5 Tips for Managing Your Child’s Asthma

Your child is all set for their soccer practice, when their asthma flares. Or maybe they’re snuggled in their bed when they wake from a sudden flare and reach for their rescue medication. Whether it happens during play or at rest, it’s so hard for you to see your child coughing and struggling to breathe or speak. 

These frightening symptoms of childhood asthma can be well-controlled, but learning how to best partner with your pediatrician may require time, patience and a lot of good communication. Pediatric pulmonologist John Carl, MD, offers these tips to help your child’s doctor develop an effective asthma action plan.

1. Keep detailed records

The best way to develop an effective treatment plan for your child is to come to appointments prepared to talk about your child’s progress, saysDr. Carl. The best way to do this is to keep a detailed account of what’s been happening with your child’s asthma. 

Things to note:

• How many times your child has had wheezing episodes.
• What triggered the onset of symptoms. 
• The number of office, urgent care or ER visits and any hospital stays.
• What preventive medications your child takes and whether there have been problems with consistent dosing — whether it was interrupted either by you or changed by another doctor.
• How often your child requires rescue medications to treat acute symptoms. 

2. Check your home environment for asthma triggers

“Exposure to tobacco smoke before and after birth is a risk factor for childhood asthma,” says Dr. Carl. In addition to second-hand smoke, Dr. Carl says you should look carefully around your home for anything that could trigger asthma symptoms, including: 

• Furry pets, such as dogs and cats may immediately come to mind. But even the smaller variety of house pet, like guinea pigs and hamsters, can make it more difficult to control asthma because their bedding is made of small particles that can kick up and add to dust.  
• Outdoor allergens, including trees and grasses in spring and weeds and molds in late summer and fall, may trigger seasonal asthma. Your child’s doctor may order an allergy test to find out exactly what your child is allergic to. ​

3. Know what tests to request

• Pulmonary (lung) function tests: If you suspect your child has asthma or if symptoms continue to get worse, your pediatrician will likely perform pulmonary function tests. These require your child to breathe into a small instrument called a spirometer. “The tests measure how much air your child’s lungs can hold and how fast air moves in and out,” offers Dr. Carl. 
• Asthma control test: This test, available online, allows children and parents to grade their symptoms without the pressure of doing so when you’re at the doctor’s office. Dr. Carl says it’s a really helpful asthma scorecard. Fill it out before your appointment. 

4. Be ready to ask: Why aren’t my child’s symptoms responding?

Having a rescue medication on hand is vital. But if you’re giving your child their medication as prescribed and it’s not working, you need to be ready. Document if your child experiences any of the following: 

• Recurrent symptoms.
• Frequent courses of oral steroids (from your doctor or emergency room).
• ER visits or hospitalizations.​

If your child requires multiple courses of oral steroids, it’s time to talk to your doctor about developing a new preventive treatment plan. Dr. Carl says it’s time for a new plan if:

• Your child’s asthma episodes interrupt daytime play more than twice a week or wake them up at night more than twice a month.
• They require a lot of albuterol aerosol or inhaler use.

5. Be patient with long-term treatments

Preventive — or “controller” — medicines do not immediately relieve symptoms in the same way that rescue inhalers do, but will help if used consistently over the long-term. 

Dr. Carl urges parents to make sure their pediatrician fully explains what to expect from each medication so they don’t grow impatient and frustrated if results aren’t immediate. “Good communication with your pediatrician is essential for achieving optimal asthma care,” he says.