Asthma Flare-Up: How to Care for Your Child

During an asthma flare-up, the muscles around the airways tighten. The lining of the airways gets inflamed, causing it to swell and fill with mucus. All these changes make it hard to breathe. A child having a flare-up may cough a lot, wheeze, feel chest tightness, or be short of breath. Asthma flare-ups, sometimes called asthma attacks, can be serious. That's why it's important to treat a flare-up as soon as symptoms start.

The health care provider examined your child and asked questions about symptoms. They may have given your child medicine to stop the asthma flare-up or prescribed medicine to use at home. Your child is doing better and you can continue care at home. 

The health care provider might have given you an asthma action plan or reviewed the plan with you and your child if you already have one. An asthma action plan is a set of instructions that detail how to manage asthma at home. Keeping the plan up to date and following it closely can help a person prevent or treat symptoms and keep their asthma under control. It's important that you and your child understand the asthma action plan, know the signs of a flare-up, and know what to do if a flare-up happens.

As your child gets better from this flare-up:

• Use the asthma medicines and any new medicines as directed.

• Ask your health care provider about when your child can return to school and other activities.

When your child's breathing is back to normal:

• Be sure to follow the asthma plan.

• If you don't yet have an asthma plan, discuss it with your child's health care provider. Follow these important tips in the meantime:

  • If your child is supposed to take a medicine every day, they should keep taking it, even if they feel fine and don't have any symptoms.

  • If your child starts to feel asthma symptoms, they should take the medicine prescribed for quick symptom relief. If they already take a daily medicine, the "quick-relief" medicine might be extra doses of the daily medicine or a different type.

  • If your child uses an inhaler, be sure they always use a spacer with it.

  • Make sure your child always has medicine available for quick relief of symptoms (at home, at school, etc.). Talk to the school nurse about keeping some of the medicine at school.

  • Your child should avoid tobacco smoke and any known asthma triggers. If anyone in your home smokes, call 800-QUIT-NOW for advice on quitting. Make your home and car smoke-free.

  • If exercise triggers your child's asthma, talk with your health care provider about safe ways for your child to stay active.

• Be sure to tell your child's health care provider or asthma specialist about any changes to the asthma medicines that were made today.

Your child:

• needs to use medicine more often than prescribed

• is not being helped by the quick-relief medicine

• is not getting better from this flare-up

• has another flare-up

Your child has trouble breathing. Signs you might see include:

• The skin between your child's ribs and neck pulls in tight during breathing.

• The nostrils flare (open wide) with each breath.

• Your child is breathing faster than usual.

Call 911 if your child is struggling to breathe, is too out of breath to talk or walk, or turns blue.

What is asthma? Asthma is a condition that causes breathing problems. It is a chronic (ongoing) condition, which means it usually lasts for years, though many kids grow out of it. Asthma can be mild or so severe that it gets in the way of daily activities. But with medicine and the right care plan, asthma symptoms can be managed so that kids can do just about anything they want to do. 

What is an asthma flare-up? An asthma flare-up is when asthma symptoms get worse. These symptoms include wheezing, coughing, or feeling out of breath. People with asthma have airways that are overly sensitive to some things (called "triggers"). Being around triggers can bring on asthma symptoms by making the airways in the lungs narrower, swollen, and filled with mucus. Asthma flare-ups are also called asthma attacks or exacerbations. They can happen even when a person takes medicine to control their asthma.

What are common asthma triggers? A trigger is something that can cause asthma symptoms to start. A trigger does not cause asthma. Triggers are different for each person. Common asthma triggers include:

• viral respiratory infections, like the common cold or flu 

• allergies to things like dust, pollen, mold, and pet dander

• dirty air from things like air pollution, tobacco smoke, aerosol sprays, or paint fumes

• weather conditions, like extreme cold or heat

• exercise

How do asthma medicines work? Asthma medicines generally work in two ways:

• Some asthma medicines work right away to relax the muscles around the airways. This opens the airways and provides quick relief of symptoms. That's why they are sometimes called "quick-relief," "rescue," or "fast-acting" medicines.

• Other medicines work over time to ease inflammation, which reduces swelling of the airways and limits mucus production. A person usually needs to take these every day, even when they feel fine and have no symptoms. These are sometimes called "controller," "maintenance," or "long-term control" medicines. Some children who have mild asthma might use controller medicines only when their asthma symptoms increase.

Some children will get both types of medicines from one inhaler device. They might need to use this "combination" inhaler every day, with added doses from it when they have symptoms. Some older kids with mild asthma might use a combination inhaler only for quick relief when they have symptoms, or before they exercise. Your health care team will help you figure out which inhaler is best for your child, and how and when to use it.

Are all asthma medicines breathed in, or can some be taken by mouth? Some medicines that ease inflammation can also be taken by mouth. For example, health care providers may prescribe oral steroids for inflammation during a flare-up, usually for 5–7 days.