Asthma - child - discharge
Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge
Your child has asthma, which causes the airways of the lungs to swell and narrow. Now that your child is going home from the hospital, follow the health care provider's instructions on how to care for your child. Use the information below as a reminder.
Did you know that asthma is one of the most common disorders affecting children, as many as 10 percent of them? Thankfully, advances in the diagnosis and treatment of asthma have dramatically improved life for these children. Asthma is caused by swelling and other signs of inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by the bronchioles, or small tubes, of the lung. Most asthma attacks are caused by triggers, such as pollen, dust mites, mold, pet dander, cockroaches, tobacco smoke, and exercise. Your child may have asthma if they experience shortness of breath, maybe gasp for air, and have trouble breathing out. When breathing gets very difficult, the skin of your child's chest and neck may suck inward. Your child may cough so hard at night he wakes from sleeping. He may have dark bags under his eyes and feel tired and irritable. Your child's doctor will listen to your child's lungs. The doctor will have your child breathe into a device called a peak flow meter. This device can tell you and your child's doctor how well the child can blow air out of his lungs. If asthma is narrowing and blocking your child's airways, his peak flow values will be low. To treat your child with asthma, you will need to work with your child's pediatrician, pulmonologist, or allergist as a team. Your child will need an action plan that outlines his asthma triggers and how to avoid them, how to monitor his symptoms, measuring peak flow, and taking medicines. You should have an emergency plan that outlines what to do when your child's asthma flares up, at home and in school. Make sure the school has a copy of your child's asthma action plan too. Your child will probably need to take two kinds of medicines, long-term control medicines and quick relief or rescue medicines. Your child will take long-term control medicines every day to prevent asthma symptoms, even when he has none. Your child will need to use quick relief medicines during an asthma attack. If your child needs to use an inhaler with his medicines, make sure the doctor shows him how to use a spacer device, to get the medicine into his lungs properly. Today, most children with properly managed asthma can lead a life unhindered by their disease. It shouldn't hold them back from even the highest levels of athletic competition. With proper education and medical management, it is possible to control this disease on a daily basis and prevent asthma attacks.
When You're in the Hospital
In the hospital, the provider helped your child breathe better. This likely involved giving oxygen through a mask and medicines to open the lung airways.
What to Expect at Home
Your child will probably still have asthma symptoms after leaving the hospital. These symptoms include:
- Wheezing and coughing that may last up to 5 days
- Sleeping and eating that may take up to a week to return to normal
You may need to take time off work to care for your child.
Take Charge of Your Child's Asthma at Home
Make sure you know the asthma symptoms to watch out for in your child.
You should know how to take your child's peak flow reading and understand what it means.
- Know your child's personal best number.
- Know your child's peak flow reading that tells you if their asthma is getting worse.
- Know your child's peak flow reading that means you need to call your child's provider.
Keep the phone number of your child's provider with you.
Triggers may make asthma symptoms worse. Know which triggers make your child's asthma worse and what to do when this happens. Common triggers include:
- Smells from chemicals and cleaners
- Grass and weeds
- Rooms that are moldy or damp
Know how to prevent or treat asthma symptoms that arise when your child is active. These things might also trigger your child's asthma:
- Cold or dry air.
- Smoky or polluted air.
- Grass that has just been mowed.
- Starting and stopping an activity too fast. Try to make sure your child warms up before being very active and cools down after.
Understand your child's asthma medicines and how they should be taken. These include:
Keep Smoking Away From Your Child
No one should smoke in your house. This includes you, your visitors, your child's babysitters, and anyone else who comes to your house.
Smokers should smoke outside and wear a coat. The coat will keep smoke particles from sticking to clothes, so it should be left outside or away from the child.
Ask people who work at your child's day care, preschool, school, and anyone else who takes care of your child, if they smoke. If they do, make sure they smoke away from your child.
School and Asthma
Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities.
There should be an asthma action plan at school. The people who should have a copy of the plan include:
- Your child's teacher
- The school nurse
- The school office
- Gym teachers and coaches
Your child should be able to take asthma medicines at school when needed.
School staff should know your child's asthma triggers. Your child should be able to go to another location to get away from asthma triggers, if needed.
When to Call the Doctor
Call your child's provider if your child is having any of the following:
- Hard time breathing
- Chest muscles are pulling in with each breath
- Breathing faster than 50 to 60 breaths per minute (when not crying)
- Making a grunting noise
- Sitting with shoulders hunched over
- Skin, nails, gums, lips, or area around the eyes is bluish or grayish
- Extremely tired
- Not moving around very much
- Limp or floppy body
- Nostrils are flaring out when breathing
Also call the provider if your child:
- Loses their appetite
- Is irritable
- Has trouble sleeping
Jackson DJ, Lemanske RF, Bacharier LB. Management of asthma in infants and children. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 50.
Liu AH, Spahn JD, Sicherer SH. Childhood asthma. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 169.
National Heart, Lung, and Blood Institute website. National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the diagnosis and management of asthma.
Last reviewed on: 5/27/2020
Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.