(This is the second article in a series on childhood asthma. For basic information about asthma, see “Childhood Asthma: What Parents Need to Know.”)

If your child has asthma, there is a lot that you need to know and do to keep her healthy. You need to take her regularly to her doctor, give her daily medicine to prevent asthma attacks, keep her away from her asthma triggers (such as colds, smoke, animal fur, dust and exercise), monitor her breathing symptoms, recognize the early signs of an asthma attack and give her quick-relief medicine to treat attacks.

With good care, children with asthma can lead normal, healthy lives, attend childcare and school, play sports, have sleepovers at friends’ houses and attend summer camp. But you also need to know that at any of these places, your child could be exposed to her asthma triggers, have an asthma attack and require her medications. For this reason, everyone who cares for your child—family members, friends, childcare providers, school teachers, sports coaches and camp counselors—must know about your child’s asthma, and know how to prevent and manage an asthma attack. To do this, everyone who cares for your child will need the following:

• A written copy of your child’s asthma action plan
• Your child’s asthma medications and equipment
• Instructions on how to give your child’s medication
• A telephone for emergency contacts

Developing the asthma action plan
Work with your child’s doctor to develop an asthma action plan for your child. It should detail your child’s asthma triggers, the signs and symptoms of an attack, your child’s routine and emergency medicines and emergency procedures and contacts.

It’s best to use a form that presents all the information clearly. Your doctor or your child’s school may have a form that they use, or you can use the excellent forms from the American Lung Association (lungusa.org or 800-LUNGUSA).

Sharing the Asthma Action Plan
Make an appointment with your childcare provider or school to discuss your child’s asthma. Make sure that all of the adults responsible for your child – including the teacher, principal, school nurse, physical education instructor and coach – are present.

Give each person a written copy of your child’s asthma plan, and review all the details. Have an extra peak flow meter and supply of your child’s medications for them to keep on-hand. Be sure to address any questions they have. Ask about their plans for sharing the instructions with other adults at school who need to know, such as assistant teachers, substitutes, assistant coaches, recess monitors and parent drivers on field trips. Also, check back periodically to update your emergency contact information and make sure the medicine is not expired.

Modifying Activities during Illnesses
When your child is experiencing asthma symptoms or recovering from an asthma attack, she may be well enough to return to childcare or school with a modified plan for activities. Ask your child’s doctor what activity modifications are recommended and communicate these with the school. For example, your child may recover quicker with reduced running during physical education class, more frequent checks of peak flow and possibly more frequent medication.

Encouraging the School to Examine its Asthma Policies
Schools are required under the Americans with Disabilities Act to make reasonable accommodations for children with disabilities, including chronic medical conditions such as asthma. Discuss the following questions with your school administrators:

1. Is there a school nurse onsite or regularly available to help write asthma plans and policies, train responsible staff, teach students about asthma and provide consultation?

2. Does the school maintain good air quality to help prevent asthma attacks? Is the school free of tobacco smoke? Does the school minimize allergens such as pets, mold, dust mites in carpets, cockroaches and fumes from pesticides, paint and cleaning products?

3. Can children take their asthma medicines at school as recommended by their doctor? Can children carry their own asthma medicines? If not, are the medicines quickly accessible at any time?

4. Can students safely participate in physical education class and recess? Can they take their asthma medicines before exercise, and have modified activities when necessary?

5. Does the school have an emergency plan for taking care of a child with a severe asthma attack?

Recommend that the school use the Asthma-Friendly Schools Toolkit at the American Lung Association website.

For more information on childhood asthma, visit The American Lung Association website, or The American Academy of Allergy, Asthma and Immunology at www.aaaai.org.