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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

A Parent's Life A Parent's Life

Help Your Child 'Breathe Easy'

April 03, 2014

By Claire McCarthy M.D.

Boston Children's Hospital

When parents hear that their child may have asthma, their minds are immediately filled with ideas of their child out of breath, puffing on an inhaler, and having trouble keeping up with friends. That may have been the case in the past, but not anymore. Living with asthma is much more about preventing an asthma attack and promoting a healthy life.

You can help your child to always "breathe easy" if you follow some important guidelines for managing asthma.

Identify Asthma Triggers

Very few people with asthma wheeze all the time. Most people wheeze when something causes their lungs to react. Those "triggers," as we call them, are different for each person. Common triggers include:

  • The common cold, or other respiratory infections — These are hard to prevent, especially in children who go to school or day care, where germs are everywhere.
  • Cigarette smoke — Not only is smoking bad for you, it can make your child's asthma worse.
  • Exercise — All children should exercise — this is not something anybody should avoid. But sometimes exercise can bring on asthma.
  • Allergies — Children may be allergic to dust mites, pollen, mold and other things found where they live and play. Cats, other animals and certain foods also can be triggers.

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Understand What To Do About Triggers

    • The common cold, or other respiratory infections — Frequent hand washing is always a good idea, but most kids still get sick sometimes — and those with asthma may wheeze when they do. If you know that colds are a trigger for your child, starting medications at the first sign of a sniffle often can prevent a bad asthma attack.


    • Cigarette smoke — Talk with your doctor about programs to stop smoking. In the meantime, never smoke where you live or in your car. Avoid taking your child anywhere people smoke.


    • Exercise — If your child has trouble only with lots of exercise, such as in a soccer game, using special medication before exercise can prevent problems (your doctor would decide which medication would be best). On the other hand, if just a small amount of exercise, such as walking up stairs, causes wheezing, daily medication may be necessary.


  • Allergies — If you know what your child is allergic to, you can do your best to prevent or limit exposure to it. Your pediatrician also may prescribe allergy medication.

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Be Familiar With the Signs

This isn't always as easy as it seems and can be different from one child to the next.

    • Get to know what your child's exact asthma symptoms are. Wheezing, when you can hear it, is a whistling, squeaky noise heard during breathing — but some children may have just a dry cough, especially at night. You may notice your child slowing down, or moving his chest more when he breathes. If you can pick up on trouble early, you can use medication to stop things from getting worse.


    • Use a peak flow meter with children ages 6 and up. These simple, easy-to-carry devices measure airflow when a person breathes into them quickly and forcefully. It takes a little practice to use them correctly. Once you get the hang of the technique, however, they are great for measuring how well a person with asthma is breathing and for knowing early on when breathing trouble is ahead. Your doctor can tell you how to get one.


  • Know the warning signs of a severe attack. These include:
    • Constant cough
    • Difficulty talking
    • Sleepiness
    • Using chest muscles to help breathe ("sucking in" around the ribs or above the breastbone)
    • Pale or bluish skin

    If any of these occurs, your child needs immediate medical attention.

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Use Medicines the Right Way

Asthma medicines have come a long way and there are more options for both treating and preventing asthma attacks. Talk with your doctor about what the best plan is for your child. This means:

    • Have an "asthma action plan." These written plans, often organized into Green, Yellow and Red zones, help you know which medications your child needs, based on his symptoms and peak flow measurements.


    • Always give medicines as directed. It's easy to start thinking that daily medicine isn't necessary when your child is doing well — but it may be exactly because of the daily medicine that she's doing so well! On the flip side, it's easy to think that giving extra medicine may help even more — but giving extra can be dangerous.


  • Know how to work inhalers and nebulizers. If you don't, your child won't get the right amount of medicine. Aero chambers, which are tubes with a hole for the inhaler at one end and a mouthpiece or mask at the other, are great for making sure asthma medicine gets into the lungs and not just into the mouth (or sprayed around the room). Ask your doctor for one, and for help on how to use it. If you use a nebulizer machine, make sure you are using the right mask or mouthpiece. Another important nebulizer tip: Make sure you change the filter as often as the company recommends.

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Get a Flu Shot Every Year

People with asthma are more likely to have worse problems if they get the flu. Therefore, all people with asthma need flu shots, as do others living with them or in regular contact with them, such as a grandparent, day care provider or babysitter.

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Visit the Doctor Regularly

Obviously, a child goes to the doctor when he's sick, but going to the doctor when he's well can be just as important.

The National Institutes of Health (NIH) recommends that all children with asthma be seen by their doctors every three months. This gives the doctor a chance to check in with you, refill medications, find out how frequent or bad your child's asthma symptoms are, and make any necessary changes in medicines or your asthma action plan. Your doctor also can help you figure out and manage asthma triggers, as well as refer you for more asthma education and support resources in your community.

Once you get in the habit of following all of these steps, they aren't so hard, and your child will have the very best chance of breathing easily and living a normal life.

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Claire McCarthy, M.D., a senior medical editor for Harvard Health Publications, is an assistant professor in pediatrics at Harvard Medical School. She is an attending physician and Medical Communications Editor at Children's Hospital Boston. 

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