Rules of Two™
If you answered ‘Yes’ to any of these questions, your child’s asthma is NOT UNDER CONTROL. Talk to your doctor about your asthma!
The Rules of Two is a registered trademark of the Baylor Health Care System
Good Asthma Control Means:
Controlling Your Child’s Asthma
There are three main aspects of controlling your child’s asthma: medical care, medications, and avoiding or reducing things in the child’s environment that trigger your child’s asthma.
A doctor should be monitoring your child’s asthma. It can be the child’s regular health care provider or a specialist such as a pediatric pulmonologist (lung doctor) or an allergy/asthma specialist. It is important to see the doctor every 3-6 months, even if your child is feeling well!
Asthma Action Plans
An asthma action plan (AAP) is a one-page guide that informs you what to do if your child has asthma symptoms. Your doctor should fill out the AAP and give a copy to you. Any adults that have contact with your child on a regular basis, such as the school nurse or child care provider, should be given a copy of the AAP. The AAP should be updated by the doctor when the treatment is changed in any way. Whenever the AAP is changed, a new copy should be given to the school nurse, child care provider, or other adults who have contact with your child on a regular basis.
Here is what an AAP looks like in English and Spanish:
Importance of flu shots!
It is very important that your child gets a flu shot every year before or during winter. This will help prevent your child from getting the flu with asthma complications!!
You may have heard that the flu shot will make a person sick. That is not true. A flu shot helps children and adults stay healthy.
Medicines help keep the asthma under control. There are two types of medicine that are most commonly prescribed for asthma. They are controller medications and quick relief medications.
Controller medication is long-acting and helps to keep asthma under control. It must be taken every day, even when your child is doing well. Controller medication keeps the airways open and helps the body to decrease mucous so the airways won’t get blocked.
This will help to decrease the number of asthma attacks your child will get and may even prevent them from happening at all!
Examples of controller medications are Asmanax, Flovent, Advair , Symbicort, and a chewable pill—Singular.
An Inhaled Corticosteroid, also called ICS, is the most common type of controller medication that doctors prescribe. ICS is excellent at controlling asthma. It contains only a tiny fraction of the amount of steroids you hear about that athlete’s sometimes take. Your child will not get huge and will not get sick from taking ICS—it will make their asthma better.
Quick-Relief Medication (also called Rescue medication) are used for quick relief when symptoms of an asthma attack begin. These medications open the airways so more air can get in and out. They are short–acting. Quick-relief medication should be administered to your child at the first signs of distress—do not wait!
Some children need to use quick-relief medication before exercise (as instructed by your doctor) to prevent asthma symptoms from occurring when they are active. This allows children with asthma to participate in activities and live normal, active lives.
Availability of the Quick-Relief Inhaler at All Times
You or your child should have the quick-relief medication on hand at all times whether at school, home, or away even for a few hours. Your health insurance will cover for two quick-relief inhalers: one to keep at school and one for home. The quick-relief inhaler should always be readily available to your child just in case it is needed in an emergency—even if your child is feeling well.
You should be sure that your permission for the school nurse to administer the quick-relief medication to your child is on file at school along with medication. If your child is old enough to take the medication him—or herself, then permission for your child to carry the medication during school hours should be on file. The medication should be available during school trips, also. Your child may need the medication before exercise or for emergencies.
If your child needs to use the quick-relief inhaler more than two times a week, or if you have to refill it more than two times a year, then your child’s asthma is not under control. Your child needs to see the doctor. Also, always be aware of the expiration date of the medication. If the medication has expired, see the doctor or call and request a refill.
Some common quick-relief medications are: Pro Air, Proventil, Ventolin, and Xopenex.
Devices to Help Children Inhale Their Medication
Spacer – A spacer is a device that attaches to your child’s inhaler. It makes it easier to inhale the full dose of medicine. Spacers are also called aerochambers.
It is important that someone who can help teach you or your child use the medications watch them and review their technique. You should bring your medicines to your visits so your provider can see what you have and how you or your child are using it.
Even babies can be given their medication with a spacer. A mask can be used to help young children inhale the dose of medication.
The video clip below demonstrates how to use the inhaler with the spacer/aerochamber.
Nebulizer – a nebulizer is a machine that is used to deliver medication to young children. The spacer is more effective in delivering the medication directly to the lungs. However, you can use the nebulizer to administer your child’s medication if for some reason your child cannot use the spacer.
This video clip below is a demonstration of how to use a nebulizer.
Controlling Asthma Triggers in Your Child’s Environment
Things that cause asthma symptoms are called triggers or allergens. Limiting or avoiding your child’s exposure to asthma triggers are will help to prevent asthma attacks. This is a very important aspect of managing asthma.
There are a variety of triggers that can make your child’s asthma worse. Some common triggers are smoke, some foods, colds, dust, pets, pollen, weather, cockroaches, strong odors such as perfumes, and strong emotions. Click on the links below to the American Lung Association and the Centers for Disease Control pages for helpful information on different triggers and how to avoid or control them.
For More Information on Asthma
Below are links to more detailed information on asthma and how to control it.
The Hudson Valley Asthma Coalition (HVAC) welcomes members of our community to participate on our coalition. Parents are encouraged to join! By becoming a member of our coalition, you will learn more about asthma from experts as well as help in reducing the burden of asthma on families throughout Dutchess, Orange, Sullivan, and Westchester counties. We meet several times a year.