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ગુજરાતી: બાળકોમાં અસ્થમા (દમ): વારંવાર ઘરઘરાટ, રાત્રે ખાંસી, કારણ, ઇન્હેલરનું સત્ય અને આયુર્વેદમાં બાળ તમક શ્વાસ
हिंदी: हिंदी
Every October and November, seven-year-old Aarav’s “chest would close up” three or four times: cough at night, a whistling sound when breathing, sometimes a night-time rush to the clinic for a nebuliser. He was kept out of running races at school and was absent 20 days a year. The doctor diagnosed asthma and prescribed a daily inhaler (controller), but the family was afraid: “an inhaler means a habit, for life.” For three months they managed with syrups and decoctions, and the attacks continued. Then came understanding: a controller inhaler with a spacer delivers a low dose of medicine directly to the lungs; at home, incense sticks and mosquito coils were stopped, sheets and mattresses put in the sun, dusty toys removed, and his father quit smoking; an action plan; Ayurvedic agni deepana, less cold food, curd and night-time sweets, warm water, gentle support on the vaidya’s advice and breathing games. That winter there was not a single night-time emergency, and in March Aarav came third in the race.
Childhood asthma is a long-term swelling (chronic inflammation) of the airways of the lungs, in which the tubes become overly sensitive; when a trigger is met, the muscles around the tubes tighten, and inside there is swelling and sticky mucus, so the air passage narrows: wheezing (a whistling sound), cough, chest tightness and breathlessness. It is the most common chronic disease of children. The good news is that with proper treatment most children can live a completely normal life: play, swim and run. In Ayurveda it is called tamaka shwasa, a type of shwasa roga in which kapha blocks the pranavaha srotas and vata moves in the reverse direction (pratiloma); the root is often in the amashaya (digestion), which is why Charaka called shwasa “pittasthana samudbhava”.
Key Takeaways
- Recurrent wheezing, cough at night or early morning, breathlessness while playing: signs of asthma.
- Dust mites, smoke, cold viruses, cold air, pollen: the main triggers.
- An inhaler is not a “habit”; it is the safest method, a small dose going directly to the lungs.
- Ayurveda’s tamaka shwasa treatment, correcting agni and ama, kapha-vata shamana, classical formulations, diet, pranayama and rasayana, reduces attacks and prevents them from returning; started alongside the inhaler, which the doctor then gradually reduces.
Symptoms
- Wheezing, a whistling sound while breathing out
- Frequent cough, especially at night, early morning, after play, after laughing or crying
- Cough continuing for weeks after a cold
- Chest tightness; older children say “my chest feels pressed”
- Getting breathless quickly while playing or running, avoiding play
- Sleep broken by cough at night, tiredness during the day
- In young children, fast breathing, tiredness while eating or drinking, irritability
- In some, only a dry cough (“cough variant asthma”)
Often along with it: allergic cold (sneezing, blocked nose, itchy nose), eczema, asthma or allergy in the family.
Important: in children under 5, wheezing with viral infections is common, and not all of them have asthma; many get better as they grow. But if wheezing is frequent, severe or occurs without a virus, and there is allergy and family history, asthma is more likely.
Causes and Triggers
Risk factors
- Asthma, allergy, eczema in the family
- Eczema, food allergy, allergic cold in the child (the “atopic march”)
- Exposure to smoking in pregnancy and childhood
- Premature birth, low birth weight
- Severe respiratory infection in infancy (RSV bronchiolitis)
- Urban air pollution
- Obesity
Triggers (that bring on an attack)
- Viruses such as cold and flu, the most common in children
- Dust mites, mattresses, pillows, curtains, carpets, soft toys
- Smoke, cigarettes and bidis, incense sticks, dhoop, mosquito coils, chulha, firecrackers
- Cold, dry air, change of season
- Pollen, fungus (damp walls)
- Pet hair and fur, cockroaches
- Exercise (especially in cold air)
- Strong smells, perfume, paint, cleaning chemicals
- Air pollution, construction dust
- Emotional stress, laughing or crying hard
- Acidity (reflux)
- Some medicines
Ayurvedic view
- Kapha-increasing food, cold food, curd (especially at night), ice cream, cold drinks, too many sweets, maida, fried food, heavy meals
- Raja (dust), dhuma (smoke), cold wind, clearly listed by Charaka
- Agnimandya, ama
- Daytime sleep, late dinner
- Inborn kapha prakriti
Ayurvedic Understanding
Charaka described five types of shwasa roga: maha, urdhva, chhinna, tamaka and kshudra; of these, tamaka shwasa matches modern asthma most closely. The symptoms of tamaka shwasa described by Charaka, wheezing, cough, some relief when mucus comes out, worsening on lying down and relief on sitting up, aggravation in cloudy, cold, damp weather and with kapha-increasing food, are a surprisingly accurate picture of modern asthma. It is called “tamaka” because during an attack the person feels as if darkness is coming over them.
Charaka calls shwasa and hikka “pittasthana samudbhava“, meaning the root of the disease lies in the amashaya (digestive system); from there kapha and vata reach the pranavaha srotas. This fits the modern view that gut health, food allergy and reflux play a role in asthma. Charaka also counted shwasa as “yapya”, something that can be kept under control, and as sadhya (curable) in children and in recent illness.
A lovely instruction from Charaka: in shwasa roga, gentle treatment, not excessive shodhana, especially in the weak and in children; warm, light, kapha-vata pacifying.
Samprapti: kapha-increasing food, dust and smoke, cold, agnimandya → kapha and ama in the amashaya → vata becomes pratiloma and carries kapha into the pranavaha srotas → obstruction of the srotas → tamaka shwasa.
Samprapti vighatana: nidana parivarjana (triggers, kapha-increasing food) → agni deepana and ama pachana → expelling kapha → vata anulomana → cleansing the srotas → strength and rasayana (apunarbhava).
Classical References
- Charaka Samhita, Chikitsa Sthana, Chapter 17, Hikka-Shwasa Chikitsa (tamaka shwasa).
- Sushruta Samhita, Uttara Tantra, Chapter 51, Shwasa Pratishedha.
- Ashtanga Hridaya, Nidana Sthana, Chapter 4 and Chikitsa Sthana, Chapter 4, Shwasa-Hikka.
- Kashyapa Samhita, reference for children’s diseases.
Diagnosis
- History and examination, the doctor listens for wheezing with a stethoscope
- Spirometry (after 5–6 years), lung function, improvement after medicine
- Peak flow meter, monitoring at home
- FeNO (at some centres), airway inflammation
- Allergy tests, skin test, IgE
- Chest X-ray, to rule out other causes (infection, a stuck object)
- Response to treatment, often the basis of diagnosis in young children
Other causes of wheezing: a swallowed object (sudden cough and wheeze, emergency), bronchiolitis, tuberculosis, reflux, heart disease, cystic fibrosis; so a doctor’s examination is necessary.
Modern Treatment, the Truth About Inhalers
Two types of medicine
- Reliever, a fast-acting bronchodilator (airway-widening) medicine; during an attack it opens the airways within minutes. If it is needed more than twice a week, asthma is not under control.
- Controller (preventer), such as an inhaled steroid; taken daily in a small dose, it reduces inflammation and prevents attacks. The effect shows in weeks, and it continues even when there are no symptoms.
Myths about inhalers
- “Inhalers become a habit”, wrong; an inhaler is not an addiction. Because asthma is long term, the medicine runs long, like spectacles.
- “The inhaler is the last resort”, wrong; the inhaler is the first and safest option.
- “Steroids are dangerous”, the dose in an inhaler is hundreds of times smaller than in tablets or syrup and goes directly to the lungs; safe under a doctor’s supervision. Repeated courses of oral steroids, which have to be given when there is no control, are more harmful.
- “Syrup is better, inhalers are for adults”, wrong; with syrup the medicine goes through the whole body, with more side effects.
The right way
- Spacer (with a mask in young children), for almost every child; more medicine reaches the lungs
- Shake the inhaler → puff into the spacer → 5–6 calm breaths
- Rinse the mouth after a steroid inhaler
- Show your technique at every doctor visit
- The doctor regularly reduces or increases the dose; if control is good, it can be reduced
- Do not stop on your own
Asthma Action Plan
Make a written plan with the doctor, with copies at home, at school and with the grandparents:
- Green (good), no symptoms, can play, daily controller
- Yellow (caution), cough, wheezing, waking at night, reliever as the doctor said, inform the doctor
- Red (emergency), cannot speak, pulling in between the collarbones and ribs, blue lips, no relief from the reliever: go to hospital immediately, reliever on the way
Useful Ayurvedic Support (in the vaidya’s child dose)
The right medicine, dose, anupana and timing are decided by the vaidya according to the person’s prakriti, age, other illnesses and current medicines.
- Sitopaladi churna, a gentle, popular formulation for kapha and cough in children.
- Vasa (adulsa), expectorant, traditional for the airways; in the form of vasavaleha.
- Kantakari / vyaghri haritaki avaleha, classical in shwasa and kasa.
- Turmeric, in food, in warm milk (if dairy increases kapha, take the vaidya’s advice).
- Chyawanprash, as a rasayana when there are no attacks, before the season (apunarbhava).
Extremely important: Ayurvedic medicine is not in place of the inhaler or controller, but alongside it. Do not lose time on decoctions during an attack. Avoid unknown “asthma medicines” containing heavy metals or claims like “cure asthma in one dose”; hidden steroids have been found in some uncertified medicines. No honey for a child under 1 year.
Gradual Ayurvedic approach: At first, Ayurvedic treatment runs alongside the doctor’s inhaler, without stopping anything. As work is done on agni, ama and kapha-vata, diet and routine improve, and rasayana builds respiratory strength, attacks and night symptoms reduce. When symptoms stay under control continuously for some months, the doctor himself gradually reduces the controller; in many children it is eventually stopped too, and then Ayurvedic dinacharya, ritucharya and rasayana (apunarbhava treatment) reduce the chance of attacks returning. This reduction is always by the doctor’s decision only; keep the reliever handy at home.
The Home Environment, Trigger Control
- No smoking at all in the house, including smoke on clothes
- No incense sticks, dhoop or mosquito coils in the child’s room; use a mosquito net
- Wash sheet and pillow covers in hot water every week, put mattresses in the sun
- Dust mite-proof covers (if possible)
- Fewer carpets, heavy curtains and dust-collecting items
- Fewer soft toys, washable ones
- Clean with a damp cloth, when the child is not present
- Remove damp and fungus
- If allergic to pets, keep them away from the bedroom
- Stay indoors on days of firecrackers, construction dust or smog
- Avoid strong cleaning chemicals and perfumes
Diet
Take: warm water, fresh hot meals, moong dal, khichdi, vegetable soup, ginger and tulsi (older children), turmeric, amla (vitamin C), seasonal fruit, a light early dinner.
Reduce: cold food from the fridge, ice cream and cold drinks, curd and bananas at night, sweets and chocolate, maida, fried food, packaged food (preservatives), very heavy meals.
Note: stop only the food to which there is a true food allergy; stopping milk and fruit indiscriminately spoils nutrition. Not every food is a trigger in every child; keep a diary.
Pranayama and Breathing Games
- Blowing balloons, bubbles, whistles, fun breathing practice for young children
- Belly breathing (diaphragm), place a toy on the belly and watch it go up and down
- Bhramari, the humming of a bee, calm
- Anulom-vilom, after 8 years, slowly
- Pursed lip breathing, breathing out slowly through rounded lips
- Asanas, bhujangasana, matsyasana, cat-cow
Pranayama is not a substitute for medicine and is not for use during an attack; regular practice increases control over breathing and confidence.
Play and Exercise
Children with asthma can play, and should play. Many Olympic athletes have asthma. If needed, the doctor will advise a reliever before exercise; warm up; a scarf over the mouth in cold air; swimming is often a good option. If play has to be avoided, asthma is not under control; tell the doctor.
For School
- Inform the teacher, give a copy of the action plan
- Reliever and spacer in the school bag
- Inform the PT teacher
- Medicine on trips and picnics
- If absences increase, review control with the doctor
By Season and Prakriti
Monsoon, sharad and early winter (August–November), viruses, damp, fungus, Diwali firecrackers: the main time for attacks; see the doctor before the season, chyawanprash, flu vaccine (on the doctor’s advice). Spring, kapha aggravation and pollen; light food, fewer sweets. Summer, usually good, but watch AC and cold drinks. Children of kapha prakriti, avoid heavy, cold food and daytime sleep; vata, dry cough, cold air; ghee and warmth; pitta, acidity as a trigger, less spicy and sour food.
The Parents’ Mind
Hearing a child wheeze at night is the most frightening experience for parents. Fear pulls in two directions: some fear the inhaler, some do not let the child play. Both are harmful. Understanding asthma reduces fear, and with an action plan in hand you know what to do. Do not label the child “sick”; they are a normal child who takes a little care. Gradually give older children responsibility for their own inhaler and triggers.
Will the Child Outgrow It?
In many children, especially those with wheezing only with viruses, mild asthma and no allergy, symptoms reduce or go by adolescence. But in some they reappear later. So do not avoid treatment now thinking “it will go away when he grows up”; uncontrolled asthma can affect lung development.
Common Myths
- “Inhalers become a habit”, wrong.
- “Children with asthma cannot play”, wrong.
- “Stop milk and bananas for everyone”, only if they are a trigger.
- “No symptoms, so stop the medicine”, reduce the controller only on the doctor’s advice.
- “Asthma is contagious”, wrong.
- “One medicine cures it forever”, avoid false claims.
Precautions
- Severe attack: emergency; no time for home remedies.
- Sudden cough and wheeze, something was in the mouth while playing, a swallowed object: emergency.
- Inhaler and Ayurvedic medicine: tell both the doctor and the vaidya.
- Avoid unknown “asthma herbs”.
Do’s and Don’ts
Do: diagnosis, action plan, regular controller, spacer, trigger control, smoke-free home, warm light meals, pranayama and breathing games, play, preparation before the season.
Don’t: fear the inhaler, stop medicine on your own, smoking or incense in the house, cold food and curd at night, keep the child away from play, wait during a severe attack.
Case Studies
Case 1: Attacks every winter, Ayurveda alongside the inhaler
7 years; attacks at every change of season, three or four night-time emergencies a year, frequent colds, poor appetite, a lot of cold and sweet food. The pediatrician started a controller with a spacer. Alongside, the vaidya treated it as kapha-vata predominant tamaka shwasa in Ayurvedic terms: agni deepana, sitopaladi churna and vasavaleha in a child dose, abhyanga of the chest with warm sesame oil and saindhava and gentle fomentation, no curd, cold food or sweets at night, a light early dinner, a smoke-free home, breathing games. That winter there was not a single emergency. After six months of steady improvement the pediatrician reduced the controller dose; Ayurveda continued, with chyawanprash before the season (apunarbhava). At a year and a half the doctor stopped the daily controller; the reliever was only kept at home and was rarely needed in the whole of the next year. Now the child takes part in races. (Results may vary from person to person.)
Case 2: Cough only at night
5 years; for two months a dry cough only at night and early morning, many cough syrups failed. The pediatrician found cough variant asthma and gave a controller for a few weeks. Alongside, the vaidya gave kantakari avaleha and sitopaladi in a child dose, warm water with ghee and turmeric before bed (if dairy does not suit), no curd, fruit or sweets at night, removal of the carpet and soft toys from the bedroom, and an early light dinner. In two weeks the night cough reduced a lot, and in three months the doctor stopped the controller; with Ayurvedic diet and routine and rasayana before the season continued, the cough did not return the next winter. (Results may vary from person to person.)
Case 3: An atopic child
9 years; eczema, allergic cold, mild asthma; allergy tests showed dust mite. Alongside the doctor’s treatment (nasal spray, controller), the vaidya worked on the root: agni deepana to correct agni and ama, haridra khanda and vyaghri haritaki avaleha in a child dose, anu taila in the nose in a child dose (pratimarsha nasya), stopping viruddha ahara, dust mite control, anulom-vilom and bhramari, and chyawanprash when there were no attacks. In six months sneezing, colds and eczema flares reduced; in a year the doctor stopped both the controller and the spray, and the child stayed healthy on Ayurvedic dinacharya, ritucharya and rasayana alone. (Results may vary from person to person.)
When to Go to Hospital Immediately (Red Flags)
- Cannot finish a sentence, cannot cry or eat
- Pulling in between the ribs or at the throat; flaring nostrils
- Blue lips or nails
- No relief from the reliever, or needed again within 4 hours
- Drowsiness, confusion
- Very fast breathing
- Wheezing goes quiet but breathing difficulty increases (“silent chest”, very serious)
About Dr. Nikul Patel
Dr. Nikul Patel (BAMS) is an Ayurvedic physician at Lifecare Ayurveda and has been practising since 1999, that is, for 27 years. In bala tamaka shwasa (childhood asthma), he gives honest guidance on agni-kapha balance, trigger control, diet, breathing practice and safe Ayurvedic support in child doses, in coordination with the pediatrician’s treatment.
Frequently Asked Questions
What are the symptoms of asthma in a child?
Recurrent wheezing, cough at night or early morning, chest tightness, breathlessness while playing.
Do inhalers become a habit?
No; an inhaler is a safe method, a small dose going directly to the lungs.
Can a child with asthma play?
Yes; with controlled asthma all sports are possible.
Does asthma go away as children grow?
It reduces in many, but there is no guarantee; control is needed now.
What is asthma called in Ayurveda?
Tamaka shwasa; formulations such as sitopaladi and vasa on the vaidya’s advice, as support alongside the inhaler.
People Also Ask
Why is a spacer necessary?
More medicine reaches the lungs and less stays in the mouth.
Do incense sticks worsen asthma?
Yes, smoke is a major trigger.
Can curd be eaten at night?
According to Ayurveda it increases kapha; better avoided in children with asthma.
What is an asthma action plan?
A written plan of what to do and when, according to green, yellow and red zones.
What is a silent chest?
In a severe attack even the wheezing stops: go to hospital immediately.
Conclusion
Childhood asthma is a disease to understand, not to fear. The right diagnosis, correct use of the inhaler with a spacer, a written action plan and a smoke- and dust-free home are the foundation. Ayurveda’s tamaka shwasa approach, correcting agni, classical formulations such as sitopaladi, vasa and kantakari, avoiding kapha-increasing food, a warm daily routine, pranayama and rasayana before the season, works on the root. With this treatment started alongside the inhaler, in many children the doctor can gradually reduce the inhaler, and with Ayurvedic ritucharya and rasayana the attacks do not keep coming back; the child gets free breathing and an active childhood. Every child’s results may differ.
Dr. Nikul Patel (B.A.M.S.)
307, 3rd Floor, Shalin Complex, Above Farki Lassi, Krishnabaug Char Rasta, Maninagar, Ahmedabad – 380008
Timings: 10:00 AM to 1:00 PM and 3:00 PM to 6:30 PM | Saturday–Sunday: Closed
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