Managing your child's asthma in the fall: What parents should know

Allergies and other environmental factors can make asthma harder to manage when the season changes to fall.

It's especially challenging for kids, in part because they have smaller airways than adults.

"Although asthma can flare up for a number of reasons, a lot of people with allergies also have asthma, and asthma can be triggered by allergies. So the fall is a tough time for asthmatic sufferers," says Dr. Gaurav Kumar, a LifeBridge Health pediatrician. "Many kids are pretty good with their asthma in the summertime, but then when the fall starts, it becomes a problem again. In general, asthma flares up much more for most people in the fall and winter, because that's when you're most likely to catch a cold."

"What happens in the fall with regards to children," Kumar adds, "is that you go from taking these outdoor summer vacations to now being in a classroom again. So now you're in contact with people in closed spaces. And of course, what happens is germs are more likely to spread that way. So you could get colds from friends who have colds, and then that becomes a trigger for asthma."

It's important that you take special precautions in the fall to make sure your child's asthma is under control. First and foremost, if they stopped taking their daily preventive asthma medications regularly during the summer, they should resume daily use right away.

Some other important tips:

Make sure your child gets regular checkups.

It's important for children with asthma to have checkups at least once a year, in some cases as much as three or four times a year.

"An asthma checkup is an opportunity for us to reassess how the year has gone and to make plans in anticipation of what might happen," Kumar says. "If they're healthy at the moment, then the reason for the checkup is to understand how frequently they use their rescue (quick-relief) medicine, to see if they are having trouble with cough that's not going away easily, if they are having interrupted sleep at night because of breathing problems, etc. A lot of kids get so used to certain symptoms that they become second nature. But we want to make sure they aren't adversely affected by their symptoms in their everyday activities."

Checkups also allow doctors to assess the current dosage of your child's medication. "If they're just on the rescue medicine but they're using it more than twice a week, that's already an indication that they need to be on a maintenance medicine," Kumar says. Using more than two inhalers in a year and waking up at night because of asthma symptoms, even only twice in a given month, are other possible indicators of needed medication adjustments, he adds.

Make sure your child has current prescriptions for quick-relief medicine.

Often, Kumar says, children experience asthma symptoms "they didn't anticipate happening so soon," and their prescriptions have expired. "They may go a day or two without medicine before getting a refill," Kumar says. "But in some cases, by then the asthma attack has been so established that it will take them much longer to recover than it would have if they had had current prescriptions readily available."

Make sure your child has access to medicine during the school day.

A lot of kids will need to carry or self-administer quick-relief medicine while at school, or have medicine stored at school and administered by staff as needed.

You should renew your child's prescriptions at the start of the school year and ensure that the prescriptions are up-to-date for the full length of the year. You should complete all necessary authorization forms the school requires for managing and accessing medicines and handling asthma episodes that may occur during the school day, as well as familiarize yourself with any related laws and policies. This may involve writing out an asthma action plan for your child that outlines specific instructions for medicine use and what to do in case of an emergency.

"You don't want the child to have symptoms at school and not be able to get medicine because there was no provision for that," Kumar says.

Get flu vaccines.

The Centers for Disease Control and Prevention recommends that everyone 6 months of age and older get a flu vaccine.

Children younger than 5 (especially those younger than 2) and children of any age with asthma are among those at high risk for serious flu-related complications, even if their asthma is mild or well-controlled by medication. Asthma is the most common medical condition among children hospitalized with the flu. Both adults and children with asthma are more likely to develop pneumonia after getting the flu than people who don't have asthma.

Flu vaccine is "very safe" in children with asthma and "will not cause any negative effects to trigger asthma attacks," Kumar says. While the effectiveness of flu vaccine can vary each season, studies have shown that it can be lifesaving for children with underlying high-risk medical conditions and otherwise healthy kids.

LifeBridge Health is committed to providing excellent pediatric care for many conditions. Dr. Kumar has immediate appointments available at LifeBridge Health Pediatrics-Baltimore North in the Lutherville-Timonium area.

You can also schedule an appointment with a LifeBridge Health physician by calling 410-601-WELL.