Around 8 to 10 percent of children in Germany suffer from asthma.
Studies show a connection between asthma and lifestyle habits and circumstances. In westernized countries, asthma is much more common in children than in Eastern European regions and developing countries.
- In Australia and New Zealand, 15% of children suffer from asthma. This is the highest proportion in the world.
- In poorer developing countries, the proportion is only around 2 percent.
Comparisons at the beginning of the 1990s during German reunification also support these observations. In the eastern federal states, the number of asthma cases in children rose to the level of the western federal states after reunification.
Western lifestyle habits and circumstances therefore have a clearly recognizable negative influence. This could also be partly related to diet.
Paradoxically, too much hygiene can promote the development of asthma in children. Through contact with germs, children develop better immune protection against asthma, among other things.
Studies show that children in rural areas generally have better immune protection than children in urban areas.
Certain genes and an unfavorable interaction with environmental factors also promote the development of asthma.
Furthermore, studies show a connection between the amount of IgE in the unborn child and the development of asthma.
The body's immune system produces immunoglobulin E (lgE) as a defense against parasites. It uses this antibody specifically against foreign substances entering the body.
If there are large amounts of IgE in the umbilical cord at birth, the child has a threefold increased risk of asthma. Corresponding studies have been carried out on infants and toddlers.
Excessively high IgE values are therefore a clear indication of an increased risk of developing allergic asthma.
Guide values for immunoglobulin E (lgE)
Age | Total lgE |
Adults | up to 100 IU/ml (240 µg/l) |
Adolescents (10-15 years) | up to 200 IU/ml (480 µg/l) |
Children (6-9 years) | up to 90 IU/ml (216 µg/l) |
Infants (1-5 years) | up to 60 IU/ml (144 µg/l) |
Babies (up to 1 year) | up to 12.2 IU/ml (29.3 µg/l) |
Medicine divides the clinical picture of asthma in children into four stages. The distinction is made according to the severity of the course of the disease.
The FEV1 value is important in the differentiation. It describes the amount of air that the patient can exhale within one second. It is therefore also referred to as second capacity. The more constricted the bronchi of the lungs are, the lower the FEV1 value.
The PEF value is a similar indicator. PEF stands for Peak Expiratory Flow and refers to the highest speed of exhaled air.

Children with asthma must learn early on how to deal with asthma attacks and breathlessness. An inhaler helps in emergencies © Africa Studio | AdobeStock
Stage 1 asthma
The child suffers from mild asthma that only occurs occasionally. This is also known as intermittent asthma.
This intermittent condition occurs intermittently in different states. The FEV1 value is over 80 percent of the target value. The PEF value measured at the same time is less than 20 percent of the target value.
Stage 2 asthma
Mild, persistent asthma is present. The child occasionally suffers from shortness of breath.
The PEF value is less than 20-30 percent of a normal target value. The FEV1 value is <80 percent of the target value.
The child occasionally experiences symptom-free phases. On average, these phases occur at intervals of less than two months.
Stage 3 asthma
The symptoms occur as peristent asthma on several days per week. Symptoms may also occur at night.
The PEF value settles at less than 30 percent of the target value, while the FEV1 value is <80 percent.
Stage 4 asthma
In the most severe asthma stage, the patient has severe, peristent asthma. It also occurs frequently at night.
Now the PEF value fluctuates by more than 30 percent of the target value, the FEV1 value is <60 percent of the target value.
During the consultation with the child's parents, the doctor asks about the patient's medical history. The time of onset of the symptoms also plays a key role.
This is followed by a comprehensive physical examination. In particular, the doctor listens to the lungs with a stethoscope.
Through a comprehensive lung function test, the doctor determines typical values for lung function such as
- Lung volume,
- vital capacity,
- FEV1 value,
- airway resistance
- and
- PEF value
value.
The doctor also looks specifically for allergies that can promote or even trigger the development of asthma in children.
There are different forms of therapy for the treatment of asthma in children.
Basic therapy (long-term therapy)
Treatment as basic therapy includes long-term anti-inflammatory medication such as glucocorticoids (cortisone).
In more severe cases, the doctor will also prescribe long-acting beta-2 sympathomimetics (LABA). These include formoterol and salmeterol, for example. These medications are usually taken via an inhaler.
Seizure therapy (on-demand therapy)
This type of therapy is required for acute asthma attacks. Fast-acting on-demand medication is used here, such as
- Fenoterol,
- salbutamol or
- terbutaline
are used. The patient inhales these fast-acting medications as beta-2 sympathomimetics (SABA).
The advantage of these medications is their rapid effectiveness. During an asthma attack, they cause the bronchial muscles to relax within a few minutes. This quickly relieves the asthma symptoms.
However, these medications are not able to cure the inflammation of the bronchial tubes.
Preventive therapy
Preventive therapy primarily involves avoiding cold air or house dust.
The clinical picture of asthma in children requires a comprehensive and precise diagnosis by a doctor.
The disease can often be cured with targeted therapy tailored to the child.