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Your Child's Asthma: Flare-Ups

When your child has asthma, the airways in his or her lungs are inflamed (swollen). This narrows the airways, making it hard to breathe. During an asthma flare-up (also called an asthma attack) the lining of the airways swells even more and makes extra mucus. This makes the airways even narrower. The muscles around the airways also tighten, making it even harder for air to get in and out of the lungs.

Outline of child with head turned to side. Trachea and lungs are visible. Closeup of cross section of normal airway showing relaxed muscle and smooth lining inside open airway. Closeup of cross section of airway with asthma showing tightened muscle, inflamed lining, and mucus building up inside airway.

What causes flare-ups?

Flare-ups occur when the airways in a child with asthma react to a trigger. These are things that make asthma worse. Triggers can include smoke, odors, chemicals, pollen, pets,  mold, cockroaches, and dust. Other things such as exercise, having a cold or the flu, and changes in the weather, can also trigger a flare-up.

What are the symptoms of a flare-up?

Your child is having a flare-up if he or she has any of the following:

  • Trouble breathing

  • Breathing faster than usual

  • Wheezing (a whistling noise when breathing out)

  • Feeling tightness or pain in the chest

  • Coughing, especially at night

  • Trouble sleeping

  • Getting tired or out of breath easily

  • Having trouble talking

What to do during a flare-up

When your child is starting to have symptoms, don’t wait! Follow your child’s asthma action plan. It should tell you exactly what symptoms signal a flare-up in your child. It should also tell you what to do. This may include having your child do the following:

  • Use quick-relief (rescue) medication. Quick-relief medications ease your child’s breathing right away.

  • If peak flow monitoring is used, measure your child's peak flow.  If peak flow is less than 50%, your child’s flare-up is severe. You need to call your child’s health care provider right away. You should also call 911 if your child is having any of the symptoms listed in the box below.

If your child doesn't have an Asthma Action Plan or if the Plan is not up to date, talk with your child's health care provider.

When to call 911

Call 911 right away if your child has any of the following symptoms. They could mean your child is having severe difficulty breathing:

  • Very fast or hard breathing

  • Sinking in between the ribs and above and below the breastbone (chest retractions)

  • Being unable to walk or talk

  • Lips or fingers turning blue

  • Peak flow reading less than 50 percent of normal best

Preventing worsening symptoms and flare-ups

To help control asthma, you should help your child with the following:

  • Work together with your child’s health care provider. Controlling asthma takes teamwork. Keep all appointments with your child's health care provider. Don’t just make an appointment when your child has a flare-up. And, follow your child's asthma action plan.

  • Use controller medications as instructed. Make sure your child uses his or her long-term controller medications, such as corticosteroids and other anti-inflammatory medications. A child with asthma can have inflamed airways any time, not just when he or she has symptoms. So controller medications must be taken daily, even when your child feels well.

  • Identify and manage flare-ups right away. Learn to recognize your child’s early symptoms and to act quickly. If your child begins to have symptoms of a respiratory infection and respiratory infections trigger his or her symptoms, start quick-relief medcations as instructed. If your child is old enough, teach him or her to recognize and treat his or her own symptoms.

  • Control triggers. Helping your child avoid triggers, or those things that cause asthma symptoms, is another key to asthma control. Once you know the triggers, take steps to control them. For example, if  someone in your household smokes, he or she should think about quitting. There are many excellent stop-smoking programs and medications that can help. Also, don't allow anyone to smoke near your child, including in your home and car.

Online Medical Reviewer: Holloway, Beth, RN, M.Ed.
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Last Review Date: 8/28/2014
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.