Asthma is among the most common of chronic diseases that affect kids–it can vary from extremely mild–causing symptoms only a couple times a year (for example, with a virus)–to severe enough to warrant emergency room visits or hospitalization. While the disease in itself and the medications used to manage it seem fairly simple, in reality, asthma can be anything but straightforward, especially in the back-to-school season.

I’ve lived with asthma for the last five years, but as a childcare assistant and respite caregiver for adolescents with special needs, I’ve also seen asthma caregiving from the other side–which is often a lot scarier than living with it inside of you.

Kids need to be taught about what asthma symptoms they could experience (coughing, wheezing, chest tightness and shortness of breath), and can usually develop a fairly solid idea of when they need their rescue medicine at an early age.  Caregivers, however, should be briefed by parents on what to look for in their child when asthma symptoms occur, and when symptoms are most likely to occur–for example, if a child is triggered by viruses, caregivers need to be more alert during cold season or when a child with asthma is sick, if their symptoms are triggered by exercise, then caregivers need to be aware of this so they can monitor them more closely during physical activity.

If exercise is a trigger, it can be helpful to have children with asthma warm-up and cool-down for 10-15 minutes before and after physical activity to give their lungs a chance to gradually warm and cool in response to the activity, and also take their rescue medication (such as Ventolin–albuterol/salbutamol) 10-15 minutes before starting to become physically active, or simply encouraging them not to go too hard, too fast (however, kids are kids, and sometimes trying to hold an active kid back, even simply for five minutes, is a bit like trying to prevent a monkey from climbing everything in sight–it’s just not going to happen). Recess and physical education classes, as well as special events, can require special planning for kids with asthma to be able to participate fully–primarily, ensuring they can access their medications when needed.

In some cases, it is reasonable to have a child keep their medicine with a teacher or other adult who is with them most of the time. In others, and with older children, it is best that they assume responsibility and, with guidance, carry their own medication and use it under supervision–school policies need to be checked to ensure this is permissible.

Parents of kids with asthma can do the following to keep their kids healthy during the back to school season:
Ensure children have a backup rescue inhaler and spacing device [i.e. AeroChamber] kept at school (i.e. with the physical education teacher, their homeroom teacher, or in the office).
Provide an Asthma Action Plan to the school and ensure the child’s teachers know the child has asthma and what to do to help. If symptoms do not go away after 10-15 minutes following dosing of a rescue medicine, 911 should be called and rescue medicine can be given every 5 minutes.
Give caregivers guidelines to know what a child’s asthma flare-ups look like. [Do they cough or wheeze? Do they get short of breath and turn red? Do they complain of an itchy neck? The last one is an odd symptom, but can be fairly common in kids!]
Keep extra rescue medication at school–inhalers are tricky and get lost easier than most would expect (I will be honest here: I’m twenty two and I’ve lost two inhalers in the last month. IT HAPPENS! :).)
Educate the child to avoid his or her triggers, and ensure older children know their symptoms and when to seek help.  Help guide them in using proper inhaler technique and encourage the use of spacers [i.e. AeroChamber]
Encourage the child to wear medical identification at all times stating he or she has asthma to ensure their needs are communicated in case of an emergency.
Most importantly, since approximately 10% of children have asthma, children with asthma need to know that they are not alone–if it is possible, young children may find it easier to deal with their asthma if they know someone else their age who lives with it, too!

For more information on asthma care in children, the following resources may be helpful:

USA
KidsHealth.org Asthma Centre

CANADA
The Asthma Society of Canada
AsthmaKids.ca