Asthma management in young children aims to achieve good symptom control, maintain normal activity levels, and reduce the risk of asthma exacerbations, impaired lung development, and drug side effects.

Global Initiative for Asthma (GINA) guidelines, 2022, regarding indications of regular controller treatment in children aged ≤5 years with asthma:

Intermittent or episodic wheezing of any severity can be caused by an isolated viral-induced wheezing episode, a seasonal or allergen-induced asthma, or unrecognised uncontrolled asthma. For all of these conditions, wheezing is initially treated with a short-acting beta-2 agonist (SABA) every 4-6 hours as needed until symptoms resolve, usually within 1-7 days. However, there is uncertainty regarding the use of additional drugs in these children, especially when the nature of the episode is unclear. The indications of regular controller treatment in these children:

• Regular controller treatment should be started, and the response should be assessed if the history and symptom pattern indicate an asthma, respiratory symptoms are uncontrolled, and/or wheezing episodes are frequent (e.g., ≥3 episodes in a season).
• Regular controller treatment might be considered if a child presents with less frequent but more severe episodes of viral-induced wheezing.
• A trial of regular controller treatment should be considered to determine whether the symptoms are caused by asthma if the diagnosis of asthma is uncertain, and inhaled SABA therapy or courses of antibiotics need to be repeated frequently, e.g. more than every 6-8 weeks. At this stage, the patient should be referred for specialist advice.