Helping Your Child Manage Asthma

Parents can make a significant improvement in their child's quality of life by taking three basic steps.

  • Step one is to educate themselves about the disease, so they understand that asthma is a chronic condition and that its severity can fluctuate, depending on everything from the weather to air quality and allergens in the home.
  • The second step is to become involved in all aspects of their child's daily asthma care, including medication routines and lifestyle adjustments.
  • And the last step is to develop easy-to-follow asthma care routines that make it simple for the family to work together to prevent and control a child's asthma attacks.

A recent study of more than 700 parents of asthmatic children ages 2 to 12 found that the higher the parents' expectations that their child would be able to control the condition and function normally, the better the child did. The study, published in Pediatrics, also found that the children were more likely to take their asthma controller medications properly if they had a clearly defined routine for doing so.

"A lot of what asthmatic children do about their asthma is a result of what their parents perceive they can do," says Tracy Lieu, M.D., director of the Center for Child Health Care Studies at Harvard Medical School in Boston and senior author of the study. "Clearly, the more involved parents are, the more directed the plans for treating asthma at home will be. There are parents who don’t realize that by using controller medications on a daily basis they can prevent their child from having asthma flare-ups and landing in the emergency room."

Good asthma management can also reduce nighttime awakenings, which often lead to missed school days and cancelled after-school activities. "Asthma is more likely to act up from 6 pm to 6 am, because that's when our levels of cortisol [a stress hormone that, among other things, dilates airways] are at their lowest," says Neil L. Kao, M.D., clinical assistant professor of medicine at the University of South Carolina School of Medicine in Columbia. "And once children don't get a good night's sleep, because they've been tossing and turning and coughing throughout the night, it's harder for them to concentrate throughout the day."

Empowering Your Child

Because children mature physically and mentally at different rates, there are no hard-and-fast age-specific guidelines for parents to follow. However, talking to your child about how to spot the warning signs of an asthma episode can help even young children (ages five and up) gain a sense of control over their disease.

"Parents should teach their child to tell them about any difficulty breathing, even if it's mild, so it can be monitored," says William H. Anderson, M.D., an allergy and immunology specialist in Bellingham, WA. Other early warning signs include coughing or wheezing and waking at night due to breathing difficulties.

The American Academy of Allergy, Asthma and Immunology offers these guidelines about what children may be able to handle at different ages:

  • Preschool Children under five are able to understand that they have lungs and that lungs are used for breathing, and that certain triggers can bring on an asthma attack, making it difficult for them to breathe. With close parental supervision, they may be able to take their own medications.
  • School-age children —This age group is able to understand asthma triggers (dog dander, pollen, etc.), use a home peak-flow meter to measure their own pulmonary function and take their own medications, with supervision.
  • Adolescents—These older kids should be able to take a more active role in asthma management. They can be almost completely independent, monitoring their peak airflow regularly and knowing when to take medications.

Have an Asthma Plan

Working with your child and the physician to develop a written plan that includes a list of asthma triggers and medication schedules can help your child feel involved in the self-care process. Also, share the plan with anyone responsible for your child's care, including grandparents, caregivers, teachers, principals and school nurses, so they will know what to do when asthma strikes.

Publication Review By: Raymond Slavin, M.D.; Derek Johnson, M.D. for MDminute™

Published: 30 Sep 2009

Last Modified: 10 Oct 2014