Each year, over one million children under the age of five suffer from the persistent wheezing and chronic tiredness of asthma.

MANY FACTORS aggravate asthma. Winter weather with its colds and coughs can be particularly unkind. Smoke, fumes, stress, mold spores, pollen, animal dander, medications, dust, and food allergies (a common cause in very young children) can all provoke asthma attacks.

Asthma manifests itself differently in different children. For some, breathing is a daily battle. Others may have only an occasional attack. Regardless of the severity of the condition, the coughing and wheezing caused by the constricted airways can be frightening to everyone involved. However, in most cases, asthma isn't dangerous.

When to Get Help

"The earlier the intervention, the better off your child will be," says Gary Stadtmauer, M.D., attending physician in allergy and immunology at Mount Sinai Medical Center in New York City. He urges all adults to be on the lookout for early warning signs. According to Dr. Stadtmauer, any of the following are indicators that the child's doctor should be contacted:

  • waking at night due to asthma
  • reduced activity level due to asthma
  • requiring medication first thing in the morning (for children already taking asthma medication).
  • If these warning signs are not attended to, the condition can become more severe, causing the following symptoms, which require immediate emergency medical care:
  • persistent wheezing signs of heavy breathing, such as nasal flaring or pursed lips
  • heightened anxiety
  • strained use of neck muscles


Talk to the family to learn what aggravates the child's condition most, such as a particular food or irritant, and try to eliminate these from your environment. Remind parents that cigarette smoke is a very common trigger. Also, try to avoid using humidifiers and vaporizers in your setting, because they can exacerbate the problem. "Dust mites and mold will proliferate in a humid environment, so it's best to keep the environment dry," advises Dr. Stadtmauer

For persistent asthma, a doctor may recommend an environment with no carpeting and no stuffed animals, covering mattresses and pillows with special plastic casings, and dusting and damp mopping as often as possible. Keep in mind, too, that in children under five an asthma attack most commonly occurs after a viral respiratory infection goes on to inflame the lining of the bronchial tubes and stimulates the muscles surrounding them. By keeping a watchful eye out for early warning signs and following some preventive measures, you will help ensure that everyone breathes easier this winter.

Working With Parents and Families

Besides sharing the information above with the families in your program, ask parents whose children have asthma to make sure you know the necessary protocol for dealing with an attack. You'll need a duplicate set of medications for the school nurse to administer and written instructions regarding the circumstances under which they should be administered (for an acute attack or for ongoing relief). Finally, talk to families about their particular concerns. Together, you can offer a safe and healthy environment for their child.

This article originally appeared in the January, 1999 issue of Early Childhood Today.