New guideline defines criteria for diagnosing asthma before age 5

A new global guideline from the Global Initiative for Asthma (GINA 2025) establishes objective criteria for diagnosing asthma in children under 5. Released in May, the document represents an important step toward improving care for children with frequent respiratory symptoms.

Until now, children in this age group with recurrent wheezing could have a diagnosis of asthma suggested, but not necessarily confirmed. "There has always been great caution regarding how to name or treat recurrent wheezing in infants and preschoolers, because it's not always asthma and can be a transient childhood condition," says pediatric pulmonologist Fabio Muchão of Einstein Hospital Israelita. "However, the new guideline consolidates something that many pediatric pulmonologists and pediatricians already practiced: treating patients with significant symptoms and risk factors for asthma with medications for this condition."

According to the document, the diagnosis of asthma in young children must include three criteria: recurrent episodes of wheezing or at least one episode of wheezing with asthma-like symptoms (e.g., coughing during physical activity, laughing, crying, sleep), absence of other diseases that can cause this condition, and improvement of symptoms with asthma medication.

For Muchão, the new guidelines can provide parents and pediatricians with greater confidence in how to treat these children. "There's a certain fear of this diagnosis, which is unfounded, because well-treated asthma can be controlled," he assures. According to the specialist, the diagnosis can also facilitate treatment adherence.

Asthma and the challenges of control

Asthma is a chronic, multifactorial disease with no cure but is manageable. It is associated with genetic and environmental factors. According to the Ministry of Health, it affects approximately 20% of the Brazilian population and is one of the most common chronic diseases in childhood and adolescence. Exposure to respiratory viruses, allergens, pollution, and climate change (extreme heat or cold) can trigger attacks.

Symptoms include difficulty breathing, wheezing, coughing, and a feeling of tightness in the chest. Without proper treatment, attacks can be severe and, in some cases, lead to death. Treatment may require the use of relief and maintenance medications, such as inhaled corticosteroids and bronchodilators, as directed by a doctor.

In addition to medication, good practices for controlling asthma include keeping your home clean, avoiding common allergens like dust mites and mold, and controlling exposure to pollutants like cigarette smoke.

Parents and caregivers should seek medical evaluation whenever a child experiences recurring episodes of wheezing, persistent coughing, or difficulty breathing, especially when exposed to factors that can trigger an attack. Early diagnosis of asthma allows the child and family to learn to recognize signs of worsening, avoiding hospitalizations and ensuring a good quality of life.

Source: Einstein Agency

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