Asthma in children | Mate huango tamariki

Asthma is a condition that leads to narrowing of the airways of the lungs. Symptoms include wheeze, cough and difficulty breathing.

This page focuses on asthma in children. See also asthma in adults for more information.

On this page, you can find the following information:

Key points to remember about asthma

  • Asthma is a condition that leads to narrowing of the airways of the lungs.
  • Symptoms include wheeze, cough and difficulty breathing.
  • Common asthma triggers are colds (viruses), exercise, dust, pollens and cigarette smoke.

What is asthma?

Asthma is a common breathing condition. It affects the small and medium-sized airways (bronchi) in the lungs. 

In asthma, your child's airways are inflamed and there is:

  • swelling of the airway wall
  • an increase in mucus or phlegm
  • tightening of the muscle in the airway wall (see the image below).

These changes cause narrowing of your child's airways. This leads to wheezing, cough and difficulty with breathing.

Wheezing is a musical, whistling sound that children make, usually when breathing out. It can also happen when they breathe in. The sound comes from the chest, not from the nose or throat. 

Image credit: Wikimedia

Why do some children have asthma?

One in 4 tamariki in New Zealand will have asthma at some time during childhood. It is not clear why some children have asthma when others do not.

Asthma in children is more likely if:

  • the mother smoked during pregnancy
  • they have eczema, hay fever or allergies
  • there is asthma in the family – parent, brother or sister
  • one or both parents have an allergic condition such as asthma, hay fever or eczema.

Modern Western lifestyle may play a part in the rise in asthma that has happened over the last few decades. Changes in housing, diet and a more hygienic environment may contribute. Outdoor environmental pollution may make asthma symptoms worse but it does not actually cause asthma. Experts continue to study the reasons for the increase in asthma.

What causes an asthma attack?

Children with asthma have airways that are sensitive and react to certain triggers. Some children have asthma all year round. Others may only have it in certain seasons or situations.

Triggers that cause an asthma attack include:

  • viruses – eg, a cold with a runny nose
  • things you are allergic to such as pollens, moulds, pet hair and dust-mites
  • cold or humid weather, or a change in the weather
  • exercise
  • emotions such as anxiety and excitement
  • air pollutants, such as cigarette smoke.

Keep a symptom diary and a record of possible triggers

Asthma symptoms and triggers may differ from child to child and from time to time. It is useful to know your child's triggers. Keep a symptom diary and keep a record of possible triggers.

Make sure your child's environment is smoke-free

Ensure your child's environment is smoke-free, wherever they happen to be. Asthma increases in children whose parents smoke. Tobacco smoke also triggers asthma attacks and makes a child's asthma more severe than it would otherwise be. Many environmental factors contribute to asthma; cigarette smoke is one that you can avoid.

If you want to give up smoking:

Could my child have asthma?

You should see your doctor and ask about asthma if your child:

  • wheezes and coughs with a cold (virus)
  • wheezes and coughs after exercise
  • wheezes and coughs during the night
  • cannot keep up when they are running around with children of the same age
  • says they are out of breath or breathless
  • complains they feel tired or asks you to carry them (depending on their age) when you go for a walk
  • does not run around as much as other children of the same age.

These are some of the symptoms of asthma in children, but they may also be due to other less common conditions. Talk to your doctor about them.

How do I treat my child's asthma attack with prescribed medications?

If you have had asthma medicine prescribed, you will need to use the blue inhaler (salbutamol) with a plastic tube called a spacer. 

  • give 2 puffs of the blue inhaler, one puff at a time, using the spacer, every 4 hours
  • for each puff of the blue inhaler, your child will need to take 6 breaths through the spacer.

If your child is still not improving:

  • you can give up to 6 puffs of the blue inhaler every 4 hours

You need to take your child to your family doctor, or an after-hours clinic, or the hospital:

  • if you need to give the blue inhaler more often than every 2 hours
  • if there is no improvement 30 minutes after giving 6 puffs of the blue inhaler

How do I treat my child's asthma attack if I don't have asthma medications?

If your child is showing symptoms of an asthma attack and you do not have a blue inhaler, call 111 for emergency help. While you are waiting for help there are things you can do to help your child breathe better.

  • Sit them upright. Do not lie them down. 
  • Focus on breathing. Get them to take slow and steady breaths.
  • Remain calm, as panicking will make things worse.

When should I seek urgent help for my child's asthma attack?

When to see a doctor urgently

Keep your child sitting up and give them 6 puffs of the blue inhaler through the spacer and see a doctor urgently if your child has any of the following symptoms:

  • Is breathing fast, wheezing and having to use extra effort to breathe.
  • Is breathless at rest.
  • Looks unwell.
  • Looks pale and is beginning to get tired.
  • Gets worse after beginning to get better.
  • Has trouble completing a sentence because of difficulty breathing.
  • You are worried.

Check out the signs that your child is struggling to breathe.

When to seek emergency medical help

With severe asthma it is usually better to dial 111 rather than drive your child in your own car to the hospital.

Keep your child sitting up and give them 6 puffs of the blue inhaler through the spacer. Immediately dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for emergency medical help if your child:

  • Has severe difficulty breathing.
  • Is too breathless to talk.
  • Is floppy and very tired.
  • Is becoming less responsive.
  • Has blue lips and tongue.
  • Has periods of stopping breathing.

With severe asthma, it is usually better to dial 111 within New Zealand (use the appropriate emergency number in other countries) and ask for emergency medical help, rather than drive your child in your own car to the hospital.

While you are waiting for the ambulance, keep giving your child 6 puffs of the blue inhaler through the spacer every 5 minutes.

Will my child grow out of asthma?

Asthma is a long-term condition. The majority of children with asthma have less troublesome asthma as teenagers. Symptoms can appear again in adulthood. If your child has severe asthma, it is more likely to continue or return in later life.

Your child should learn about asthma and gradually take over responsibility for its management, as they become a teenager, with support from you.

Learn more



Content courtesy of KidsHealth NZ which has been created by a partnership between the Paediatric Society of New Zealand (PSNZ) and the Starship Foundation, supported and funded by the Ministry of Health.
Page last reviewed by KidsHealth 2 May 2022.

Credits: KidsHealth NZ.