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 (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. This makes it even harder for air to get in and out of the lungs.

Outline of child with showing respiratory system. Insets show normal airway and airway with asthma.

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 can also trigger a flare-up. These include exercise, having a cold or the flu, and changes in the weather.

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. This is 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) medicine. Quick-relief medicines ease your child’s breathing right away.

  • Measure your child's peak flow if you use peak flow monitoring. If peak flow is less than 50%, your child’s flare-up is severe. You need to call your child’s healthcare 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 healthcare 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)

  • Can't walk or talk

  • Lips or fingers turning blue

  • Peak flow reading less than 50% of normal best

  • Not acting as normal or seems confused

  • Not responding to asthma treatments

Preventing worsening symptoms and flare-ups

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

  • Work together with your child’s healthcare provider. Controlling asthma takes teamwork. Keep all appointments with your child's healthcare provider. Don’t just make an appointment when your child has a flare-up. Follow your child's Asthma Action Plan.

  • Use controller medicines as instructed. Make sure your child uses his or her long-term controller medicines. These may include corticosteroids and other anti-inflammatory medicines. A child with asthma can have inflamed airways any time, not just when he or she has symptoms. Controller medicines must be taken every day, 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. Start quick-relief medicines as instructed if your child begins to have symptoms of a respiratory infection and respiratory infections trigger his or her symptoms. If your child is old enough, teach him or her to recognize and treat his or her own symptoms.

  • Control triggers. Helping your child stay away from things that cause asthma symptoms is another important way to control asthma. 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. Many excellent stop-smoking programs and medicines can help. Also don't allow anyone to smoke near your child, including in your home and car.