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What should I do if my child is having an asthma attack?
Sit them up, stay calm, use their reliever inhaler — and call for emergency help if they do not improve.
Your child is not the general case. Ask about yours →
What it is
Asthma is a common condition that affects breathing [6]. The main symptoms are wheezing, coughing, shortness of breath and a tight chest [6]. Symptoms can be mild or severe, usually come and go, and may be worse at night and early in the morning [6].
An asthma attack is when symptoms become severe and breathing is difficult [6]. An attack can be life-threatening [6][7]. Attacks may come on gradually or suddenly [10].
In children, symptoms can also include rapid breathing, gasping for air, feeling tired, dark circles under the eyes, irritability, and trouble eating or sucking in infants [10].
What you can do at home
During an attack, according to the NHS:
- Help your child sit up straight, to help their breathing [1].
- Try to stay calm [1].
- Use their reliever inhaler if they have one [1].
- If it is a blue reliever inhaler, give 1 puff every 30 to 60 seconds until they feel better, up to a maximum of 10 puffs [1].
- Shake the inhaler between each puff, and use a spacer if you have one [1].
- If it is an AIR or MART inhaler, give 1 puff every 1 to 3 minutes until they feel better, up to a maximum of 6 puffs [1].
- If their personal asthma action plan gives a different maximum dose, follow the plan [1].
If symptoms are no better after 10 minutes and an ambulance has not arrived, use the inhaler again if you have one, up to the same maximum dose [1]. Do not drive yourself to the emergency department [1].
A spacer makes an aerosol inhaler easier to use and helps the medicine reach the lungs [4]. A spacer is a plastic container with a mouthpiece or mask at one end and a hole for the inhaler at the other [4].
To help prevent attacks in general:
- Always have the inhaler with you [3].
- Use inhalers as recommended by your care team [3].
- Try to avoid triggers such as air pollution, smoke, pollen or animals [3].
- Keep to a healthy weight [3].
- Keep vaccinations such as the flu vaccine up to date, because viruses like flu can make asthma symptoms worse [3].
- If exercise triggers symptoms, ask your doctor or nurse about exercising safely [3].
For children, a treatment plan is made with their health care provider [5]. It includes avoiding triggers — for example, nobody should smoke in your home or car if tobacco smoke is a trigger [5]. It also includes quick-relief medicines to have at all times, and sometimes control medicines that reduce airway inflammation [5].
When to see a doctor or go to the emergency department
Call your local emergency number if you or someone else is having an asthma attack and:
- they start to feel worse at any time [1]
- they do not feel better after the maximum dose of a reliever inhaler [1]
- they do not have an asthma inhaler [1]
Do not drive yourself to the emergency department [1]. The person you speak to on the emergency line will give you advice about what to do [1].
Warning signs of a severe attack in a child include severe coughing, serious breathing problems, and turning very pale or blue in the face, lips or fingernails [10]. If your child has these symptoms, get medical help right away [10]. If your child has a severe attack and the quick-relief medicines do not work, get medical help right away [5].
Ask for an urgent appointment with your doctor if you have had an asthma attack and have recovered — even if you feel better, it is important to be seen within 2 days to discuss treatment and help prevent another attack [1].
See your doctor if you or your child have asthma symptoms, if treatments are not helping, if you need to use the inhaler more often, or if symptoms are stopping usual activities or waking you at night [6].
A severe attack that does not get better may need hospital treatment, which can include oxygen through a mask, a nebuliser, or steroid tablets or injections [2].
Common questions
Can asthma be cured? No. Asthma cannot currently be cured, but with good treatment you should not have problems with symptoms [6]. The World Health Organization says asthma cannot be cured, but inhalers can control the disease and let people enjoy a normal, active life [4].
What types of inhaler are there? Bronchodilators such as salbutamol open the air passages and relieve symptoms; steroids such as beclometasone reduce inflammation and lower the risk of severe attacks; and combination inhalers contain both [4]. Depending on symptoms, a person may be offered an AIR inhaler, a MART inhaler, or two separate inhalers — a preventer every day and a blue reliever when needed [8].
What if inhalers are not enough? A care team may recommend a stronger inhaler or tablets such as montelukast, and for severe asthma, injected medicines called biological therapies [9].
Does asthma go away? Asthma is often life-long, although asthma in young children sometimes goes away by the time they are teenagers or adults [7]. It affects everyone differently [7].
Is asthma serious in pregnancy? If you are pregnant, tell your doctor or midwife about your asthma — managing it keeps you and your baby well [7].
Sources
[1] NHS — “Asthma” (2024), section “How to treat an asthma attack”, p. 1 — https://www.nhs.uk/conditions/asthma/ [2] NHS — “Asthma” (2024), section “Hospital treatment for an asthma attack”, p. 1 — https://www.nhs.uk/conditions/asthma/ [3] NHS — “Asthma” (2024), section “Things you can do to help with asthma”, p. 1 — https://www.nhs.uk/conditions/asthma/ [4] WHO — “Asthma”, section “Treatment”, p. 1 — https://www.who.int/news-room/fact-sheets/detail/asthma [5] MedlinePlus — “Asthma in Children” (2024), section “What are the treatments for asthma in children?”, p. 1 — https://medlineplus.gov/asthmainchildren.html [6] NHS — “Asthma” (2024), section “Asthma”, p. 1 — https://www.nhs.uk/conditions/asthma/ [7] NHS — “Asthma” (2024), section “How asthma affects your life”, p. 1 — https://www.nhs.uk/conditions/asthma/ [8] NHS — “Asthma” (2024), section “Asthma inhalers”, p. 1 — https://www.nhs.uk/conditions/asthma/ [9] NHS — “Asthma” (2024), section “Other treatments for asthma”, p. 1 — https://www.nhs.uk/conditions/asthma/ [10] MedlinePlus — “Asthma in Children” (2024), section “What are the symptoms of asthma in children?”, p. 1 — https://medlineplus.gov/asthmainchildren.html
This guide summarises published paediatric guidelines. It is not medical advice and does not replace your paediatrician. In an emergency, call your local emergency number.
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