for the less common and more subtle signs and symptoms. Children with seasonal allergies are more likely to have asthma, and the flare-ups may only occur seasonally. Watch for asthma flares with colds, other viruses, tobacco smoke, extremely cold air, exercise, and pollution. 

Asthma is a condition that has treatment options to prevent flare-ups and also to treat acute attacks. When managed properly, asthma can be controlled, and the child can lead a relatively normal life. The key is to never stop a medication without first speaking to a doctor. Some medications need to be tapered while another one is started.

Need to discuss your child’s individual situation with a doctor?

Telemedicine services like eDoc Telemed is a convenient and affordable way to address these type of concerns from the comfort of your home. To schedule an appointment, go to www.edoctelemed.com. Board-certified pediatricians and specialists are available to you.