Asthma in Children

You can limit the impact asthma has on your child's life by learning about asthma and learning how you can help your child follow his or her treatment plan.

Learn about asthma and see your doctor

Educate yourself and your child about asthma. This questionnaire can help you and your child see what you already know about asthma and what you may need to discuss with your doctor.
See your child's doctor regularly to monitor asthma. The frequency of checkups depends on how your child's asthma is classified. Bring the asthma plan to each appointment.
Set goals that relate to your child's quality of life. Decide together what you want to be able to do. Have symptom-free nights? Be able to exercise on a regular basis? Feel secure in knowing you both can deal with an asthma attack? Work with your doctor to make sure your child's goals are realistic and your child knows how to reach them.

Follow your child's action plan

The asthma action plan helps you minimize the long-term effects of asthma and describes which medicines to take every day. The action plan also contains the steps to handle asthma attacks at home. See an example of an asthma action plan (What is a PDF document?). Your child also may have an asthma diary where you or your child records peak expiratory flows, symptoms, and triggers of asthma attacks. This valuable tool can help your doctor manage your child's asthma.
Understand your child's barriers and solutions. What may prevent your child from following his or her plan? These may be physical barriers, such as living far from your doctor or pharmacy. Or your child may have emotional barriers, such as having undiscussed fears about the condition or unrealistic expectations. Talk with the doctor about your child's barriers, and work to find solutions.

For more information on how to monitor and treat asthma, see:

Asthma: Taking Charge of Your Asthma.

Asthma: Using an Asthma Action Plan.

Monitor peak expiratory flow

It is easy to underestimate the severity of asthma. Measuring peak expiratory flow (PEF) is a way to keep track of asthma symptoms at home and to know when your child's lung function is getting worse before it drops to a dangerously low level. For more information, see:

Asthma: Measuring Peak Flow.

Know your child's asthma triggers

A trigger is anything that can lead to an asthma attack. If your child can avoid triggers, he or she may reduce the chance of having an asthma attack. For more information, see:

Asthma: Identifying Your Triggers.

Control allergens

Your child may be allergic to certain substances (allergens). You may reduce your child's asthma symptoms by limiting exposure to those substances.

Control cockroaches, especially if you and your child live in an area where cockroaches are common.
Control dust mites. House dust mites have been linked with asthma in children.¹
Control animal dander and pet allergens. If your pet is a known trigger for your child, you may need to think about giving your pet away. If that is too hard, taking steps such as keeping your pet out of your child's bedroom and dusting and vacuuming often may help your child's asthma.
Control indoor mold, especially if you live in an area with high humidity.

It also may be necessary to avoid exposure to other types of triggers that cause asthma symptoms.

Have your child avoid foods that may cause asthma symptoms. Some children have symptoms after eating processed potatoes, shrimp, or dried fruit. These foods and liquids contain sulfites, which may cause asthma symptoms.
If pain relief medicines such as ibuprofen seem to cause asthma symptoms or make them worse, use acetaminophen (such as Tylenol) for pain relief. (Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome.)

Control symptoms at night

Coughing and wheezing can wake your child. Special problems that might cause night symptoms include:

Delayed allergic reactions. Sometimes allergens that get in the airway can cause problems up to 8 hours later. Talk to your doctor about treating allergies that affect your child at night. The doctor may be able to change your child's medicine or the time your child takes it.
Medicine that wears off in early morning, causing your child to wake up. To make sure that the medicine lasts through the night, the doctor may be able to change your child’s dosage or medicine or the time your child takes the medicine.

Treating a sinus infection, cold, or allergies can keep your child’s symptoms from occurring at night.

Avoid upper respiratory infections

Upper respiratory infections, including the common cold, cause 85% of asthma attacks in young children.¹⁸ Basic preventive measures include the following:

Avoid contact with other people who are ill. If there is an ill child in the home, separate him or her from other children, if possible.
If you have a respiratory infection, such as a cold or the flu, or if you are caring for someone with a respiratory infection, wash your hands before caring for this person.
Do not smoke. Secondhand smoke irritates the mucous membranes in your child's nose, sinuses, and lungs and increases his or her risk for respiratory infections.
Children who have asthma and their family members should get an influenza vaccine (flu shot (What is a PDF document?) or nasal spray vaccine (What is a PDF document?)) every year.

Help your child take medicine

Taking medicines is an important part of asthma treatment. But it can be hard to remember to take them. To help you and your child remember, understand the reasons people don't take their asthma medicines. And then find ways to overcome those obstacles, such as taping notes on the bathroom mirror.

Most medicines for asthma are inhaled. With inhaled medicines, a specific dose of the medicine can be given directly to the bronchial tubes, avoiding or decreasing the effects of the medicine on the rest of the body. Delivery systems for inhaled medicines include metered-dose and dry powder inhalers and nebulizers. A metered-dose inhaler (MDI) is usually used by older children, and nebulizers are used most often with infants.

For more information, see:

Asthma: Using a Metered-Dose Inhaler.

Asthma in Children: Helping a Child Use a Metered-Dose Inhaler and Mask Spacer.

Asthma: Using a Dry Powder Inhaler.

More tips for managing your child's asthma

To manage your child's asthma:

Stay with a daily routine. Make treatment part of normal, daily activities to help your child adjust to the condition and take responsibility for managing treatment. Your child could, for example, get used to taking medicine before brushing his or her teeth.
Check your child's symptoms. If your child is old enough to understand the process, teach him or her what symptoms to watch for and how to check the peak expiratory flow. Help your child understand how to follow his or her asthma action plan.
Inform others in your child's life about asthma. Inform the principal, school nurse, teachers, and coaches at your child's school that your child has asthma. Give the staff a copy of your child's asthma action plan so that they can help your child to take his or her medicine and will know what to do during an asthma attack. Encourage your child to participate in exercise and sports. Asthma, when well controlled, should not prevent your child from participating in sports and other physical activities.

It is important to treat your child's asthma attacks quickly. If your child does not improve soon after treating an attack, talk with a doctor.

During attacks, stay calm and soothe your child. This may help your child relax and breathe more easily.
Don't underestimate or overestimate how severe your child's asthma is. It is often hard to know how much breathing difficulty a baby or small child is having. Seek medical care early for babies and small children with asthma symptoms.

Medications

By:	Healthwise Staff	Last Revised: March 17, 2011
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Lora J. Stewart

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