As children move into cold weather activities, a familiar pattern seems to emerge. Temperatures drop, air becomes cold and dry—and some kids begin to cough and feel fatigued more quickly than their peers. They even secretly push through chest tightness.
“These kids are experiencing an airway response to cold weather during outdoor sports and activities,” says Gurpreet Phull, MD, director of pediatric pulmonology at Atlantic Health. “It’s a condition that can quietly drain a child’s energy long before anyone realizes there’s something bigger going on.”
When lungs limit performance
Exercise-induced asthma or bronchospasms can start just minutes into exercise or just after a child stops the activity—and last for about 30 minutes. Here are a few classic signs:
- Coughing and shortness of breath from activities or sports
- Wheezing or tightness and pressure in the chest
- Working harder than peers to keep up
- Losing stamina and endurance in cold weather
- Avoiding activities or sports due to breathing troubles
- Getting winded quickly
- Worsening each year with less tolerance for cold air exercise
Diagnosing exercise-induced asthma
If your child is experiencing these types of symptoms, consider talking with a pediatric pulmonologist.
A common test they perform, known as the cold air exercise challenge, safely measures how a child’s lungs behave in cold air conditions. The test helps diagnose exercise-induced asthma or bronchospasms, which cause the airways to narrow during or just after vigorous exercise.
The pediatric pulmonologist begins the test by measuring the child’s resting lung function. Then, while the child runs on a treadmill, the doctor gradually increases speed and incline while delivering cold, dry air.
“This specialized diagnostic test recreates the real outdoor conditions we see in the fall and winter months—combining cold dry air and physical exertion—all in a safe, controlled clinical setting so we can measure and evaluate a child’s lung function and airway reactivity,” says Dr. Phull.
How to know when it is something more
Dr. Phull explains that kids don’t need to push through uncomfortable symptoms. With the right evaluation, a pediatric pulmonologist can identify what’s happening in the child’s airways and create a personalized plan to improve their quality of life.
“Many young people don’t realize that what they’re feeling during cold-weather activities isn’t normal and could be a sign of exercise-induced bronchospasm or asthma,” says Dr. Phull.
Simple solutions for better breathing
“The good news is that we can easily test and treat it. For example, some children are prescribed inhalers ‘just in case.’ With the cold air exercise challenge, we’ll know whether the child truly needs an inhaler—and exactly how and when it should be used,” he says.
He also shares some practical steps that families can take at home.
“Dressing in layers—an undershirt, T-shirt, sweater and fully zipped coat—helps keep the larger airways warm and reduces bronchospasms. Wearing a scarf or mask also helps. It encourages breathing through the nose, rather than mouth. Mouth-breathing pulls in cold, dry air which dehydrates the airway and can trigger bronchospasms.”
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