Asthma 

Help Your Child Gain Control Over 
United States 

Agency 

Division 

Office of Air and Radiation 

Environmental Protection September 2004

Indoor Environments EPA 402-F-04-021 
means fewer days out of school and fewer attacks that 

can be scary for you and your child. 

since we put together an asthma action plan with her 

Carrie’s asthma 

—

1 

It’s hard to see your child sick. The good news is that 

you can help your child gain control over asthma. That 

Along with the doctor, you have an important role in 

helping your child control asthma. We congratulate 

you for reading this booklet. 

“My daughter Carrie has asthma. Life is a lot easier 

doctor. She’s sick a lot less now. 

“Coming up with a plan that works and making sure 

medicines were taken on time and the right way really 

cut down on her sick days. Going through the house to 

get rid of the ‘triggers‘—those things that brought on 

—made a huge difference too.” 

Rita, mom of 7-year-old Carrie Lynn 
2 

• Read 

of asthma. 

• Read for ways to find and keep things away 

child’s asthma attacks. 

• 

• Put this booklet in a handy place and 

listed will help your child have 

Read this booklet to learn 

about helping your child. 

To get the most from this booklet 

You will want to read this booklet to learn more 

about helping your child prevent asthma attacks. 

The booklet is broken into two parts. 

Part 1 for how to create a plan to take control 

Part 2 

from your child that trigger—or bring on—your 

Share this booklet with friends, family, teachers, 

daycare staff, and your child’s doctor. 

pull it out to read now and again when 

you need it. We hope the practical tips 

fewer problems with asthma. 
Learn about asthma 

Learn about asthma attacks, what causes 

an attack, and warning signs that show 

your child’s asthma may be getting worse. 

warning signs 

gets worse. 

Make an asthma action plan 

your child. 

3 

Part 1 

Create a plan to take control 

Page 4 

Be aware of your child’s Page 6 

Find out how to stop an attack before it 

Page 11 

Work with your child’s doctor to design 

a daily plan and a rescue plan that work for 
Learn about asthma 

Learn about asthma and the early warning signs 

that works for your child. 

What is asthma? 

Asthma is a disease that causes the airways of the 

lungs to tighten and swell. It is common among 

An asthma attack happens when your child has 

attack. 

can be full of triggers such as pests and mold. Read 

4 

before asthma gets out of control. Work with your 

child’s doctor. Come up with an asthma action plan 

children and teens. 

What is an asthma attack? 

asthma and their lungs aren’t getting enough air to 

breathe. Your child may cough or wheeze during an 

What causes an asthma attack? 

Things that cause asthma attacks are called triggers. 

Triggers are everywhere. Your child’s home or school 

Part 2 on page 15 to learn more about triggers. 
5 

“I found it helpful to learn all I could about asthma. 

It made it easier to talk to my son’s teacher when I 

asthma attack in school.” 

—

knew what to tell him to look for if Tyler has an 

Mary, mom of 9-year-old Tyler 

Tell the school if your child has asthma. 
6 

worse. 

or she feels. So you may have to watch a younger child 

Learn your child’s warning signs and catch an attack 

Think about the last time your child had an asthma 

Be aware of your child’s warning signs 

Often your child may show warning signs. Warning 

signs are clues that your child’s asthma may be getting 

A very young child may not be able to tell you how he 

more closely to find out if something is wrong. 

How will I know if asthma is getting worse? 

before it gets worse. While warning signs differ from 

child to child, parents report some common signs. 

attack. On the next page, check off the signs you 

noticed before the attack. Be sure to go over this 

checklist with your child’s doctor. 
Coughed at night 

Had a cold or the flu 

Had a fever 

Sneezed and had watery eyes 

Face was pale 

Had tightness in the chest 

Seemed to have a headache 

7 

List other signs here that you have noticed: 

Warning signs 

you noticed 

Had a stuffy or runny nose 

Had a tickle in the throat 

How he or she looked 

or seemed to feel 

Acted very restless 

Had dark circles under the eyes 

Seemed to feel weak or tired 

Asthma Warning Signs Checklist 
8 

for to help you know when your child is having a 

• 

• Is coughing or wheezing and can’t stop. 

• Has bluish fingernails or lips. 

Emergency Warning Signs 

There are times when you need to take your child to 

the hospital or urgent care right away. 

Ask your child’s doctor what emergency signs to look 

medical emergency with asthma. 

Some parents know their child is having a medical 

emergency with asthma if he or she: 

Is breathing in a different way: faster, or slower, 

or more shallow than usual. 

Write your child’s emergency signs here: 
“Both my kids have asthma and both have very 

asthma is getting bad. I ask him to pull out the peak 

flow meter right away to check for low numbers.” 

9 

Read how some parents learned 

to look for warning signs 

different warning signs before a full-blown attack. 

My 5-year-old daughter Kim is about to go into 

asthma when she gets these very dark circles under 

her eyes. And she gets cranky and clingy. 

“With 13-year old Clay, I watch for times he doesn’t 

feel like eating and he seems to be tired a lot—real low 

energy. As a teen, Clay doesn’t like to admit when his 

—Rebecca, mom of 5-year-old Kim 

and 13-year-old Clay 

“When Jamie starts to cough at night, I know we’re 

headed for trouble.” 

—Carlos, dad of 7-year-old Jamie 
• 

• 

warning signs of an asthma attack. 

• 

10 

How can I help my child have fewer 

asthma attacks? 

You’ve taken a great first step. You’re reading this 

booklet. That’s great! 

Become aware of your child’s warning signs that 

asthma is getting worse. Learn the emergency 

Talk to your child’s doctor and work on an 

asthma action plan . . . together! 

Write down your child’s warning signs. 
11 

Make an asthma action plan 

The action plan looks at what triggers or brings on 

your child’s asthma. The plan also includes your 

child’s 

rescue medicines 

or when asthma signs start. 

a written action plan for managing your child’s 

asthma. 

• 

school, teachers, babysitters, and family members. 

• 

of an asthma attack they will know what to do. 

Follow the action plan. It can help lower the number of 

to make changes in the plan. 

daily medicine needs. And the plan lists 

for quick-relief during an attack 

Work with your child’s doctor and come up with 

Share the asthma action plan with your child’s 

Talk it over with people in your child’s life. In case 

While asthma action plans may differ from doctor 

to doctor, most plans will address two areas: a 

daily program and a rescue program. 

asthma attacks. Talk to your child’s doctor if you need 
12 

• 

• Daily medicines and how to use them 

• Peak flow meter chart 

• 

• 

• 

as an asthma attack gets worse 

• Steps to take if your child has an asthma attack and 

when to call the doctor 

• 

The action plan’s daily program may list: 

Your child’s asthma triggers 

The action plan’s rescue program may list: 

Your child’s warning signs 

Your child’s peak flow meter readings 

Names of the rescue medicines used to treat asthma 

Emergency numbers and when to take your child to 

the emergency room 
13 

Remember parents

“I found we needed to talk to the doctor about what 

—

Learn all you can about asthma. 

—make sure you know the right 

amount of medicine your child needs to take each day. 

Talk to your child’s doctor if you have questions. 

Does your child use an inhaler, a spacer or a peak flow 

meter? Ask the doctor to show you how to use these at 

home. Have your child practice a few times in front of 

the doctor. 

was and wasn’t working with Garrett’s asthma action 

plan. By making a few changes we helped Garrett stop 

little problems before they became big health problems!” 

Brenda, mom of 8-year-old Garrett 
• Read about asthma. 

• Learn all you can about your child’s warning signs. 

• 

come up with an asthma action plan that works 

• 

how to follow it. 

14 

To review Part 1 

Ask questions. Work with your child’s doctor to 

for your child and your family. 

Follow the action plan. Make sure all the people 

who care for your child know about the plan and 
Use these tips to help find out what may be 

making your child’s asthma worse. 

Read the good news about what you can do 

of triggers inside and outside your home. 

15 

Part 2 

Control your child’s 

asthma triggers 

Learn what may trigger Page 17 

your child’s asthma 

Take steps to control asthma Page 19 

to control your child’s asthma. 

Get rid of your child’s Page 20 

asthma triggers 

Follow this guide to help you become aware 
“I kept getting asthma attacks because of our cat Josie. 

now I like not being sick with asthma all the time. 

And I use lots less medicine now that I have fish 

instead of a furry cat.” 

16 

Fish are good pets for kids with asthma. 

We found a good home for Josie and I now have a 

goldfish. At first I was sad about losing my pet, but 

—Liz, age 9 
17 

As we said in 

start your child’s asthma attack or make it worse. 

that several things act as triggers. 

• 

trigger asthma. 

• 

• 

an asthma attack. 

asthma triggers. 

Once you know what triggers your child’s asthma, 

Remembering to smoke outside or keeping pests out 

Learn what may trigger 

your child’s asthma 

Part 1, triggers are the things that can 

Your child may have just one trigger or you may find 

For some kids, being around pets or dust can 

Some kids find their asthma gets worse from 

cigarette smoke. 

For other kids, running and playing may bring on 

Be sure to work with the doctor to identify your child’s 

it is important to take steps to control these triggers. 

of your home means taking action every day. The more 

these habits are part of your daily life, the less chance 

there is your child will have an asthma attack. 
18 

And that means I am having fewer asthma attacks.” 

“After I kept getting asthma both my mom and step-dad 

And now I need a lot less medicine and that is a very 

—

Older kids can often tell you what triggers their asthma. 

Kids can learn to control their triggers 

“We used to have cockroaches all over our kitchen 

counters. Now we put bread and crackers in plastic 

containers, and guess what? No more roaches. 

—Becky, age 12 

stopped smoking. No smoke means no bad attacks. 

good thing. Now my mom even makes sure my Aunt 

Kim smokes in the driveway—even in the winter.” 

Marcus, age 10 
19 

Think about when your child’s asthma got worse. 

Playing with a friend’s dog? Outside when the air 

pollution level was high? 

Look at the triggers listed on pages 21 to 30. 

asthma worse. 

Use the tips on the next several pages and 

work with your child’s doctor to learn ways to: 

• 

• 

Circle the triggers that make your child's asthma worse. 

Take steps to control asthma 

First: 

Was your child near someone who was smoking? 

Next: 

Circle the triggers you notice make your child’s 

Finally: 

Keep your child away from triggers when possible. 

Remove the triggers from your home, school or 

daycare. 
20 

Ask your doctor how to remove triggers from your home. 

your child stay healthy and have fewer asthma attacks. 

Use pages 21 to 30 as a guide to find what may trigger 

your child’s asthma and what you can do about it. 

I was able to take the list to my child's doctor and we 

talked about what things trigger his asthma and how 

Get rid of your child’s asthma triggers 

When you remove triggers from your home or keep 

your child away from triggers outdoors, you help 

“I found it very helpful to read about asthma triggers. 

to remove them.” 

—Lia, mom of 9-year-old Jordan 
21 

Secondhand smoke 

What It Is: 

• Don’t let anyone smoke near your child. 

• 

calling 

to make your home smoke-free. 

Secondhand smoke is the smoke from a cigarette, 

cigar, or pipe, and the smoke exhaled by a smoker. 

What You Can Do: 

If you smoke—until you can quit, don’t smoke in 

your home or car. 

Pledge to make your home and car smoke-free by 

1-866-SMOKE-FREE (1-866-766-5337). 

Call 1-866-SMOKE-FREE and pledge 
22 

Dust Mites 

Dust mites live in things like sheets, blankets, pillows, 

• 

• 

• 

every week. 

• 

completely to help control dust mites. 

What They Are: 

Dust mites are tiny bugs that are too small to see. 

Where They Live: 

mattresses, soft furniture, carpets, and your child’s 

stuffed toys. 

What You Can Do: 

Wash bedding in hot water once a week. 

Dry completely. 

Use dust proof covers on pillows and mattresses. 

Vacuum carpets and furniture 

Choose stuffed toys that you can wash. 

Wash stuffed toys in hot water. 

Dry completely before your child 

plays with the toy. 

Wash stuffed toys and dry them 
23 

Animals in your home, such as cats and dogs. 

• Find another home for your cat or dog. 

• Keep pets outside if possible. 

• If you have to have a pet inside, keep it out of 

• 

• 

Pets 

What Type: 

What You Can Do: 

your child’s bedroom. 

Keep pets off of your furniture. 

Vacuum carpets and furniture when your child is 

not around. 

Vacuum every week to help control pet hair and dust. 
24 

basement. 

• 

• 

• 

• 

instead of sprays. 

• Cover trash cans. 

Cockroaches 

(“roaches” or other “pests”) 

Where To Look: 

Areas with food and water such as your kitchen 

and bathroom. Areas where you store paper bags, 

cardboard boxes, or newspapers such as your 

What You Can Do: 

Keep counters, sinks, tables, and floors clean and free 

of clutter. Clean dishes, crumbs, and spills right away. 

Store food in airtight containers. 

Seal cracks or openings around or inside cabinets. 

Use roach baits or traps 

Cover the trash to keep pests away. 
25 

Mold 

• 

• 

and kitchen when showering, cooking, or washing 

dishes. 

• Fix water leaks as soon as possible 

• Dry damp or wet things completely 

within one to two days to keep 

Fix leaks as soon as possible to 

keep mold from growing. 

Where To Look: 

Mold grows in damp places such as kitchens, 

bathrooms, and basements. 

What You Can Do: 

If you see mold on hard surfaces, clean it up with 

soap and water. Let the area dry completely. 

Use exhaust fans or open a window in the bathroom 

to keep mold from growing. 

mold from growing. 
26 

Use the exhaust fan when cooking on a gas stove. 

What It Is: 

fuel-burning appliances. 

Nitrogen Dioxide 

Nitrogen dioxide is a gas that can bother your eyes, 

nose, and throat. It may also cause shortness of breath. 

Where To Look: 

This gas can come from appliances inside your home 

that burn fuels such as gas, kerosene, and wood. 

Appliances that burn fuels are sometimes called 
27 

• 

• Gas cooking stoves: If you have an exhaust fan in 

the kitchen, use it when you cook. Never use the 

stove to keep you warm or heat your house. 

• Unvented kerosene or gas space heaters: Use the 

• 

• Fireplaces: 

Nitrogen Dioxide—What You Can Do: 

If possible, use fuel-burning appliances that are 

vented to the outside. Always follow the maker’s 

instructions on how to use these appliances. 

proper fuel and keep the heater adjusted the right 

way. Open a window slightly or use an exhaust fan 

when you are using the heater. 

Wood stoves: Make sure the stove doors are tight 

fitting. Follow the maker’s instructions for starting, 

burning, and putting out the fire. 

Always open the chimney flue before 

you build a fire. 
28 

What It Is: 

clear information every day on whether air quality in 

that may make asthma worse. 

Outdoor Air Pollution 

Small particles and ozone come from things like 

exhaust from cars and factories, smoke, and road dust. 

Where To Look: 

Watch for the Air Quality Index, or AQI, during your 

local weather report. The AQI is a tool that offers you 

your area could be a health worry. 

The AQI uses colors to show how much pollution is in 

the air. Green and yellow mean air pollution levels are 

low. Orange, red or purple mean pollution is at levels 

Watch for the AQI during your local weather report. 
29 

purple): 

• Have your child play outdoors at times when the 

the morning. 

• 

a long time. 

Pay attention to your child’s asthma warning signs. If 

Outdoor Air Pollution—What You Can Do: 

When the AQI reports unhealthy levels (orange, red or 

air quality is better. In the summer, this may be in 

Limit outdoor games that involve running hard for 

you start to see signs, limit outdoor activity. Be sure to 

talk about this with your child’s doctor. 
30 

A Note About Chemical Irritants 

If you find that your child’s asthma gets worse when you 

• 

• Open windows or doors, or use an exhaust fan. 

Chemical irritants found in some products in your house 

may make your child’s asthma worse. Your child’s 

asthma may be worse around scented or unscented 

products, including cleaners, paints, adhesives, 

pesticides, cosmetics, or air fresheners. 

use a certain product, consider trying different products. 

If you must use a product, then you should: 

Make sure your child is not around. 

Remember to always follow the instructions on the label. 
31 

• Read about asthma triggers. 

• Learn all you can about your child’s triggers. 

• 

your child how to avoid triggers outside your 

home. 

• 

• 

the triggers and your child’s asthma is not getting 

To review Part 2 

Work with your child’s doctor to come up with 

a plan to control triggers inside your home. Teach 

Make sure all the people who care for your child 

know your child’s triggers and how to control them. 

Talk to your child’s doctor if you have removed 

better. 
32 

doctor(s) here: 

Write questions to ask the doctor(s) here: 

Write your child’s name here: 

Write the name and number of your child’s 

Write the number of your family’s pharmacist here: 
• 

• 

• 

• 

Place your child’s asthma action plan here. 

Keep a copy of this booklet for each child with asthma. 

Call one of the toll-free numbers 

on the back of this booklet to: 

Talk to an asthma expert. 

Find support groups near your home. 

Join in programs for you or your child to learn 

about controlling asthma. 

Get materials to learn more about asthma. 
of Asthmatics 

4403 

American Lung Association 

- 4872 

8462 

Get more information 

Allergy and Asthma Network* Mothers 

1-800-878-

On the Web: www.aanma.org 

1-800 LUNG-USA or 1-800-586-

On the Web: www.ala.org 

Asthma and Allergy Foundation of America 

1-800-7-ASTHMA or 1-800 -727-

On the Web: www.aafa.org 

Environmental Protection Agency (EPA) 

To learn more about controlling indoor asthma 

triggers, visit www.epa.gov/asthma. Call the EPA’s 

Indoor Air Quality Information Line at 1-800-438-4318 

to order free materials about indoor asthma triggers. 

To learn more about the Air Quality Index (AQI), visit 

www.epa.gov/airnow. 

Centers for Disease Control and Prevention 

Visit www.cdc.gov/asthma to learn about asthma.