Asthma at school and nursery

How to make sure your child is happy and healthy at school and nursery


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 it can be even harder to trust someone else to look after them.

Perhaps your child’s starting a new school and you’re wondering how they will cope if they get asthma symptoms. Or maybe your child’s got suspected asthma or has recently been diagnosed and you’re still trying to work out how to keep them safe when they’re not with you.

An infographic of Fiona Wright

Some parents have told us they worry about coming across as paranoid or over-protective. But it’s natural to have worries about handing over responsibility for their child’s wellbeing, whether or not they have asthma. It’s completely reasonable for you to ask for certain things.

Fortunately, putting some simple steps in place can help you, your child, their teachers and childminders to feel more confident and relaxed. Our expert tips will help you make sure your child’s asthma is looked after well.

The essentials at school

Looking after your child’s asthma at school doesn’t have to be complicated – here are the four key things every parent of a child with asthma needs to do.

1. Find out who will have responsibility

Your child’s teacher – or their head of year at secondary school - will usually be responsible for looking after their asthma. The school nurse could also be a very useful contact – this is a registered nurse who works for the local authority and comes into schools. They may be particularly vital if you come across difficulties with the school or your child’s asthma is more troublesome. 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 a lot of time off. It details 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

Book an appointment for you and your child to speak to your child’s teacher and the school nurse. You could also ask if there’s anyone else who should come, such as a welfare or medical officer, classroom assistant or a PE teacher.

During this meeting you can:

  • Talk the teacher through your child’s asthma action plan, and give them a copy to keep. As an action plan explains clearly what to do if your child has asthma symptoms, this can give both you and your child’s teacher peace of mind.
  • Explain how asthma affects your child – your child’s usual symptoms and the signs 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 waking them at night. Asthma is very individual so the teacher needs to know 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 be contacted with any updates about your child’s asthma. “We like very open lines of communication about all aspects of the children’s welfare, so we would encourage parents to contact us freely. We use email for discussing quick issues and problems - important info can then be cascaded by the tutor to other members of staff." Teacher Hannah Dodwell

“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 caps on. Also, check the inhalers regularly to make sure there is plenty of medicine in them, and to make sure they’re in date
  • If your child needs to take any extra medicines during school hours, tell the teacher that you’ll put the instructions in writing.
  • Show the teacher your child’s reliever inhaler and spacer (if they use one). 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 needs 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 the teacher knows your child must be constantly watched and reassured by an adult until they’re feeling better. It’s important your child is never sent to get their inhaler – the inhaler must be taken 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 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

Enjoying PE and sports day

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 the 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.

"This is the best year we’ve ever had with Patrick’s asthma. He’s doing brilliantly at school and has hardly had any days off sick. He’s made some good friends and he has lots more confidence. I put that down to his swimming and being part of a team.”  Jeannette Speight, mum to Patrick, 11.

Times when your child may need extra care

The autumn term

There is a dramatic rise in the number of children rushed to hospital due to their asthma every September in the UK. Our most recent statistics show that across the UK in 2014, children aged 14 and under were almost three times as likely to be admitted to hospital in September than in August. Make sure your child keeps taking their asthma medicines as usual over the summer, even when you’re out of your routine on holiday. 

Exam time

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.
  • Pack an ‘exam kit’ - reliever inhaler, tissues and an unlabelled bottle of water in a clear plastic bag to make sure your child stays hydrated.
  • On the way to the exam, your child could wear wraparound sunglasses to stop pollen getting in their eyes.
  • Suggest your child splashes their eyes with cold water before going into the exam room. 

Help and advice for schools

Asthma at nursery

Before your child goes to school, they are likely to spend some time at nursery or with a childminder. You might find it helpful to read our expert tips on leaving your child in other people’s care.

There are also some key questions to ask which will help you open up a conversation with the person looking after your child. The conversation will help you understand how much they know about asthma already. It will also help your child’s carer learn how asthma affects your child so they can give them the best possible care.

Questions to ask 

1. Do you have an asthma policy? 

Anyone who looks after your child should have local authority guidance on how to care for children with medical conditions. They may have a specific asthma policy, a set of guidelines that covers how your child will be cared for. Your child’s carer should consider:

  • the environment your child will be in
  • the asthma training that child carers 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 follow if your child has an asthma attack
  • procedures they 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 emergency? 

If your child starts having asthma symptoms your child carer should know how to recognise them and be sure of what to do if your child has an asthma attack.

Your easy nursery checklist

These four simple things will help your child’s carers look after their 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 your child’s carer 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 your child’s carers 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).