Poorly controlled asthma in children can significantly interfere with their quality of life, limiting their day-to-day activity and potentially leading to missed school days, emergency room visits, and hospitalization. It is important for parents and caregivers to understand their child’s asthma treatment plans by asking the right questions and getting the information they need from their child’s doctor.
Treatment for asthma typically consists of maintenance or controller medications (such as an inhaled corticosteroid) that are taken every day to control symptoms, as well as quick-relief or rescue medications (such as albuterol) to treat periodic asthma attacks.
Combination medications combine maintenance inhaled corticosteroids with a long-acting bronchodilator medication (similar to quick-relief medications). Some medications are given orally, but most are administered using an inhaler or nebulizer to deliver the drugs directly into the lungs.
Additionally, there are other treatments that are given on a less frequent schedule, such as injected biologics that may be given once or twice a month. Most children with asthma have allergic asthma, so allergy testing and allergy treatment go hand in hand with asthma treatment.
Learn about treatments for moderate to severe childhood asthma.
When talking to your child’s doctor about asthma treatment, discuss the goals of treatment, including how to know if medications are working or not. As a caregiver, you need to know when treatments aren’t working well enough and when to contact the doctor about making changes to the treatment plan. Make sure to tell the doctor about how your child is responding to treatment, especially how frequently they need to use quick-relief medicines, such as rescue inhalers.
Always be open and honest with your doctor about missing doses or not following instructions. It can be embarrassing to admit, but your doctor needs to know if you or your child are not following the treatment plan.
Additionally, make sure to report any problems administering asthma medicines. For example, if your child is having trouble using an inhaler, they may not be getting an effective dose of medication, which can lead to increased symptoms. In this case, they may not need a change to their treatment plan, but simply more training.
It is important for parents and caregivers to understand their child’s asthma medications. It is also important for children to know and understand their own medications. This is especially true for older children who carry their own inhalers.
You may be surprised at how quickly a child can learn about and understand their treatment, even at a very young age. Make sure that your child is part of the discussion with their doctor about their medications.
When talking with your child’s doctor, make sure you know the names of asthma medicines — including both the brand name and the drug name — and what they look like. You should also understand the proper route of administration. This can include pills, inhalers, or nebulizer treatments. It may be a good idea to bring your medications with you to every doctor visit.
Ask the doctor about the dosage (how much to give your child), such as the number of puffs of an inhaler or how much to put into a nebulizer. You should also understand when and how often treatments should be given, including when and if additional treatments should be given before exercise or physical activity.
Sit down with your doctor or a nurse and physically go through each medication. Some inhalers may look similar but have different uses. Some inhalers, such as powder inhalers, are used differently than others.
Make sure you and your child know how to operate each inhaler. This includes when and how to prime a new inhaler before use, and how to properly use a spacer that attaches to some inhalers. For nebulizers, you’ll need to know how to operate the nebulizer machine, as well as how to properly attach tubing and use a mask. For inhalers, spacers, and nebulizers, ask how and when to clean them as well.
Don’t forget to discuss when and how to use a peak flow meter, including how to clean it. A peak flow meter can tell you if your child is having a bad asthma day or an asthma episode. Just as checking blood sugar levels is important for people with diabetes, using a peak flow meter daily and as needed is important for children with asthma (who are old enough).
Make sure to work with your doctor to determine your child’s “personal best” flow meter reading; this number will determine how to interpret daily readings. Discuss how to use the peak flow meter as part of your child’s asthma action plan.
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An asthma action plan is more than a detailed treatment plan. It includes information about what medications to take and when to take them, as well as how to identify and treat acute asthma flare-ups and asthma emergencies. An asthma action plan is not just for you and your child, but for all caregivers — including school staff.
Learn more about preparing your child with asthma to return to school.
When talking to your child’s doctor, it is important to make a detailed, written asthma action plan that can be shared with your child’s school, child care center, and anyone else caring for your child, such as a babysitter.
It is important for everyone involved in your child’s care to be able to:
Asthma action plans are typically broken down into zones:
Zones are determined by peak flow readings and a child’s asthma symptoms. The zone a child is in helps determine what activities a child can perform and what medical care they need.
An asthma action plan includes several pieces of key information:
Additional information can include:
You can study an example asthma action plan form.
When it comes to caring for your child, do not settle for less than your child deserves. If you are not satisfied with your child’s doctor, don’t hesitate to get a second opinion. Doing so can give you peace of mind that your child is getting the best possible care.
There are many reasons to seek a second opinion from another health care provider, including:
Childhood asthma affects about 1 in 12 children in the United States; it is a very common chronic illness among kids. However, there are many possible causes of breathing difficulties in young people that can be misdiagnosed as asthma. If asthma is not the correct diagnosis, then your child’s symptoms may not respond to treatment.
Even if asthma is correctly diagnosed, you may not feel that your child is seeing enough improvement from treatment. You may even feel that a doctor is overtreating your child. It is perfectly reasonable to seek a second opinion to make sure your child is getting appropriate care.
Additionally, some parents and caregivers are not satisfied with a particular doctor for other reasons. You may feel like a doctor does not communicate well or listen to your concerns. Maybe you or your child just do not like a doctor’s personality. Some doctors, even pediatric specialists, don’t have an ideal bedside manner. These can all be good reasons to seek a second opinion.
You should always try to get care from a doctor you feel you can trust. If you do seek a second opinion, try to find a doctor who specializes in asthma, such as an allergist/immunologist and pediatric pulmonologist (lung doctor). Before you go to see another doctor, make sure that all of your child’s medical records, including laboratory and lung function test results, are forwarded to them.
The relationship between a doctor and a person with asthma is based on trust and communication. Make sure that you discuss any concerns you have about your child’s asthma treatment with your doctor.
When it comes to caring for your child, there are no stupid questions. Always ask about anything you are unsure about during a doctor’s visit. And, if you are not satisfied with the care your child is receiving, do not be afraid to seek a second opinion.
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