context: Based on your child's history and the severity of asthma, his or her doctor will develop a care plan, called an "asthma action plan." The asthma action plan describes when and how your child should use asthma medications, what to do when asthma gets worse, and when to seek emergency care for your child. Make sure you understand this plan and ask your child's doctor any questions you may have. Your child's asthma action plan is important to successfully controlling his or her asthma. Keep it handy to remind you of your child's daily asthma management plan, as well as to guide you when your child develops asthma symptoms. In addition to following your child's asthma action plan, you want to make sure exposure to asthma triggers is limited, and preferably avoided. If an infant or child is experiencing symptoms of asthma that require treatment with a bronchodilator medication more than twice a week during the day or more than twice a month at night, most doctors recommend daily anti-inflammatory drugs. Most asthma medications that are given to adults and older children can also safely be prescribed to toddlers and younger children. Drugs that are approved for younger children are given in doses adjusted for their age and weight. In the case of inhaled drugs, a different delivery device based on the child's age and ability may be required. ( Many children aren't able to coordinate their breathing well enough to use a standard inhaler. You may give your child asthma medications using a home nebulizer, also known as a breathing machine. A nebulizer delivers asthma drugs, usually bronchodilators, by changing them from a liquid to a mist. Your child gets the drug by breathing it in through a facemask. These breathing treatments usually take about 10-15 minutes and are given up to several times a day. Your child's doctor will tell you how often to give your child breathing treatments, based on the severity of his or her asthma. Your child may be able to use a hydrofluoroalkane inhaler or HFA (formerly called a meter dose inhaler or MDI) with a spacer. A spacer is a chamber that attaches to the HFA and holds the burst of medication. Talk with your child's doctor to see if an HFA with spacer is right for your child. You know your child's asthma is well controlled if, with medication, your child: Lives an active, normal life Has few troublesome symptoms Attends school every day Performs daily activities without difficulty Has few urgent visits to the doctor, emergency room, or hospital for asthma Has few asthma drug side effects By learning about asthma and how it can be controlled, you take an important step toward managing your child's disease. We encourage you to work closely with your child's asthma care team to learn all you can about asthma, how to avoid triggers, what medications do, and how to correctly give them. With proper care, your child can live free of asthma symptoms and maintain a normal, healthy lifestyle. Once a person's airways become sensitive due to asthma, they remain that way for life. However, about 50% of children experience a noticeable decrease in asthma symptoms by the time they become adolescents, therefore appearing to have "outgrown" their asthma. About half of these children will develop symptoms again in their 30s and/or 40s. Unfortunately, there is no way to predict whose symptoms will decrease during adolescence and whose will return later in life. If your child is showing symptoms of an asthma attack: Give your child his/her reliever (bronchodilator) medicine according to the asthma action plan. Wait five to fifteen minutes. If the symptoms disappear, your child should be able to resume whatever activity he/she was doing. If symptoms persist, follow your child's asthma action plan for further therapy. If your child fails to improve or you are not sure what action to take, call your child's doctor. Danger signs are severe wheezing, severe coughing, trouble walking or talking, or blue lips or fingernails. Increasing shortness of breath with decreased wheezing is especially dangerous because it means less air is moving in and out of the lungs. If any of these are present go to the emergency department or call 911.