Exercise-induced asthma: The symptoms and how to prevent it in your child
Up to 90% of children with asthma have exercise-induced symptoms, easily making it the most common trigger for asthma in the pediatric population. 
These symptoms are also quite common in children with allergic rhinitis (up to 45% of them, in fact).
Exercise-induced symptoms-wheezing, coughing, chest tightness or squeezing-usually begin 5 to 10 minutes after you start vigorous exercise and peak a few minutes after you stop. "Symptoms can last for about 30 to 90 minutes without intervention," says Corey Martin, M.D., a pediatric pulmonologist for the Division of Pediatric Pulmonology at The Herman & Walter Samuelson Children's Hospital at Sinai.
Any trigger for asthma in children is concerning for parents, but those related to physical activity can be most concerning. There are measures, however, that can be taken to prevent exercise-induced symptoms in your child, beginning with increasing their overall physical fitness. "We usually recommend about an hour of moderate to vigorous exercise a day, and then for children to be as active as possible throughout the rest of the day," Martin says.
Something that can help during physical activity in cold weather is having your child wear a mask or scarf over their mouth. "What this does is it helps you warm that air before it goes into the lungs. That warm air tends to be better tolerated than cold air, which can cause wheezing of the airways," Martin says.
It is also recommended that children with asthma breathe through their nose as much as possible during exercise and do warm-ups for 5 to 10 minutes beforehand. Another potential remedy (if your child's doctor approves): two puffs of albuterol with a spacer 10 to 15 minutes prior to exercise. "This is an excellent way to prevent the airways from squeezing down," Martin says.
If your child has more frequent symptoms, intranasal corticosteroids may be prescribed, or if they're having daily symptoms, a daily controller medication may be needed.
If you are wondering about realistic goals or constraints for kids with asthma, Martin says as long as their condition is well controlled, there generally are no limits.
"I would say that there's probably only 5% of asthma patients that really are truly limited, usually only the most severe asthma sufferers," Martin says. "But otherwise, the vast majority of kids who have asthma and whose condition is well-controlled should live a normal, happy life and should be able to achieve any goals they want to."
The Division of Pediatric Pulmonology has outpatient clinics at Sinai Hospital of Baltimore and Quarry Lake (2700 Quarry Lake Drive, Suite 270, Baltimore, MD 21209) and will soon open a clinic in Loch Raven. Immediate patient appointments are available. To schedule an appointment and learn more about our services, call 410-601-4096.