Asthma is highly under-diagnosed in all age groups and more so in children. It is a common perception by parents that if a child is not breathless then it cannot be asthma. The clinical presentation of asthma in children is quite different from that in adults. In reality only a few children with asthma have breathlessness as compared to adults where breathlessness is a common symptom. The other important symptoms could be chronic cough or non-improvement in cough with the usual medicines, cough recurring very frequently, night time cough, cough on exercise/laughing or any other activity and recurrent wheezing. A lot of children with asthma will have recurrent episodes of cough with wheezing (sometimes recognized as whistling sounds by parents but many a times recognized by the treating doctor on chest examination with a stethoscope) requiring treatment with antibiotics, syrups and nebulizations. There might be multiple such episodes throughout the year ranging from 4-5/year to daily symptoms. The duration of each episode ranges from 5-7 days to 3-4 weeks.
It also need to be clarified that many children might not these symptoms regularly but have underlying airway swelling and are extra-sensitive to allergens. These stages also need to be treated for preventing symptoms and flare-ups of asthma.