It’s a big moment for any parent: leaving your child at nursery or school for the first time. And when your child has asthma, or 'suspected asthma', it can be even harder to let go and trust someone else to look after them.
Our advice can help make sure your child's asthma is looked after, and stop it getting in the way of friendships, trips, homework, exams, clubs and PE.
On this page:
- The essentials at school
- Enjoying PE and sports day
- Times when your child may need extra care
- Help and advice for schools
- Asthma at nursery
Looking after your child’s asthma at school doesn’t have to be complicated. Some parents tell us they worry about coming across as paranoid or over-protective. But it's completely reasonable for you to ask certain things so you can feel reassured that your child will be safe.
Here are some key things to help if you have a child with asthma who's starting school, or going back to school after the holidays.
1. Find out who will have responsibility for your child's asthma
Your child’s teacher – or their head of year at secondary school - will usually oversee their asthma. Most schools have a school nurse who works for the local authority and comes into the school now and again. The school nurse could be a very useful contact, particularly if you're having problems with how the school is dealing with your child's asthma, or if your child's asthma is harder to manage.
The school nurse, and the teacher who has responsibility for your child, may write up a document called an Individual Healthcare Plan (IHP). Ideally, every child with asthma would have one but at most schools, an IHP is usually only written if asthma is causing problems – for example, if your child needs to be absent from school for long periods of time. An IHP spells out how your child’s asthma will be looked after in school, when they need care, and who will give it to them.
"Sending Emelia off to school was really hard because it meant that I wasn’t in control of her condition any longer. We had several meetings before she started – with the head teacher, school cook, class teacher and support teacher. I found the meetings very reassuring."
Maria Brain, mum to Emelia, 8, and Elisia, 3, who both have asthma
2. Book a meeting
Make an appointment to speak to your child’s teacher and the school nurse. You could also ask if there’s anyone else who could attend, such as a welfare or medical officer, classroom assistant or a PE teacher. You can think about whether it would be helpful for your child to come along to this meeting too.
Use the meeting to:
- Talk staff through your child’s asthma action plan, and give them a copy to keep. A written asthma action plan explains clearly what to do if your child has asthma symptoms, which can give both you and school staff peace of mind.
- Explain how asthma affects your child – their usual symptoms, and the signs that indicate they may need to use their reliever inhaler (usually blue). You could explain that sometimes symptoms may not be obvious – for example, if your child seems sleepy or can’t concentrate, that may be a sign symptoms are keeping them awake at night. Asthma affects everyone differently so the teacher needs to know that your child’s situation isn’t necessarily the same as that of other children with asthma.
- Discuss how teachers can let you know if your child has any asthma symptoms at school or has used their reliever inhaler (usually blue) during the day.
- Ask how the school would prefer to get any updates about your child’s asthma.
“If either of the boys has a cold, I go in and tell the class teacher that they need to go to the office if they’re coughing a lot. I don’t want to be seen as a neurotic mother, but I worry that teachers aren’t trained to spot symptoms and in a class of 30 children they might easily miss the signs.”
Anna Bonnett, mum to Gabriel, 10, and Beau, 5, who both have asthma.
3. Manage your child’s medicines
- If your child’s school keeps spare emergency reliever inhalers on the premises, find out where they’re kept. Your child may need to use one if they can’t access their own inhaler for any reason.
- Make sure your child’s inhaler is labelled. Ideally, keep it in the original box with the prescription label, stored with the cap on. Also, check the inhalers regularly to make sure there is plenty of medicine in them, and to make sure they’re still in date.
- If your child needs to take any extra medicines during school hours, give the teacher a guidance note from your GP.
- Show the teacher your child’s reliever inhaler and how they use it. Explain that if your child has a spacer, they must always use it as it helps make their inhaler more effective.
4. Plan for emergencies
Your child’s teacher, and other key school staff, need to know the signs that your child may be having an asthma attack, and when to call 999. Your child’s written asthma action plan lists asthma attack symptoms and has step-by-step instructions on what to do.
Make sure staff understand that your child mustn't be left alone without an adult present until they’re feeling better. They also need to know that your child shouldn't be sent to get their own inhaler - someone needs to bring it to them.
Questions you could ask your child’s teacher
Every school’s different. Some have an asthma policy – a set of guidelines that covers how your child will be cared for. It’s not a legal requirement but all schools should have a general medical conditions policy. Ask questions about what’s in place at your child’s school – you could always open up a discussion about anything else you feel would be helpful.
- Does the school have an asthma policy?
- What training have the staff had about asthma?
- Do you have a photo display of children with medical conditions in the staff room or school office?
- Who looks after the children during playtimes and lunchtimes? Is there a midday supervisor who needs to know about my child’s condition and health needs?
- What plans are in place to look after my child’s asthma on school trips and sports days?
- How will supply teachers be kept informed about my child’s needs?
- If the school holds any charity events would you like to support Asthma UK? Find out more about fundraising in your community.
Questions for your child at secondary school
As your child gets older, they’ll take more responsibility for managing their own asthma. Sit down with your child and run through our checklist. Ask whether they:
- check their reliever inhaler is in their bag before leaving for school every day
- put their bag where they can get to it quickly if they’re having any asthma symptoms
- know where the school's spare inhalers are kept (if the school has these) in case they lose their reliever inhaler
- know which teacher looks after their reliever inhaler in a PE lesson on the field, at the swimming pool or on a school trip
- know when they need to use their reliever inhaler
- recognise the symptoms of an asthma attack and know when they need to ask somebody to call an ambulance.
“If Oliver’s going through a bad patch with his asthma he can be awake coughing all night. I don’t think his teachers realise that being tired affects him so much – his concentration is affected, he can get more tearful and he has less energy to do things he normally enjoys. Fortunately Oliver’s bright and hasn’t got behind.”
Alexa Keatley, mum to Oliver, 11
Evidence shows that exercise is good for everyone, including children and young people with asthma. If you’re worried that PE lessons at school may trigger your child's asthma symptoms, speak to their teachers. Be aware that on sports day, they may have extra triggers such as excitement, and exposure to pollen for longer than usual. If your child is old enough, remind them to:
- tell their PE teacher or sports coach that they’ve got asthma
- tell their PE teacher or sports coach if they’re going through a period where they’re getting lots of symptoms, during hay fever season or if they’ve got a cold for example
- keep their reliever inhaler (usually blue) with them at all times, but especially when exercising
- always warm up and cool down properly
- stop exercising if they start to get any asthma symptoms (coughing, wheezing, a tight chest and/or breathlessness), take their reliever inhaler and wait at least five minutes after symptoms have gone before starting again
- tell someone immediately if they’re having an asthma attack.
The autumn term
There’s a noticeable rise in the number of children in the UK rushed to hospital every September due to their asthma. Our most recent statistics show that across the UK, children aged 5-19 were 1.7 times more likely to be admitted to hospital in September than in August . As well as coming into contact with more colds and flu in the autumn term, getting out of a routine with your child’s preventer medicines over the summer can increase their risk. It’s important that your child continues to take their regular asthma medicines over the summer so that they stay protected for when school starts up again.
Research shows having a diagnosis of asthma is a risk factor in dropping a grade between mock and final exams. You can help your child put some special steps in place to prevent asthma affecting their results:
Deal with stress
Feelings of stress can be a trigger for asthma. If you find that studying brings on your child’s asthma symptoms, ask your GP or asthma nurse what support they can give.
Manage hay fever
Is your child among the four in five people with asthma who also have hay fever? Evidence shows that hay fever can affect concentration and work productivity too. Plus hay fever symptoms often trigger asthma symptoms. Use this simple checklist to avoid the asthma grade drop, and protect your child from pollen.
- Make sure your child takes all their usual asthma and (if needed) hay fever medicines. Managing their asthma well is the best way of reducing the risk of pollen making asthma symptoms worse.
- See your child’s GP or asthma nurse for an asthma review before the hay fever season, so that their hay fever can be treated. Check with your GP, asthma nurse or pharmacist that your child is taking their hay fever treatment – such as nasal sprays – the correct way.
- Tell teacher(s) your child has hay fever as well as asthma. They may be able to write to the exam board on your child’s behalf, asking if the condition can be taken into account during marking.
- Keep an eye on the pollen forecast by following us on Twitter. If you notice that your child’s asthma symptoms are worse when the pollen count is high, ask your GP or asthma nurse to assess their treatment.
People with asthma have told us the following tips have helped them too:
On exam days:
- Make sure your child takes their usual medicine.
- Give your child wraparound sunglasses to wear on the way to the exam to stop pollen getting in their eyes.
- Education for Health has developed a free online education programme to support any one who works with children or young people with asthma.
- Health Conditions in School Alliance is a group of over 30 organisations, including Asthma UK, working in collaboration to support schools to create a safe environment for children and young people with medical conditions.
Before your child goes to school, they are likely to spend some time at nursery or pre-school. Just a few key questions can help you start a discussion with the staff looking after your child. The conversation will give you an idea of how much they know about asthma, or 'suspected asthma', already. It will also help nursery staff learn how asthma symptoms affect your child so they can give them the best possible care.
Questions to ask
1. Do you have Individual Healthcare Plans for children with health needs?
Individual Healthcare Plans are used by nurseries and childminders to record a child's healthcare needs. Healthcare plans are really useful as sometimes children don't have just one condition and all the information can be kept in one place. If your baby or toddler has 'suspected asthma' this should be noted on their plan.
Anyone who looks after your child, whether it's staff at a nursery or a registered childminder, should have local authority guidance on how to care for children with medical conditions.
They may have a specific asthma policy, which is a set of guidelines that covers how your child with asthma will be cared for. Even if your child is too young to have a definite diagnosis you can explain that their GP suspects they might have asthma, and talk through the key points in the asthma policy that apply to your child.
Any guidelines or policy should cover:
- the environment your child will be in
- the asthma training nursery staff get and what happens when there’s a supply teacher or assistant
- whether staff will help your child to take their asthma medicine and whether you need to give them written permission to do this
- where they’ll keep your child’s inhalers
- procedures they'll follow if your child has an asthma attack
- procedures they'll follow when there’s an outing and your child will be ‘off site’.
2. Are you able to provide the individual care that my child needs?
Every child's asthma is different. The environment needs to be as safe as possible for your child. This means practical measures are taken to avoid their triggers, for example: no furry or feathery pets, no aerosols, and no air fresheners. Ask if the nursery fills in a home/nursery book to log how your child has been during the day.
3. Do you have Individual Healthcare plans for children with health needs?
Individual Healthcare plans are relatively new but they’re starting to be used by nurseries and childminders as the best way to record a child’s healthcare needs. Healthcare plans are really useful as sometimes children don’t have just one condition and all the information can be kept in one place.
4. Do you know how to recognise and deal with an asthma attack?
Nursery staff should know how to recognise asthma symptoms starting and be confident of what to do if your child has an asthma attack.
Your nursery checklist
These four simple things will help your nursery staff look after your child's asthma well:
- Leave spare medicine, ideally in its original box with labels so your child’s name is clearly shown. Keep a note of the expiry date so that you can change it when needed.
- Keep staff updated about any changes to your child's asthma.
- Talk to your child about who they need to tell when they’re feeling unwell with their asthma.
- Don’t forget to tell nursery staff about our website and Helpline so they can find out more about asthma – the more they know about asthma the better they’ll be able to look after your child.
Whatever your questions or concerns about asthma, our asthma nurse specialists are just a call away on 0300 222 5800 (9am – 5pm; Mon – Fri).