How you talk with your child about his asthma and related symptoms is very important. Communications, of course, will vary with the age of a child, and the messages will evolve as well as he grows older. But, it is important that as a parent you anticipate what to expect, and help guide your child toward appropriate asthma management and daily activity decisions. As your child's understanding of asthma grows and develops, he will need to take more — and eventually all — responsibility for his care. Allow your child to participate in care as his age permits, and teach him appropriate words and terms for communicating symptoms, as well as the names and appropriate use of medications and equipment.

Setting the Tone

The key to communicating with your child is to first understand your own reaction to the diagnosis of asthma. Initially, learning that your child has asthma can be confusing and upsetting. You may wonder: “Why my child?” Or, you may feel angry with yourself that you didn't recognize that symptoms — such as coughing or wheezing — were actually related to asthma. Those feelings are natural among parents and families.

Children may internalize that worry — afraid to run, exercise, or play with other children. This could lead to other problems in the long run for them, such as poor physical conditioning and lack of socialization skills. Increasingly, it appears that obesity may even be another factor that can make asthma worse.

If you find yourself extremely anxious about your child's condition, talk to your health care provider about your feelings, or find other parents of asthmatic children in local support groups. While it's understandable for you to be cautious when it comes to asthma symptoms, you also want your child to feel confident that she can manage her condition in a variety of situations.

Empower Through Knowledge

Children, even as young as preschoolers, should have an understanding of what their condition is and how severe it could be. Talk with him about what signs and symptoms make him uncomfortable, and when he should mention them, for instance, to you, a caretaker, a teacher, or a coach.

These are symptoms — maybe a feeling of tightness in the chest or breathing problems while playing a sport — that might not be immediately apparent to those watching over him but may signal an asthma problem.

He should be familiar with what his green zone (doing well), yellow zone (getting worse), and red zone (medical alert) mean on his asthma action plan or daily management plan prepared by his health care provider. This should be on file with his daycare provider and/or school. And, he should be aware of the potential “triggers” — such as dust mites, pollen, or air pollution — that could affect his asthma symptoms.

Dissolving the Myths

Aside from talking to your child about what asthma is, you need to emphasize what it is not:

• Asthma cannot be cured. However, its symptoms can be controlled with medication and management. Among some children, symptoms — such as wheezing or coughing — may improve as a child gets older.

• While asthma is a common chronic condition, it is not an infectious or contagious disease. While this may be an obvious-point to adults, it may not be to children who today are constantly bombarded by news headlines about outbreaks and diseases. Let her know how asthma is related to heredity (possibly other family members have it) or to various triggers. (See Chapter 4.)

• Asthma is not a condition to be ignored — even when your child feels better. When she feels healthy and free of her symptoms, daily medications should not be stopped. Just remind her of why she is feeling better in the first place — with her medications.

• Asthma is not another word for inactivity. In years past, children were persuaded not to be active — lest they trigger an asthma episode. Today, the opposite is true: the asthmatic child should be encouraged to be as active as possible — providing her asthma is under control.

• Use of inhaled steroids to treat asthma will not harm your child physically, will not become addictive, or will not make her appearance “puffy.” Part of those concerns may be based on the confusion between inhaled asthma steroids and anabolic steroids, which have been used and abused by some athletes to become stronger. These are two different compounds.

• Going to the emergency room or being hospitalized is not a regular part of having asthma. While it can happen, the goal should be for your child to control her asthma through proper management every day.

• You do not need to buy lots of expensive retail products and equipment to control your child's asthma symptoms at home. While many products are on the market (see Chapter 16) to reduce indoor triggers that are related to asthma, reducing symptoms starts with basic activities such as vacuuming, eliminating molds, and reducing exposure to tobacco smoke (see Chapter 15).

Be a Part of Life

Help your child realize that asthma is not a condition that automatically places him on the sidelines and prevents him from participating in many activities with his family and friends.

If your child feels disconnected from those around him at times because of his asthma, encourage him to talk about it. Maybe he might be embarrassed or self-conscious about his condition or frustrated with continuing use of medications. Keep an open mind about suggestions — such as using a smaller inhaler that can be used without notice during the day.

If your child is using asthma as a reason why he needs to skip activities in school, such as recess or physical education class, additional questions may need to be answered to determine if his asthma is being adequately managed. In fact, 10 to 15 percent of Olympic athletes have learned to manage their asthma and compete at that elite level. This indicates that asthma can be controlled and should not be a reason to prevent a child from actively playing with friends.

When it comes to household chores, keep in mind that some asthmatic children probably should avoid various chores such as vacuuming floors and carpets, dry dusting, raking leaves, mowing grass, or brushing or bathing pets because they might trigger asthma symptoms.

But on the other hand, they can do many other chores around the house such as washing dishes, folding laundry, cooking most foods (except for fried foods), running errands, washing cars, food shopping, or even babysitting.