As a parent, the task of making sure a child with asthma understands his or her medication falls to you — ready or not. Once you master what different asthma medications do, you’ll be better prepared to keep tabs on whether your child knows when and how to use them independently.

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Almost 5 million U.S. children have asthma, according to a 1998 report in the American Journal of Respiratory and Critical Care Medicine. The National Asthma Education and Prevention Program (NAEPP, a project of the National Institutes of Health) recommends that children be directly involved in asthma management as soon as they’re ready. But when exactly is that?

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Asthma triggers are as individual as children themselves. When exposed to an asthma trigger (an allergen or irritant), the airways and lungs of people with asthma react with a cascade of symptoms, such as wheezing, coughing, and shortness of breath. If your child is diagnosed with asthma, you’ll work closely with your child’s doctor to pinpoint his or her personal asthma triggers.

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Before allergy treatment can begin, the problem allergen must be identified. Allergens that are present all year usually provoke the year round symptoms of perennial allergic rhinitis. On the other hand, pollen is usually the allergen that triggers seasonal allergic rhinitis (hay fever).

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Just because you or your spouse has asthma doesn’t mean your child will. In fact, controlling your child’s early exposure to allergens actually may slow down or prevent the development of asthma. The American Academy of Allergy, Asthma & Immunology (AAAAI) reports that early and prolonged exposure to allergens contributes to the later development of asthma and allergies.

Start by getting dust mites (the most common pediatric asthma trigger) out of the crib. Doing so can delay or prevent the development of allergic disease, as is documented in study after study. For example, research published in the January 1998 Journal of Allergy and Clinical Immunology confirmed that dust mite-blocking bedding encasements can prevent dust mite sensitization.

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As the parent of a child with asthma, keeping your child safe and healthy is a top priority. You do your best to make sure your child understands his or her asthma management plan and asthma action plan. You take steps to rid your home of things that might trigger an episode. You check up on whether your child is using medication as directed. And still you can’t help wondering if a severe, life-threatening asthma episode (status asthmaticus) may strike.

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As your child grows, his or her role in taking medicine slowly changes from passive to active. Eventually, your child will “graduate” from you giving the medication, to taking medication on his or her own. In real terms, that means moving from a nebulizer to a metered dose inhaler, or MDI.

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Since infants and toddlers can’t take asthma medication on their own, the task of delivering medication usually falls to you, the parent. And in most cases, this requires learning how to use a nebulizer, a device that breaks down medicine particles into the best size for absorption into the airways. A nebulizer delivers the custom-mixed aerosol through a mouthpiece or face mask.

You may have seen a nebulizer used in hospital settings. Before using one at home, ask your child’s doctor (or other health care professional) to demonstrate the technique. Then, try it yourself with someone from the doctor’s staff looking on to offer feedback.

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Researchers have found that exercise can trigger symptoms in as many as nine out of ten children with asthma. Does that mean a child with asthma can’t exercise safely? Absolutely not. It means asthma needs to be controlled, so the child can participate fully in everyday active play, exercise, and even team sports. The myth of the miserable asthmatic child sitting on the sidelines is just that — a myth.

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“Can I try out for the softball team?”

If you are the parent of a child whose asthma is triggered by exercise, answering this simple question may make you nervous. Can softball be risky? Is there adequate adult supervision? Does the coach know enough to spot an emergency? Will my child be safe?

These are normal concerns for the parent of a child who has exercise-induced asthma (EIA). Keep in mind that most parents have similar concerns about their child’s safety. You may have felt some of the same fears on the first day of preschool. It might help you to know that kids with asthma can exercise safely as long as their asthma is under control.

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