alking with your child regularly about their asthma is important. Depending on their age, some children may find the topic scary or confusing. Some may feel embarrassed or resent what they need to do to manage their asthma. Helping your child understand asthma will make it easier for them to control their condition.
It is important that your child, at the appropriate age, learns how to care for themselves. Self-care includes gaining the ability to use and even carry their own medicine as well as learning how to fill prescriptions and feeling empowered to speak up during doctor’s visits.
Some tips for talking to them about asthma include:
- Use language that is appropriate for your child’s age and encourage them to ask questions.
- Use pictures to help you explain. Ask your doctor for pictures if you don’t have any.
- Use activities (see Appendices at the end of this handbook) to explain what happens to the lungs during an asthma episode.
Explaining Asthma to your Child10
It can be hard to explain asthma to your child, especially when they are young. The tips below may make it a little easier. You will need to relate these explanations to your child’s own asthma symptoms and treatment, including their Asthma Action Plan.
Talk about how lungs work
“Your lungs are in your chest. The job of the lungs is to move the air in and out. The tubes inside your body that carry the air in and out of your lungs are round and open and clear.”
Talk about what happens during an asthma episode
“When you are around something that bothers your asthma, your lungs can get tight (the muscles around the tubes in your lungs squeeze down) and make thick, sticky stuff called mucus. That’s why it’s hard to breathe, and you may feel like coughing.”
Talk about the medicines they will take and how they will help
Long-term controller medicines: “You need to take some medicine every day to keep your lungs from getting tight and making that thick, sticky stuff. Even when you feel good, you need to keep taking it, because it helps you stay feeling good every day and keeps you from having asthma symptoms.”
Quick-relief medicines: “When you feel like you are having trouble breathing (like your chest is tight or you are coughing), use this medicine which acts fast to help the lungs open.”
Spacer/Holding Chamber: “The spacer helps the medicine get into your lungs better. When you push down on the inhaler, the medicine goes inside the tube and makes a cloud of medicine inside the tube, which gives you time to slowly breathe the medicine deep into your lungs.”
Nebulizer: “The nebulizer is a machine that makes a mist with your medicine in it. It looks like the steam that comes out of the tea kettle, but it isn’t hot like that steam. It’s like a cloud. When you breathe that mist in, the medicine can go deep in your lungs. This makes it easier for you to get the medicine you need.”
Talk about going to the doctor
“Asthma is a disease that can be serious and tricky. The doctor helps us figure out the best ways to take care of it so that you can play and be active just like other kids. We may need to go to the doctor pretty often, so that they can make sure you are doing okay with your medicines and aren’t having any trouble breathing. The doctor will listen to you breathe and ask you if you have any trouble when you sleep or play. They will make sure we know all about your medicines and the things that lead you to have asthma symptoms, so we can keep an episode from happening.”
“At the doctor, we will make an Asthma Action Plan, which is a plan for how to take care of your asthma. We will give copies of this plan to your school and _________(list all the adults with whom your child spends time, such as a grandparent or babysitter) so that they know what to do if you have trouble breathing.”
Talk about triggers (using the specific triggers that affect your child)
Exercise: “You know how when you’re running around you sometimes feel like it’s hard to breathe, and you have to stop or slow down? That’s what starts your asthma. We want to keep your asthma under control so you can do everything all of your friends are doing.”
Infections: “When you get a cold, the germs that make you feel yucky also can make your breathing feel tight. That’s what starts your asthma.”
Allergies: “You are allergic to____________ (put in child’s allergy/allergies, such as cats). When you are around ____________ (child’s allergy), you breathe in stuff that can make your asthma act up, like making you cough or making your breathing hard.”
Irritants: “There are things in the air sometimes that cause people with asthma to start to have trouble breathing. Your asthma starts up when you are around ______________ (put in child’s trigger(s), such as cigarette smoke).”
Weather: “We have figured out that your asthma is started by the weather sometimes. That’s why we watch for ____________ (put in child’s symptoms) on _________ (type of weather, such as foggy) days. That’s what starts your asthma.
Emotions: “When you are______________ (put in child’s emotional trigger, such as laughing or crying) a lot, sometimes you start to feel like you can’t breathe. That’s what starts your asthma.”
Vaping:
Depending on the age of your child, speak to them about how e-cigarettes and other smoking devices can make their asthma worse. This important topic is addressed in a separate section of this handbook.
Talk about what to do about their asthma episodes (fit to your child’s warning signs/symptoms).
Green zone: “This green zone is when you are feeling good and aren’t having asthma symptoms. In order to stay in the green zone, we’ll keep using the medicine and staying away from your triggers.”
Yellow zone: “When you start _______________ (put in child’s early warning signs, such as coughing), we know that your asthma is starting so we’ll do what it says to do on the action plan for yellow zone. For you, that means we _______________ (put in child’s yellow zone actions). If I’m not with you and you feel like your asthma might be starting, tell an adult right away. It’s much better to take the medicine when you first start feeling bad than to wait for your breathing to get hard.”
Red zone: “When you feel like you can’t breathe very well, tell someone right away. You’ll need to do what your asthma action plan says to do for the red zone, and for you that means _______________ (put in child’s red zone actions). Then we’ll take you to the doctor or the emergency room. This is a bad time for your lungs and we need to make sure they get lots of help fast.”
Addressing Stigma Associated with Asthma11
Both younger children and teenagers may feel like their asthma makes them different than others. This feeling can be difficult at a time when they just want to fit in with other children their age. They may be embarrassed by their symptoms or by having to use an inhaler. They may feel that having asthma makes them look weak.
Feelings of shame about their asthma can negatively affect your child’s health. This may include:
- Feeling anxious
- Delays in diagnosis
- Denial and hiding the fact of having asthma
- Limiting physical activity
- Avoiding inhaler use around other people or in public
How to Help Your Child Feel Less Stigmatized
Let them know they are not alone.
Asthma is one of the most common chronic conditions among children. In fact, in the U.S., nearly 5 million children (17 years of age and younger) have asthma.12 It is likely that your child has some friends or schoolmates who also have asthma.
Encourage your child to take care of their asthma.
Every state has a law or guidance that allows children with asthma to carry and use their inhalers at school. Depending on their age, carrying an inhaler at school means your child no longer needs to go to the nurse’s office to get their medicine and can stay in their classroom with their peers. Talk to your child about who they can talk to when they take their medicine and what to do if their symptoms do not improve after taking their medicine.
Show your child positive role models who have asthma.
Many famous people have asthma and still thrive in their fields. These individuals include athletes (including David Beckham and Dennis Rodman), singers (including Pink, Coolio, and Harry Styles), activists (including Jesse Jackson, Jr.), and six past presidents (including Bill Clinton and John F. Kennedy). Knowing this may help your child feel less different about their asthma.
Modeling good behavior
If you, another family member, or a close friend has asthma, be open about having asthma and model good behavior. For example, have them openly use their inhaler and talk about adjustments made, such as for triggers like animals or air quality.
Keep communicating!
Getting your child to talk openly about their feelings can be challenging, particularly when they are teenagers. As a parent or caregiver, you can bring up the issue of asthma stigma and see if this is an issue for your child and help them share their feelings.
10Asthma Initiative of Michigan for Healthy Lungs. Compiled from the experiences of asthma educators across the state of Michigan, 2001, and adapted from the Practical Guide for the Diagnosis and Management of Asthma, NIH Publication No. 97-4053, October 1997, National Institutes of Health, National Heart, Lung and Blood Institute.”
11Information for this section was compiled from Asthma.net at https://asthma.net/living/stigma#
12U.S. Centers for Disease Control and Prevention. Current asthma prevalence by select sociodemographic characteristics (2021).