It is devastating to witness your child having an asthma attack. Even if they’re not technically a baby anymore, they’re your baby, and you have a natural instinct to protect them. Seeing and hearing them struggle to breathe can bring out that instinct in a way that feels overwhelming. You want to help them but may not know how. You feel panicked but don’t want to make their environment even more stressful. What can you do to help them through such a scary incident?

How Do I Know If My Child is Having an Asthma Attack?

Asthma attacks can begin all at once, but more often, they start gradually. Your child may show some early warning signs, such as: 

• Complaints like, “My chest feels weird” (indicating chest tightness) or “It’s hard to breathe”
• Mild coughing and/or wheezing
• Fatigue
• Irritability
• Headache
• Congestion
• Runny nose
• Sore throat
• Itchy, watery eyes

When the asthma attack gets underway, your child will likely exhibit one of more of these symptoms:

• More intense coughing, wheezing and/or tightness in the chest
• Trouble breathing, speaking, crying or eating 
• Rapid breathing, which means:
  • Birth to 1 year old: More than 60 breaths per minute
  • 1 to 3 years old: More than 40 breaths per minute
  • 3 to 6 years old: More than 34 breaths per minute
  • 6 to 12 years old: More than 30 breaths per minute
  • 12 to 18 years old: More than 16 breaths per minute

What Is Happening to My Child When They Have an Asthma Attack?

Asthma is a chronic condition that affects your child’s airways, the passages in their lungs through which air flows when they breathe in and out. When a child has asthma, certain triggers cause the airways to become inflamed, tightened and clogged by mucus. This obstructs their breathing and causes an asthma attack.

What Can Trigger an Asthma Attack?

There are many things that can trigger an asthma attack, including:

• Environmental allergens (trees, grass, weeds)
• Animals (mainly those with fur or feathers)
• Infections that affect the lungs (a cold, the flu, RSV)
• Smoke (fires, tobacco)
• Mist from vape pens
• Air pollution
• Dust
• Mold
• Cockroaches
• Barns (grain dust, hay)
• Exercise or playing
• Food allergies
• Stress and/or strong emotions
• Sudden changes in weather

What Should I Do When My Child is Having an Asthma Attack?

When your child is having an asthma attack:

• Stay as calm as possible. Anxiety can make an asthma attack worse, so if you are calm, it’s more likely that your child will be less anxious.
• Help your child to sit up straight. They should not be laying down during an asthma attack.
• Help child take their reliever inhaler: one puff every 30 seconds for five minutes or one puff every 60 seconds for 10 minutes.
  • If your child has been diagnosed with asthma, their doctor has likely prescribed them two inhalers: a “controller” inhaler to take every day as maintenance and a “reliever” to take when symptoms are severe. Make sure you are giving your child the reliever inhaler.
• If your child does not have a reliever inhaler or it has gotten lost, call 911 or take them to the emergency room. Do not have them use another person’s inhaler.

When Should I Call 911 or Take My Child to the Emergency Room/Urgent Care?

You should call 911 or take your child to the emergency room/urgent care for an asthma attack if:

• Your child’s symptoms have not improved 20 minutes after using their reliever inhaler
• Your child can barely speak or cry at all because of severe difficult breathing.
• Your child’s wheezing is constant.
• Your child does not have an inhaler or it has gotten lost.
• Each time your child takes a breath, the skin around their ribs and neck get sucked inward. (This is called having retractions.)
• Your child’s nostrils get wide with each breath.
• Your child’s symptoms appear after eating a certain food, getting stung by a bee, or taking a certain medication.
• Your child’s lips are blue, purple or grey. (This means they are being severely deprived of oxygen.)
• Your child has a new or worsened fever.
• Your child coughs up red or dark brown mucus.
• Your child has fainted.

How Can I Reduce the Chances of My Kid Having an Asthma Attack?

Unfortunately, there is no surefire way to prevent your child from having an asthma attack. However, you can reduce the likelihood of one if you:

• Help your child use their controller inhaler and/or take their asthma medicine every day (or as often as directed by their doctor). 
• Schedule an urgent, same-day appointment with your child’s Mercy doctor after they have an asthma attack. 
• Tell your child’s doctor that you want to create an asthma action plan.
• Learn what triggers your child’s asthma and help them to avoid it. 
  • For example, if your child’s trigger is smoke, avoid campfires and ask people not to smoke around them. If their trigger is dust, try to dust and vacuum your house on a regular basis. 
• Make sure your child gets a flu shot every year.
• If your child is 19 months old or younger, ask their doctor if they are eligible for a form of RSV immunization called nirsevimab.
• Ask your child’s doctor if they are eligible for the pneumococcal (pronounced noo-mow-kaa-kl) vaccine.