Acute Asthma (Child)

Asthma is a condition where the medium and small air passages in the lung go into spasms and block air flow. Inflammation and swelling of the airways cause them to become narrower, make more mucus, and further slow air flow. When a child has asthma, these airways react to triggers such as smoke, colds, or pollen. During an acute asthma attack, these factors cause trouble breathing, wheezing, coughing, and chest tightness.

Image of a child showing airway and lungs and an inflamed bronchiole

Nighttime cough is also common with poorly controlled asthma. Asthma attacks vary from mild to severe. During an attack, quick-acting medicines are used to open the airways. Your child may also take other medicine daily. This is to help reduce inflammation and prevent attacks.

Children with asthma often have allergies. A substance that causes an allergic reaction is called an allergen. Allergens may trigger an asthma attack or make an attack worse. This may occur right after contact, or several hours later. For this reason, a child with asthma may be referred to an allergist to find out if he or she has allergies.

Home care

The healthcare provider may prescribe an anti-inflammatory medicine. This may be an inhaler with a spacer and face mask. Or it may come as a pill or liquid. Follow all instructions for giving this medicine to your child. For babies, inhaled medicine is often given with a machine called a nebulizer. This uses a face mask to help a young child breathe in the medicine.

General care

  • If your child has an inhaler, learn how to check the amount of medicine in the canister. Children should always use a spacer with an inhaler when using an inhaled steroid medicine. Depending on your child's age, the healthcare provider may tell them to breathe in and out 5 to 10 times after each dose before removing the spacer.

  • It's important to use the inhaler and spacer the correct way. Talk with your child's provider or the pharmacist to ensure the correct use of the inhaler.

  • Give all medicines as prescribed. Don't let your child share medicines.

  • Make sure your child has a written Asthma Action Plan. You and your child should know what to do in case of an asthma attack. Update your child's plan each year. And update it when your child visits the provider who manages their asthma.

  • Give a copy of the Asthma Action Plan to daycare providers, babysitters, and school officials. Carry a copy of the Asthma Action Plan when you travel.

  • Make sure all family members know about your child's Asthma Action Plan. They need to know how to spot early signs of an asthma attack. They also need to know how to identify and act in an emergency.

  • Help your child learn and practice breathing exercises as advised. In an age-appropriate way, teach your child about their asthma and how to manage it.

  • Teach your child how to stay away from allergens or activities that can trigger an asthma attack. Allergens can be tree, grass or weed pollen, dust mites, cockroaches, or animal dander. Things such as running and playing hard, crying, or laughing can also trigger an attack. Other common triggers can be in the air. These include smoke, chemical fumes, or strong odors such as perfume.

  • If your child uses a smart phone, think about getting apps that offer educational games about asthma. These apps help children learn about asthma in a fun and engaging way. Check with the American Lung Association or your child's provider about advised asthma-related apps. Find out how much time a child should spend using them.

  • Encourage your child to write down and ask their provider asthma-related questions.

  • Have your child wear a medical alert bracelet or necklace.

  • Protect your child from upper respiratory infections or colds.

  • Reduce your child's exposure to allergens. Talk with the provider about how to make your house as allergen-proof as possible.

  • Keep your child away from tobacco smoke.

  • Make sure that your child has a healthy diet, gets regular exercise, and keeps doing normal activities. Check with your child's provider about the best types of physical exercise for your child.

  • Ask the provider about keeping your child up to date on all vaccines. This includes the flu shot.

  • Call the provider right away if your child's symptoms change. Also call if the medicine stops working as well.

Follow-up care

Follow up as advised with an allergist or other specialist. Keep all follow-up healthcare provider appointments.

Special note to parents

It can be very scary when your child has trouble breathing. Try to stay calm. Your child may be more anxious if you are anxious. When you're anxious, it can be hard to remember what to do. Keep the Asthma Action Plan on your smart phone or an electronic device you use often. Put a hard copy in an easy-to-access place in your home.

Call 911

Call 911 if your child:

  • Is showing any of the red zone symptoms listed on their Asthma Action Plan

  • Has trouble staying awake, walking, or talking because of shortness of breath

  • Uses a peak flow meter as part of an Asthma Action Plan, and it is still in the red zone 15 minutes after using quick-relief inhaler medicine

  • Has lips or fingernails turning gray, purple, or blue

When to get medical advice

Call your child's healthcare provider right away if any of these occur:

  • Asthma attacks that happen more often or are more severe.

  • Trouble breathing that is not relieved by the medicines prescribed for an acute asthma attack.

  • Your child needs to use a rescue inhaler more than twice per week.

  • Your child has flu symptoms. Children with asthma are at high risk for complications or an asthma attack if they get the flu, sinusitis, or an upper respiratory infection.

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