For parents, there are few things as terrifying as watching your child suffer through an asthma attack like a fish out of water. This time of year, when allergens are high, if you have a child with asthma (or suspect you might), you’ll want to be prepared.


Asthma is a chronic inflammation of the airways, and it’s the leading cause of school absences among children ages 5 to 17, according to the Asthma and Allergy Foundation of America (AAFA). The disease may improve as your child gets older, but it never actually goes away, and symptoms can reoccur periodically during adulthood (though between episodes, asthmatics often have completely normal lung function). Since there’s no cure, the goal of any treatment is to decrease inflammation and avoid emergency flare-ups where your kid can’t breathe. The good news is that with proper management and treatment, this potentially lethal ailment can usually be controlled.


When your child comes into contact with an asthma trigger, the muscles around the airways tighten, causing inflamed, swollen, smaller airways to constrict. Mucus production increases and thickens, narrowing the airways even more. All this makes it hard for air to travel in and out of the lungs.


• Allergens: Most children with asthma suffer from allergies, too. Pollen, mold, dust mites and pet dander are common triggers. Children with a seasonal allergy, such as ragweed, often experience an increase in symptoms during certain times of the year.

• Viral infections: Some viruses can trigger asthma attacks, including those that cause the common cold. There’s also a correlation between respiratory syncytial virus (RSV) and asthma. At some point, most children will have RSV and recover with no complications. But some children with severe RSV may develop asthma.

• Exercise: Vigorous activity or exercise can induce asthma symptoms. Using an inhaler to dilate the airways before exercise can help prevent attacks.

• Irritants: Common irritants include cigarette smoke and strong odors. Asthmatic children may not be able to tolerate perfumes, chemical fumes, air fresheners, hair sprays or air pollution.

• Other triggers: Changes in weather, particularly cold air and wind, can produce asthma symptoms. Emotional stress, such as anxiety and anger, may also be factors.


• Cough: One of asthma’s less recognized symptoms, coughs are typically worse at night and persistent or intermittent, leading to sleep disturbances. Coughing can also occur in the early morning and when crying or running.

• Wheezing: A whistling sound heard when breathing, wheezing can occur after exposure to allergens or physical activity. If your child is having difficulty breathing and the wheezing stops, it could be a sign that very little air is moving through the airways and emergency action is needed.

• Chest tightness: This can happen with or without other symptoms. Your child may describe it as a feeling of tightness, heaviness or even pain.


An asthma action plan is a series of guidelines written specifically for an asthmatic patient by a doctor. Your asthma action plan should include basic information about your child, including name, date of birth, emergency contact numbers and physician information. It should also include numbers for a normal peak flow meter reading to establish a benchmark. (A peak flow meter measures airflow and normal breathing rates.) Often, numbers begin to decrease even before asthma symptoms appear. Being aware of the normal and low readings can be helpful in knowing when to be on the alert for worsening symptoms. Info about medication and symptoms can be divided into three separate sections so that adults caring for your child will have specific direction for every phase of asthma, according to the Pediatric/Adult Asthma Coalition of New Jersey (PACNJ):

• Healthy: Sometimes referred to as the Green Zone, this section includes any medication taken on a daily basis. When asthma is controlled and peak flow readings are normal, your child should be here.

• Caution: The Yellow Zone indicates that asthma symptoms have been triggered. Peak flow readings are lower, or symptoms have flared. In this stage, it becomes difficult for your child to do regular activities. Fast-acting medications are required in addition to the regular daily ones. When breathing is in the caution zone, you need to be diligent. If symptoms don’t improve, you should follow up with your pediatrician.

• Emergency: Also called the Red Zone, this indicates a breathing emergency. If readings are in this zone and fast-acting medications aren’t working, you should seek medical care. If your child is having difficulty talking or is using abdominal muscles to breathe, call 911.

Every child with asthma should have a plan, and all adults responsible for that child should receive a copy (including baby sitters, teachers and school nurses). It should be updated yearly—more often if the child’s health changes.

By working together, parents, health care providers and school personnel can be sure kids with asthma receive proper care regularly, as well as in an emergency at home or in school. 

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