Understand your child's asthma

Knowing the signs that your child's asthma is getting worse can help you get the right support.

Just as every child is an individual in the way they walk, talk, eat, play and see the world, every child’s asthma is different too.

There are some classic signs of an asthma attack that you need to be aware of - but your child may also have symptoms personal to them that show their asthma’s getting worse. It’s really useful to get to know what these are, so you can quickly spot the signs that mean you may need to take action to help prevent an asthma attack, or reduce its severity. This page is designed to help you spot those small changes in your child that show an asthma attack may be on its way.

The ‘window of opportunity’

In most children, symptoms build up gradually before an asthma attack. This is known as the ‘window of opportunity’ because during this time, there’s a chance to take action to prevent an asthma attack happening. Some research has found that in children, the window of opportunity can vary from 3 to 12 days, although sometimes symptoms can start in just a couple of hours. This means that if you know the warning signs, you may be able to take steps to ward off an asthma attack or reduce its severity. Getting help quickly can save your child a lot of distress – and you and the rest of your family a lot of worry.

Even if your child’s never had an asthma attack before, you can still look out for the classic warning signs. And this page covers lots of the less common signs other parents have noticed – so you can read them and check anything that’s unusual for your child with your GP or asthma nurse.

Feel you already know your child’s asthma well? Remember that asthma can change as they get older and at certain times of the year. So it’s well worth taking these five easy steps so you can stay on top of their asthma over time.

1. Know the classic signs

Your child may have their own specific symptoms when their asthma’s getting worse - but it’s still important to know the typical signs. You might think you’re already familiar with these, especially if your child’s had asthma for a while – but it’s always worth a recap.

Classic signs that asthma is getting worse include:

  • needing to use their reliever inhaler (usually blue) more than three times a week, or more than usual
  • wheezing
  • waking in the night with coughing or wheezing
  • having shortness of breath or feeling tight in the chest
  • having to take time off nursery or school because of asthma 
  • feeling they can’t keep up with their normal activities or exercise
  • a drop in their peak flow meter readings
  • not being able to walk as far or as fast as usual, or being breathless when they do.

What you can do:

  • Regularly read the amber section (about worsening symptoms) of your child’s written asthma action plan. This will help you become very familiar with the signs that typically show asthma is getting worse, and what you need to do if this happens. You could keep a copy of the plan on the fridge or family notice board, and/or take a photo of it to keep on your phone.
  • Understand that even if your child has none of these classic symptoms, there could be other signs that suggest their asthma is getting worse.

“I can see Zane’s neck and stomach muscles straining, and hear a high-pitched noise, especially if I put my ear to his chest.” - Hayley Wing, mum to Zak, 10, and Zane, 8, who both have asthma.

2. Pinpoint your child’s specific symptoms

As well as the classic signs listed above, your child may have other symptoms that show their asthma’s getting worse. These might be linked to their behaviour as well as physical signs. Some parents tell us they notice them before they spot the more typical symptoms, such as coughing and wheezing – so it can be a really useful way to tell your child needs help fast, before it becomes an emergency.

The following examples of warning signs are based on what parents have told us they’ve noticed in their children. But your child may have their own unique pattern of signs – so these are just some ideas to get you thinking.

Your child may…

  • go quiet
  • complain of a tummy ache
  • go off their food
  • say that their ribs ache
  • seem more tired than usual
  • become very active
  • seem distracted
  • not want to do their usual activities
  • cry more than usual
  • become clingy
  • seek attention
  • have very slight wheezing so you can only hear a sound when you press your ear to their chest.

What you can do:

  • Make a list of all your child’s specific symptoms. Think back to the last time your child had an asthma attack and jot down signs you noticed. And speak to your child about how they felt before their asthma attack. Ask other people to help you put your list together, too – talk to anyone who looks after your child about any signs they spotted.
  • Check all these signs through with your GP or asthma nurse. If they agree they’re linked to your child’s asthma, ask them to add the signs to your child’s written asthma action plan.
  • Once the action plan is updated, make copies or share photographs of it with other people who look after your child, such as childminders, teachers or grandparents.

“Don't let anyone fob you off - you know your own child. When Corey was having an asthma attack, the hollow above his collarbone sucked in deep. You’ll notice individual signs with your child, too.” - Cheryl Davies Pyatt, mum to Corey, now 20, who has had asthma from a young age.

3. Talk to your child

Your child won’t be with you all the time. So make sure they know all the signs that can show their asthma’s getting worse – and explain to them it’s important they tell an adult if they notice any of these signs.

What you can do:

  • Sit down with your child and talk to them about some of the early signs their asthma might be getting worse. For example, you could say, “Last time you weren’t very well with your asthma, you had a tummy ache/felt very tired the day before.”
  • Explain to your child that it’s important to tell an adult if they feel like that again. You could say, “The grown-up you’re with can speak to the doctor and nurses and help stop you getting ill again.”

4. Look out for new signs

Remember that asthma can change over time – so your child may no longer get the symptoms you’re used to and might develop new symptoms you haven’t seen before. Or they might express how they feel in a different way as they get older.

This doesn’t mean you have to be constantly watching your child and worrying, though. Just be aware of anything that’s unusual for them, particularly any symptoms that happen alongside their more typical asthma symptoms.

What you can do:

  • Encourage your child to tell you if they don’t feel well for any reason – even if they don’t have their usual asthma symptoms.
  • Make a note of any new symptoms you’re not sure about so you can speak to your child’s GP or asthma nurse when you next see them, and update the action plan.

“I know that just because I can’t hear Beau wheeze, it doesn’t mean he’s not struggling to breathe.” - Anna Bonnett, mum to Gabriel, 10, and Beau, 5.

5. Know what steps to take

Now you know how to spot whether your child’s symptoms are getting worse, make sure you understand what action to take.

What you can do if you spot your child’s symptoms are coming back or getting worse:

  • Follow the advice on your child’s written asthma action plan for 24 hours
  • If they don’t improve, or if you’re worried at any time, make an urgent same-day appointment to see your child’s GP or asthma nurse
  • Call 999 for an ambulance if:
    • Your child’s symptoms get worse using the blue inhaler
    • Their inhaler isn’t helping
    • They don’t feel better after 10 puffs
    • You’re worried at any point, even if your child hasn’t yet taken 10 puffs.

Last updated May 2016