How Parents Can Help Kids with Asthma

As millions of children head back to school this month, doctors are bracing for an increase in asthma attacks. The exposure to allergens and contagious colds and viruses in the classroom often triggers episodes among asthmatics, leading to a spike each fall in the number of hospitalizations for the disease. And there are plenty of children at risk: research published in this week's issue of the British medical journal The Lancet finds asthma has become more prevalent in younger children in North American over the past decade. If the chronic condition is controlled through medication and management plans, children can usually lead relatively normal, healthy lives. But many parents aren't taking such steps.

In a survey by the American Lung Association reported Tuesday, nearly three quarters (73 percent) of 2,010 parents with asthmatic children said they are concerned about how their child's asthma will affect their ability to participate in school. Yet fewer than a third of the parents have made sure their children are under medical supervision or have talked to school administrators about their child's asthma. And fewer than half (48 percent) say they've talked to the schoolteachers about their child's asthma or made sure the child's medicine is available at school (42 percent).

"That's a source of concern," says Dr. Norman H. Edelman, chief medical officer for the American Lung Association, which has launched a back-to-school campaign to help parents recognized asthmatic symptoms in their kids and to develop a management plan. "This really has to be a collaboration between the doctor, parents, child and school."

At least 6 million children now suffer from asthma. It is the most common chronic condition and the leading cause of hospitalizations for those under 18, according to the Asthma and Allergy Foundation. Edelman says as many as 2 million more may have mild forms of the disease that have not have been diagnosed. Frequent shortness of breath and wheezing are common symptoms of the chronic condition. Parents should also check with their child's physician if their child is waking up coughing during the night or can't keep up with other children during playtime.

Many parents with children who have been diagnosed with asthma have taken steps to control it, meeting with a physician to get medication, identifying allergens—like dust, pollen or cat fur—that might trigger attacks and taking steps to lower their children's exposure. But when kids go back to school, it becomes harder to do so. Too often, the ALA says, parents don't think to sit down with the school staff and share information about their child's condition.

When Leia Schwartz was diagnosed with asthma at 3 years old, her parents didn't realize how serious the condition was. Two years later, the Miami girl suffered an attack so severe that her lung collapsed and she remained hospitalized in critical condition for more than two weeks. "We almost lost her," says her mother, Laura.

Leia survived. But each year, more than 4,200 Americans die from the disease—about 5 percent of them children. Leia's parents were determined to make sure she wouldn't risk being among them. They now meet each school year with her principal and teachers to review her symptoms, asthma triggers and medications and to establish an action plan for her in case her asthma flares up. They've arranged to have Leia, now 10, spend gym class and recess in the library reading to kids in the younger grades, which she enjoys. And the school staff keeps her medication in the office, along with a list of the Schwartzes' contact numbers.

The ALA recommends all parents with asthmatic children take similar steps—working with a physician to create a written back-to-school plan that includes individualized information about the child's particular symptoms, attack triggers, daily medications, rescue inhaler (one that can be used if an attack has started), limitations on physical activity and specific instruction about what to do and whom to call if a child gets an attack at school. The plan should be shared with the school nurse, administrator and the child's teachers. The group also recommends that asthmatic children get vaccinated against influenza, another potential trigger. (For more information or to download an action plan form, go to

Leia, now in fifth grade, still has to be hospitalized occasionally. But both the frequency and length of her visits have decreased since the family created an action plan to manage her asthma, and her episodes have become less severe now that teachers can detect problems earlier and call her parents. "I'm afraid to think what would happen if we didn't have the plan," says her father, David Schwartz. "It's made a huge difference."