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Back to school: Top tips to manage your child’s asthma


Did you know that the return to school can cause what’s known as the asthma peak in September? We’re looking at helping children manage their asthma, with some top tips to get you started.

Asthma is the most common long-term childhood illness,1 with 10.5 million school days missed each year in the USA.2 It’s also the leading cause of persistent childhood disease as measured by school absences, emergency department visits, and hospitalizations.1 According to Asthma & Allergy Network, 25% of all asthma-related hospitalizations in children occur in September.2

What causes it?

The return to school exposes children to multiple allergens, from indoor mold and pet hair to pollutants from the school bus.2 Children are mixing in large numbers again, spreading colds and flu, while the anxiety and stress of the new school year can also provoke symptoms.2 The summer break can be a time when medication is neglected as symptoms are less noticeable, but if children don’t keep up their treatment, they’re more at risk from these sudden triggers in September.2

What's the advice?

Asthma & Allergy Network offers some top tips to help patients and families to reduce the risk:2

  1. Book an asthma check-up before the school year begins.
  2. Make sure medicines are topped up.
  3. Preventer inhalers should be taken as prescribed.
  4. Medicines should be carried or kept at school, particularly quick-relief inhalers.
  5. Remind children to wash their hands often – even young patients can do this so encourage them to learn to manage their condition.
  6. Identify and avoid environmental triggers. If pollen is a problem, perhaps tell their teacher so the child stays inside at the riskiest times.
  7. Use flu vaccinations where possible.
  8. Develop an asthma action plan with your healthcare team and share it with the school.
  9. Maintain good asthma control throughout the year using all your healthcare team’s advice, even when your child’s symptoms seem to be under control.
Sitting on the sidelines?

Asthma may be a long-term illness, but it doesn’t have to be debilitating. An accurate diagnosis and an asthma action plan could mean the difference between your child sitting on the sidelines or fully participating in activities with family and friends.3

The main goal is to keep airway inflammation down to reduce the risk of an asthma attack.1 Respiratory infections such as colds, and other common triggers in the September peak, can all contribute to asthma flare-ups.2 Scheduling a check-up and making sure your child’s level of inflammation is tested is quick to ask for but could make all the difference.

Your doctor can measure airway inflammation using fractional exhaled nitric oxide (FeNO) testing. A FeNO value over 35 ppb in a child shows that airway inflammation is likely.4 Managing asthma with FeNO has been shown to reduce attacks by up to 50%.5 Measuring FeNO is a simple test that can be performed during your child’s appointment and is suitable for people from the age of seven with a hand-held desktop device.6 Results are available in less than two minutes, so your doctor or nurse can take immediate action.7

Click here to download information about FeNO testing that you can take to your child’s next appointment.

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What is FeNO?

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Information for Doctors

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Taking a test

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Supporting evidence:

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2023. Available at; https://ginasthma.org/2023-gina-main-report/
2. Allergy & Asthma Network. Asthma management and control. 2023. Available at; https://allergyasthmanetwork.org/what-is-asthma/asthma-management-and-control/. Accessed; July 2023.
3. American Academy of Allergy Asthma & Immunology (AAAAI). Childhood Asthma. 2020. Available at; https://www.aaaai.org/Tools-for-the-Public/Conditions-Library/Asthma/Childhood-Asthma. Accessed; July 2023.
4. Dweik RA et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602-15.
5. Petsky HL et al. Tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils): a systematic review and meta-analysis. Thorax. 2018;73(12):1110-9.
6. Alving K et al. Validation of a new portable exhaled nitric oxide analyzer, NIOX VERO®: randomized studies in asthma. Pulm Ther. 2017;3:207-218.
7. Czubaj-Kowal M et al. Relationship between air pollution and the concentration of nitric oxide in the exhaled air (feno) in 8–9-year-old school children in Krakow. International Journal of Environmental Research and Public Health. 2021 Jun 22;18(13):6690.

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