Pediatric Asthma Management Guide for Parents & Caregivers

Overview

Pediatric asthma is the most common chronic childhood illness in the United States, affecting roughly 1 in 12 kids. It causes the airways in the lungs to become inflamed, narrowed, and extra sensitive to triggers like pollen, pet dander, or respiratory infections. When exposed to these triggers, the airways swell, muscles around them tighten, and mucus builds up, making it hard for a child to breathe. While asthma has no cure, it can be very well managed with the right care plan, so most children with asthma live normal, active lives.

Signs & Symptoms

Asthma symptoms can vary from child to child, and may get worse at night, during exercise, or when your child has a cold. Common signs to watch for include:

• Frequent coughing, especially at night, during play, or when laughing
• Wheezing (a high-pitched whistling sound when breathing out)
• Shortness of breath or rapid breathing
• Chest tightness or pain (young children may say their chest hurts or feel fussy)
• Fatigue during physical activity, or avoiding sports/play because of breathing trouble
• Flared nostrils or retractions (skin pulling in between the ribs or at the base of the neck when breathing)

Causes & Risk Factors

Doctors don’t know exactly what causes asthma, but it’s thought to be a combination of genetic and environmental factors. Kids are more likely to develop asthma if they have a parent or sibling with the condition, or if they have other allergic conditions like eczema or food allergies. Environmental risk factors include exposure to tobacco smoke (before or after birth), air pollution, indoor mold or dust mites, and frequent respiratory infections in early childhood.

Diagnosis

There is no single test for pediatric asthma. Your child’s provider will start by asking about their symptoms, family history, and what makes symptoms better or worse. They may also perform a physical exam to check for signs of allergies or other respiratory conditions. For kids old enough to cooperate (usually 5 and up), a spirometry test is often used: this measures how much air your child can breathe out and how fast they can exhale, to check how well their lungs are working. For younger kids, providers may use a trial of asthma medication to see if symptoms improve, or track symptoms over time to confirm a diagnosis.

Treatment & Management

The goal of pediatric asthma treatment is to control symptoms, prevent flare-ups, and let your child participate fully in daily activities. Most treatment plans include two types of medications, plus a personalized written asthma action plan from your provider that outlines daily medications, how to adjust medications during flare-ups, and when to seek emergency care. Share this plan with all caregivers, including teachers, school nurses, and babysitters.

Living With It

With proper management, most kids with asthma can do everything their peers can, including play sports, attend school, and go on overnight trips. Key steps to reduce flare-ups include identifying and avoiding your child’s specific asthma triggers, keeping up with all provider appointments, and making sure your child takes their controller medication every day, even when they feel well.

• Keep rescue medication accessible at all times: at home, school, sports practices, and when traveling
• Use a peak flow meter (a small device that measures lung function) to track your child’s breathing and catch early signs of a flare-up
• Get your child a flu vaccine every year, as respiratory infections are a common asthma trigger
• Work with your child’s school to create an asthma management plan that allows them to take medication as needed during school hours
• Teach your child age-appropriate asthma self-management skills as they get older, so they can take charge of their own care as teens