If your child has asthma, you’re always on the watch for a possible attack. Coughing, wheezing, trouble breathing and a tight chest are well known. 

Did you know there are lesser known signs that may surprise you?

Watch for these early warning signs:

• Itchy neck
• Dark circles under the eyes
• Feeling tired 
• Short-temper or cranky 
• Nervous or on edge

What should you do if your child shows any of these signs? Use of a peak-flow meter to monitor to see if your child's airways are narrow or blocked. If the peak-flow value is low, or other asthma symptoms like wheezing appear, it's time to use a quick-relief or rescue medicine (called bronchodilators). These drugs help relax the muscles in your child’s airways, making breathing easier. 

Make sure you always have an Asthma Action Plan. The plan should outline steps to help your child during an asthma flare up. Share the plan at your child’s school and with any caregivers, including grandparents and babysitters. 

Keep Asthma Under Control

Get help if you see any of these warning signs. They could mean your child’s asthma is getting worse. Talk to your child’s doctor if:

• Your child’s symptoms are more acute, occur more often or cause your child to lose sleep. 
• Your child is missing school because of asthma or cannot complete activities as usual.
• Your child’s medicine doesn’t seem to work as well 
• Your child needs quick-relief medicine  two or more times per week. 
• Your child needs to go to the hospital because of an asthma attack.

Keep a daily log of your child’s peak-flow meter  readings so you can tell if it is low or varies day-to-day. Your doctor may also ask you to track these readings for a couple of weeks leading up to an office visit.

A change in medicine or other steps might help get your child’s asthma symptoms under control.

Urgent Danger Signs

If your child has any of these symptoms, call 911 right away:

• Trouble walking or talking
• Hunching over
• Lips or fingernails are blue or gray
• Breathing very slowly
• Fast pulse
• Severe drowsiness or confusion
• Severe anxiety due to shortness of breath

To learn more about Asthma and the Taking on Asthma initiative, visit our website.

Sources: Allergies & Asthma,  Asthma Medicine,  American Academy of Pediatrics; Peak Flow Meter,  Nemours Foundation.

Originally published: 6/30/2016; Revised 2020, 2021