Your Kid's Asthma Questions Answered: From Inhalers to Allergies to "Growing Out of It"

No parent or caregiver wants their child to have asthma—in part because of the perceived limitations and lingering stigma. (Hint: The stigma is outdated.)

An asthma diagnosis also raises new questions. Can pediatric asthma go away as your child grows up? Will your child need to use an inhaler? Can they still play sports?

“The reality is, there are Olympic athletes that have asthma,” says pediatrician Martin Randall, MD. “It’s typically very manageable for most kids.”

With the right knowledge and treatment, asthma can be just another part of life—not something that holds your child back.

“Education is a powerful tool for asthma,” says respiratory therapist and asthma educator Kathy Barnum. Keep reading to learn the common questions Kathy and Dr. Randall answer.

Want some quick tips? Here’s the short list of their top pediatric asthma advice:

• Visit regularly: Visit your pediatrician every six months (at least) to update your child’s asthma treatment plan so it grows with them.
• Use a spacer: Teach your child to use the spacer with their inhaler every time—otherwise the medicine won’t work as intended.
• Know the triggers: Anticipate how respiratory infections and allergies may affect asthma.
• Make it easy: If your child is hesitant to follow part of their treatment plan, your pediatrician’s office can find creative solutions.

How do you treat kids’ asthma?

If you suspect your child has asthma, start with a visit to the pediatrician. They can provide an accurate diagnosis.

Not all breathing problems are caused by asthma. For example, some children have wheezing and chronic cough during cold and flu season. Respiratory viruses can make their airways narrower, and an occasional inhaler treatment can help.

If your child does have asthma, your pediatrician will recommend the right treatment plan—one that’s tailored to your child’s needs. They’ll prescribe the lowest effective dose to help your child get their symptoms under control.

Asthma albuterol inhaler

For many, the first step is an albuterol (pronounced al-byoo-ter-all) inhaler. Albuterol is a medication that relaxes and opens the lung’s air passages.

Families should use this “rescue inhaler” at the first sign of a problem. That includes difficulty breathing, coughing, wheezing or a respiratory infection.

Inhaled steroid medication

If your child still has difficulty breathing after using the albuterol inhaler, your pediatrician may recommend a daily inhaled steroid medication. This keeps airways more relaxed and less sensitive to asthma triggers.

“When you say the term ‘steroids,’ parents get nervous,” says Dr. Randall. But the inhaled steroid is a much lower dose than steroid pills. “Taking steroid pills for five days is about the same amount as using a steroid inhaler for a year.”

Consistently using a steroid inhaler may help children avoid long-term side effects of steroid use. The steroid inhaler will prevent the need for future oral steroids at higher doses.

Daily inhaler with combined albuterol and steroid

The daily steroid medication can be combined with a long-acting form of albuterol. Having a single inhaler makes it simpler for your child to carry and use. It may even save money.

“Kathy and I recommend it because it’s so much easier to carry and use one inhaler, especially for kids,” says Dr. Randall.

Updating the treatment plan

Dr. Randall recommends visiting the pediatrician at least every six months to update the treatment plan. Dosing guidelines are updated each year, your child’s asthma may evolve, and seasonal triggers or illness play a part.

For example, some children’s asthma is worse in the winter (cold and flu season) and improves in the summer. They might come off the steroid inhaler in the summer and only use it in the winter. Or some children with allergies might need higher doses during peak allergen season, depending on what they’re allergic to.

Can pediatric asthma go away as they get older?

“If you truly have asthma, you don’t grow out of it,” says Dr. Randall. “But for many children, their symptoms may improve as they get older.”

For example, a child may need daily medication when they’re younger. As they grow, they might have only situational symptoms, such as when they’re exercising, sick or have allergies.

Even if their symptoms improve, Dr. Randall suggests always carrying an albuterol inhaler. And don’t change their medication use without first speaking with their pediatrician.

What triggers kids’ asthma?

The most common asthma triggers are viral illnesses like cold, flu, RSV and Covid. They cause the lung’s airways to narrow and can lead to wheezing and difficulty breathing, making asthma symptoms worse.

Your pediatrician may recommend changes to your child’s medication dosage or treatment during illness to help them breath better.

Asthma and allergies

Both seasonal and environmental allergies trigger asthma by causing inflammation and irritation in your child’s airways. You could work with a pediatric allergist to pinpoint your child’s specific allergens.

For example, if they’re allergic to pollen most common in spring, your pediatrician may recommend medication changes during that season. This could mean taking allergy medication with a higher-dose inhaler.

If your child is allergic to pet dander and dust, you can clean where they typically accumulate by:

• Changing home and car air filters
• Servicing your air conditioning
• Using hypoallergenic covers on pillows and mattresses
• Vacuuming rugs and carpets often
• Washing bedding and blankets frequently

Do I need a spacer with the inhaler?

Spacers—short tubes that attach to inhalers—help the medication reach the lungs to work properly. But some parents and caregivers may hear they’re “optional” when they pick up the prescription from the pharmacy.

“Use your spacer every time,” encourages Kathy. “If you don’t, some of the medication ends up in the mouth instead of in the lungs.” If the pharmacy doesn’t automatically give you one, request one before you leave.

“Some kids don’t want to bring a spacer to school,” Kathy notes. “I get it. They’re not convenient or small. But it’s going to make such a difference!”

Spacers help the medication work better by:

• Evenly distributing medication particles in the lungs.
• Making inhaling medicine easier when you’re having asthma problems.
• Eliminating the need to synchronize your breath with your inhaler. The one-way valve does the work for you.

Without a spacer, the medicine doesn’t control the asthma symptoms as well, increasing the likelihood of a more serious asthma attack.

And you never outgrow a spacer. Everyone, from children to adults, should use spacers with their inhalers so the medication works.

My child doesn’t want to use their inhaler. What can we do?

You might find the hardest part of managing your child’s asthma is getting them on board with the plan—and sticking to it.

The objections are understandable. Kathy talks with teens who say being seen using an inhaler isn’t “cool” at school. Or younger children might have a hard time juggling two separate inhalers. Kathy discusses their daily routines to find creative solutions and make it feel easier.

For example, switching to a single combination inhaler can make it easier to keep track of. She can also talk through strategies children can use to feel more comfortable using their inhaler in public settings. 

Get ready to breathe easier

With the right asthma plan, your child can play sports to their heart’s content—and lay claim to every available weekend (sports schedules are no joke). Or they can simply enjoy their childhood doing their favorite activities.

Talk to your pediatrician for an asthma diagnosis and personalized treatment plan that will help both your child and you breathe easier. Then visit every few months so the plan grows with them.