Managing Your Child's Asthma: Signs of an Attack

Allergies and AsthmaMore than 23 million people in the United States have asthma. It's the number one reason kids chronically miss school. Flare-ups will often send kids to pediatric emergency rooms.

Parents whose children have asthma learn how to recognize their kids' signs and triggers. Their next step is working with their child's doctor to set up an asthma management plan.

Asthma can be hard to see in babies and toddlers. It's not uncommon for the disease to be diagnosed when a child's first major asthma attack requires a trip to the emergency room.

Catherine, a mom of two little girls and member, shares her thoughts. "Danika is six now. She was diagnosed with asthma just before she turned two, but didn't start treatment until age four. Her doctor said he didn't think it was necessary and didn't think she had asthma. Most of her asthma problems are in the upper airways and not in the lungs, so they think she's fine as they hear her lungs are clear," Catherine said.

Every child with asthma has built-in early warning signs that signal when an asthma flare-up is about to happen.

Catherine talked about Danika's warning signs, "We have no idea what triggered her attack last summer, but suspect it was red grass. Danika gets dark circles under her eyes when she is having trouble with allergies. She breaths shallow and hums. We've learned that the humming is a sign of asthma."

While each child has a unique set of signals when breathing becomes difficult, parents often share these common signs. This is a case where there is no shortage of good information and support.

Early Warning Signs and Symptoms

A baby, toddler or preschooler probably won't be able to tell you when they don't feel quite right. You'll have to watch for a sign that something's wrong.

What to Watch For

Think about the last time your child had an asthma attack. Check off the signs you recognized before the attack took place.

Warning signs:
__ Coughed, with or without a cold
__ Had a cold or the flu
__ Had a fever
__ Had a stuffy or runny nose
__ Frequently cleared his or her throat
__ Irregular or noisy, difficult breathing
__ Sneezed and had watery eyes
__ Wheezed, no matter how slight

Symptoms your child might have exhibited:
__ Acted restless
__ Face was pale
__ Had dark circles under the eyes
__ Had tightness in the chest
__ Seemed to be tired or weak
__ Seemed to have a headache

What to Do

Reference your asthma management plan that you and your child's doctor put together. Most plans cover three areas to help keep your child's asthma under control: 1) Triggers that bring on your child's asthma; 2) your child's daily medicine needs; 3) and a rescue plan in case of an emergency.

The action plan's rescue program might include:

  • Your child's warning signs
  • Your child's peak flow meter readings
  • The names of the rescue medicines for quick-relief during an attack or when asthma signs start
  • Steps to take if your child has an asthma attack and when to call the doctor
  • Emergency numbers and when to take your child to the emergency room

Catherine adds, "As with most children, Danika has a hard time understanding when she needs the help." Her mom's explained that Danika has a typical asthma plan. She's currently taking Zyrtec, Singular, Qvar daily, and will start Flonase as summer approaches. She has albuterol in an inhaler and nebulizer. As a last resort, she gets a steroid to open up her breathing. When she's going to be doing extreme activities -- more than normal play or physical education -- she uses her inhaler beforehand. She also has a Peek Flow Meter that she uses when she feels like she's not breathing well.

If you don't have a plan in place, work with your doctor to make one for your child. It can help lower the number of asthma attacks. Is your current plan suddenly less effective? Discuss what options are available and what changes you can make with your doctor.

Danger Signs

One of your main goals to managing your child's asthma is avoiding trips to the emergency room. It's equally important to know when to take your child in. Don't ignore flare-ups. If an attack isn't responding to medication, seek emergency care even if it isn't convenient and happens to be the middle of the night.

What to Watch For

  • Being unable to stop coughing and vomiting
  • Having trouble talking
  • Feeling unusually sleepy, trouble waking up
    lips or skin look blue
  • Skin sucking in on the neck or chest as your child breathes

What to Do

Follow your asthma plan's emergency instructions. It should tell you whom to call and where to take your child when an attack isn't controlled with the rescue medications.

If you don't have a plan, call your local emergency room immediately and follow their instructions for transporting your child.

Keep Asthma Under Control

Thanks to new medications and treatment strategies, kids with asthma are having much fewer scary attacks. They can join in activities instead of being delegated to the sidelines.

Patient education and creating the right asthma plan helps families control their kids' symptoms and asthma flare-ups with increased independence. The result are the children are now able to do just about anything they set their minds to doing.

How is your child's asthma plan working? Share what's worked for you! Share some of your successes, frustrations and challenges!