Managing asthma in children

Sometimes it might seem like your child is the only person in the world with asthma. That is not true. There are about 20 million people in the United States with asthma. When their asthma is not well controlled, some children are not able to play sports or take physical education (PE). Children with poorly controlled asthma miss 14 or more school days each year.

By understanding what asthma is and how you can control it, your child with asthma can live an active life, participate in all activities and avoid unnecessary visits to the Emergency Room or hospital.

Three things happen in the airways during an asthma attack or flare:

  1. The muscles around the breathing tubes (airways) tighten or squeeze
  2. The inside (lining) of the airways gets swollen and sensitive
  3. Thick mucus is made and blocks the airways

All of these things make it hard to breathe when asthma is not well controlled.

  • Look for the symptoms of asthma

    Symptoms of asthma include:

    • coughing
    • wheezing
    • tight chest
    • shortness of breath

    These symptoms may be worse after running or playing or at night. Your child does not need to have all of these symptoms to be diagnosed with asthma. The symptoms may change over time.

  • Different degrees of asthma

    There are different degrees of asthma, and symptoms can be present all the time, or they can come and go.

    Asthma is classified based on whether or not the asthma is under control.

    Under control means your child is not coughing, wheezing or having shortness of breath. They can run, play, and sleep without difficulty. They can go to school everyday.

  • Know if your child’s asthma is under control

    There are excellent treatments available for asthma, but there is no cure. Your child’s asthma is under control when your child:

    1. Does not require the use of a reliever inhaler more than two times a WEEK, DURING THE DAY to relieve symptoms.
    2. Does not require the reliever inhaler more than two times a MONTH, AT NIGHT to relieve symptoms.
    3. Has breathing tests that are normal or near normal.
    4. Does not need to go to the emergency room, have hospital admissions or unscheduled doctor visits.
    5. Is able to run, play, and be active without any breathing trouble.

    Good asthma control means:

    You have asthma symptoms less than two times a week.

    • That means:
      • NO coughing
      • NO wheezing
      • NO shortness of breath
      • NO tight chest
    • You should not miss school or work because of asthma symptoms
    • You should not have side effects from your asthma medications

    If your asthma is NOT under control, talk to your health care provider about making a plan and getting control.

  • Goals and tips: know the warning signs of asthma symptoms

    Setting goals when you are managing your child’s asthma is an important part of controlling asthma. These are reasonable and attainable asthma goals. Your child should:

    • Be able to have normal activity levels (including exercise)
    • Not have asthma symptoms (coughing, wheezing, chest tightness or shortness of breath) during the day
    • Be able to sleep through the night without asthma symptoms
    • Not need to go to the emergency room or need to be admitted into the hospital because of asthma
    • Have normal or near normal breathing tests
    • Get the most benefit from their asthma medications without side effects

    Additionally, you and your child should be satisfied with the asthma care you are getting when you see your health care professional.

    Tips for the caregiver

    • Asthma should not limit activity or interfere with normal activities of children. Encourage your child to be active and to tell you if they are having any asthma symptoms
    • The best way to overcome your anxiety and feelings of helplessness is to understand your child’s condition and take control of your child’s treatment
    • Remember to always tell your child: “You control your asthma. Don’t let your asthma control you!”
    • Focus attention on the things your child can do, not on the things your child cannot do

  • Know the warning signs of asthma symptoms

    You and your child can better manage your child’s asthma by knowing and recognizing the warning signs of asthma symptoms. Most people with asthma have warning signs (physical changes). These occur hours before symptoms begin. It is possible asthma episodes can occur without warning.

    Treat your child’s asthma symptoms early so you can help prevent an asthma attack or keep it from becoming worse.

    Common warning signs of asthma include:

    • Increasing cough
    • A whistling sound or wheezing when your child breathes
    • Shortness of breath
    • Waking at night with coughing, wheezing, shortness of breath, or chest tightness or pain
    • Need for reliever medicines
    • A drop in peak flow rates
    • Symptoms with running or playing
    • Being cranky or fussy
    • Tiredness
    • Itchy, scratchy throat
    • Trouble sleeping
    • Headache
    • Stomachache
    • Blue lips or fingernails
    • Sinking or pulling in of the skin between the ribs or under the throat

    Warning signs are not the same for everyone. What are your child’s warning signs?

    Your child may have different signs at different times. If you know your child’s warning signs , follow your child’s Asthma Action Plan. You may be able to avoid a serious episode of asthma.

  • Know when to call 911

    Call 911 if:

    • Your child's lips or fingernails are blue
    • Your child is fighting to breathe
    • Your child does not feel any better after taking a reliever
    • Your child’s symptoms and/or peak flow are still in the Red Zone 15 to 20 minutes after taking extra reliever medicine
    • If in doubt, don’t wait. Call 911!
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