Managing Your Child's Asthma

What should you do if you think your child has asthma? First of all, don't panic: You're not alone, and there are steps you can take to manage the disease. More than 130,000 children in New York City live with asthma every day - and the vast majority lead normal, healthy lives.

Steps to take at the doctor's office

The initial - and most important - steps toward managing your child's asthma should come while you're still at the doctor's office.

Make sure you're comfortable with the doctor's diagnosis of your child's condition. If you're not, insist on a referral to a lung specialist.
Try to determine what triggers your child's asthma attacks. (You may never determine all the possible triggers.)
Teach your child how to:
- Recognize asthma warning signs.
- Contact someone other than you for help, if necessary.
- Rest and relax during an attack.
- Take his or her medicine.
- Do deep coughs after an attack.
Make an action plan with your doctor and your child. It should include:

Ways to keep your child away from triggers.
A prescription for medicine, if necessary.
A shopping list for any asthma "tools" that the physician prescribes. The most common are a metered dose inhaler, a spacer, a nebulizer and a peak flow meter, all of which could help your child prevent or ease an attack. You should get them from your doctor and check to see whether your health insurance covers it.
Careful instructions for you and your child from the doctor on how to use these tools before and during an asthma attack.
A list of goals that your child should strive to meet for the upcoming school year, such as "I won’t forget to carry my asthma medicine with me," "I will always rest when I feel out of breath" and "I will always let my teacher know about my asthma."

Steps to take at home

When you return home from the doctor's office, discuss the action plan with your child and practice the correct use of the asthma "tools." When asthma management becomes routine, your child will be safer and less afraid to participate in sports and other fun activities. Nothing is more important than making sure your child is comfortable with the plan and knows how to properly use the "tools" - after all, you can't watch your child 24 hours a day.

When your child has an attack:

Stop whatever activity is taking place.
Help your child into a comfortable sitting position - do not lay him or her down.
Move him or her away from any possible triggers.
Administer treatment if needed according to the management plan.

Remember: Most asthma attacks should not result in hospitalization if you follow the steps outlined above - so don't rely on a trip to the hospital to treat your child's asthma, unless it's an emergency. Contact your doctor for advice. Here is what you can do at home to reduce the chance that your child will have an asthma attack:

FURNITURE

Put mattresses, pillows and box springs in airtight, dust-proof covers and tape over the zipper.
Wash your child's bedding - including non-feather pillows - every week in water that is at least 130 degrees.
If possible, don't let your child lie down on upholstered furniture.
Remove carpeting, especially in the bedroom.
Keep plants out of your child's room.

CLEANING

Use a damp cloth when dusting.
Keep windows open and your child in another room when cleaning.
Use air conditioning or fans to keep rooms dry.
Use a dehumidifier to reduce mites and avoid mold; do not use humidifiers.
Avoid using aerosol or spray cleaners in your child's bedroom.
Keep your child away from vacuuming, fresh paint, solvents, room deodorizers and perfume.
Aggressively exterminate cockroaches with traps, not sprays.

AIR

Cover air vents with cheesecloth to reduce the amount of dust and other particles that come into the room.
Avoid tobacco and wood smoke.
Wash furry pets regularly.

Steps to take at school

Once you've done all you can at home, you need to make sure your child's asthma needs are met at school. Here are some suggestions:

Ask the school secretary for a "504 Form" and have your doctor fill it out. This document, which is required by federal law, describes your child's medical needs and makes it possible for the school to keep and dispense medication, both in school and on class trips. It also may allow your child to carry an inhaler in school. Without it, inhalers are not permitted at school. Unfortunately, few parents routinely fill out a 504 Form - meaning many students with asthma who needed to keep medication at school were unable to do so.
Ask to meet with the principal and school nurse to discuss your child's needs. Here are some issues to raise:
Ask if classrooms and hallways are free of common asthma triggers such as excessive mold and dust, animal waste, roaches and poor ventilation. Or request a tour of the school.
Ask if your child's classrooms are well-ventilated and free of common schoolroom triggers such as insecticide sprays.
Ask if your school participates in special programs such as the American Lung Association's Open Airways For Schools, which teaches 3rd graders and their parents how to manage asthma and tracks these students in subsequent grades.
Ask what precautions the school takes for students with asthma.
Discuss the action plan you and your child have developed with your doctor. Write the plan on a card and make sure copies are kept in the school's health office and in your child's pocket or backpack at all times.

If you're not satisfied with the answers you get to your questions, insist that the problem or procedures be changed. But even if your principal is sympathetic, your request may not be enough to bring needed changes. For one thing, the solution may involve a large expenditure (such as improving a ventilation system). You may have to take up your concerns with the school's parent association or the local school board or superintendent. Another resource is your school's UFT representative, who is known as the UFT chapter leader and can be reached through the school secretary. The UFT representative can bring your concerns about school conditions to one of the UFT's Health and Safety Committees, which have representatives in each borough.