Many children with asthma are not correctly diagnosed with the disease. Hidden asthma is asthma that has not produced obvious symptoms and has therefore escaped detection by parents and medical professionals. Even though the child may not be experiencing wheezing or other signs of asthma, inflammation of the airways may be present.

In some cases in which underlying inflammation has existed without a proper diagnosis of asthma, a child may have a full-blown asthma attack as the first noticeable symptom. In those cases, the child often needs emergency medical services and may be hospitalized since the child has not been previously diagnosed and therefore has no asthma prescriptions to treat the illness.

The risk factors for asthma in children are obesity, low birth weight, living in urban areas that have high levels of air pollution, and exposure to tobacco smoke. Some risk factors have a genetic component. If the members of the child’s family have asthma, eczema, or allergies, the child is at greater risk of developing asthma. The child may also have a personal history with allergies or eczema that makes the child more prone to asthma.

Other respiratory infection and conditions may increase the child’s risk of developing asthma. Children who have had croup may be up to twice as likely to develop asthma than infants and children who have not. Croup and other respiratory illnesses can cause hypersensitivity of the respiratory system. Respiratory Syncytial Virus (RSV) is a respiratory illness that affects newborns. RSV increases the risk of asthma in children.

Diagnosing asthma in children can be more difficult than in adults. Children over the age of six may be able to be accurately diagnosed using the standard asthma tests like a lung function test. Young children cannot perform the breathing exercises necessary for an accurate spirometry or lung function test. Doctors may need to rely on a physical examination and information about the asthma symptoms that the child is experiencing.

For toddlers showing signs of asthma, the doctor may be reluctant to treat the asthma with regular asthma medication. Little information is available on the safety of these medications for very young children. Older children may do very well when provided with a rescue asthma inhaler to use when asthma symptoms flare-up. Other children need a daily preventative medication to reduce the frequency their symptoms. The general rule for medication management of asthma in children is that the least amount of asthma medication used to effectively control the symptoms, the better.