Any parent of a child with asthma knows all too well that for kids,
living with asthma can mean dealing with symptoms like shortness of breath and coughing that can interfere with playing or sleeping. Asthma is also a leading cause of missed school days, emergency room visits, and even hospitalizations. According to the Centers for Disease Control and Prevention (CDC), more than four million children — about 1 in 15 kids — ages 17 and younger had asthma in 2021, and almost 39 percent of kids with asthma reported having one or more asthma attacks.
But while asthma may be a chronic condition that causes mild to severe breathing problems, the good news is that symptoms can be controlled by avoiding or reducing exposure to allergens and irritants, making sure you and your children learn about asthma control strategies, and working with your child’s doctor to manage and prevent symptoms.
“Asthma is a very manageable disease,” says Scott Schroeder, MD, a clinical professor of pediatrics at the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire. “Kids should be able to sleep well at night and play whatever sports they want, but it takes work.”
Here are some strategies you can follow to help your child breathe easier.
1. Schedule Regular Doctor’s Appointments
Kids often need to take prescription medication, like steroids and bronchodilators, to keep their asthma under control. Your child’s healthcare provider will design a treatment plan and reevaluate it at each visit, says Dr. Schroeder. To make sure that your child is using an inhaler correctly, your doctor may also ask for a demonstration, notes Mayo Clinic.
Schroeder usually asks his new patients to return for a follow-up visit a month or two after their first appointment; this way, he can see how their treatment plan is working. He also rechecks people every three months, six months, and up to a year, depending on how well they’re doing. Schroeder recommends scheduling a new appointment if your child’s symptoms don’t improve with new treatment.
According to the Global Initiative for Asthma, people with asthma should be seen one to three months after starting treatment and every 3 to 12 months after that, though if you’re pregnant, you should see your doctor every four to six weeks. After an exacerbation of asthma, a review visit within one week is recommended.
2. Make Sure You Have a Written Asthma Action Plan
Work with your child’s healthcare provider to develop a written plan for managing symptoms and handling emergencies. “It’s all about empowering the family to do the right things,” says Schroeder. Keep a copy on hand (the refrigerator is a good spot) and make sure your child’s school nurse has one too.
A well-written plan should be simple and understandable, but should also contain details on how to monitor your child’s asthma, what to do when your child doesn’t feel well or experiences a flare-up, how to adjust their medication, and when to see the doctor, says Harold J. Farber, MD, professor of pediatrics in the pulmonary section at Baylor College of Medicine and Texas Children’s Hospital in Houston.
3. Modify Your Action Plan as Needed
Visualize your ultimate goal as preventive maintenance rather than a response to problems. “If your child is having a lot of crises, you may need a new asthma action plan,” says Dr. Farber. For instance, frequent or persistent symptom flares may also be a sign that she needs a change in treatment, such as the addition of a long-term control medication.
Farber uses the analogy of avoiding falling off a cliff to describe the ideal asthma management: You can either prevent a fall by hanging off of the edge or by moving away from the edge, says Farber. If you notice that your child is experiencing asthma attacks or symptom flares, you may need to discuss formulating a new plan with your child’s doctor.
4. Help Your Child Use Their Medication
Sometimes, asthma treatment comes in pill form; other times, it includes devices such as inhalers or nebulizers and your child will need to learn how to use them correctly to maximize their effectiveness. Talk with your doctor about which options are best for your child.
Some children do better with nebulizers, but by age 2½, many kids can use an inhaler, says Schroeder. He recommends using an inhaler spacer, a small device that connects to the inhaler’s mouthpiece. “It takes out the need for hand-eye coordination,” he says. Your doctor will demonstrate how to use these devices, and you should also help your child use them, especially in the beginning.
Whether your child is prescribed inhaled or oral asthma medication, you can make it easier for them to remember to take their dosage by making it part of the daily routine, says Farber. “If your child needs medication daily, link it to brushing teeth or have him take it before meals,” suggests Farber.
5. Make Sure You Know How to Use a Peak Flow Meter
A peak flow meter is a small, hand-held device that measures your child's breathing to see if they need special medicines or emergency attention and helps you keep track of your child’s breathing over time.
Peak flow meters are typically used with children over 4.
Marks on the side of a manual device indicate your child's peak flow, while a digital meter displays the number on a screen.
Your doctor may ask you to take peak flow readings once or twice a week. If you're measuring peak flow as part of regular tracking, repeat the test two or three times, then record the highest score, recommends the American Academy of Pediatrics.
6. Schedule a Flu Shot for Your Child
Even in kids who have mild asthma or well-controlled symptoms, the flu can be a serious infection. That’s because in people with asthma, the airways are more swollen and sensitive, and the influenza virus can cause more inflammation of the airways and the lungs. According to the CDC, the flu can trigger asthma attacks and flare-up of symptoms, and increase the risk of developing other respiratory illnesses like pneumonia.
An influenza vaccine is a must because it can reduce your child’s risk of getting sick in the first place. You can get one from your child’s doctor or a local pharmacy, ideally every autumn.
7. Limit Your Kid’s Exposure to Triggers and Allergens
Minimize your child’s exposure to allergens like pollen, dust, mold, or pet dander, all of which may give him or her breathing trouble. If seasonal allergies are a problem, your doctor might recommend increasing medication during the tough times.
“How you breathe starts with what you breathe,” says Farber. He recommends also paying attention to other possible triggers, like strong household chemicals such as cleaning products or scent diffusers.
8. Shield Your Child From Cigarette Smoke
If you smoke, you could damage your child’s lungs. While the research varies, in one study, children in Japan with a father and mother who smoked indoors had a 43 to 72 percent increased odds of hospitalization for asthma — and the risk was similar if the parents smoked outdoors, too.
Even thirdhand smoke — the particles that linger in carpets, couches, and other materials — may be harmful, notes the Asthma and Allergy Foundation of America.
“The only way to eliminate exposure is to stop smoking,” says Farber. If you smoke, talk with your doctor about strategies to help you quit.
9. Keep Emergency Medication Handy
Equip your household with the medicines your child’s doctor has prescribed for emergencies, and ensure that your child’s school nurse has them too. Check your school’s policy to see whether children can keep medication in their backpacks. “I like to empower kids to use the inhaler at school if the school will allow it,” says Schroeder.
10. Give Your Child Positive Role Models
Tell your kid about successful people who didn’t let asthma bring them down. President Theodore Roosevelt had asthma.
Soccer icon David Beckham, singer Pink, and actress Jessica Alba reportedly all have it, too.
“We want to keep kids with asthma as healthy as possible so that they can achieve their full potential,” says Schroeder.
11. Encourage Good Expectations
Helping your child to understand what asthma is can help you both manage the condition. With young kids, the American Academy of Allergy, Asthma, and Immunology recommends using basic language to describe what occurs during an asthma flare, making sure your child is aware of what triggers their symptoms. With teenagers, where self-management is the goal, it’s important to communicate that staying healthy means your child needs to take their medication as prescribed.
Teach your child to have a positive outlook about her asthma. “Expect good management and not just crisis control, and teach her to follow her asthma plan,” says Farber. Empowering your child to take control of her asthma can be a key part of how well she manages her condition.
The Takeaway
- Consistent management is key to keeping childhood asthma under control, giving kids the chance to participate fully in activities they enjoy.
- Work with your healthcare provider on a personalized asthma action plan, making it easier to handle flare-ups and recognize when you need medical help.
- Be mindful of environmental triggers like smoke and pollen, which can aggravate asthma symptoms — reducing exposure can make a significant difference.
- Ensure regular checkups with a healthcare provider to adjust any medications and interventions as your child's needs change over time.
Additional reporting by Katherine Lee.
