What Is Asthma? Asthma Triggers Avoiding Asthma Triggers Asthma/Allergy Action Card Medication Basics More Resources Childcare Checklist Of the more than 13 million American children age five and under currently enrolled in childcare, an estimated 1.4 million have asthma (about 1 child in every 11). Do you know how to make your childcare setting safe for children with asthma?

• Asthma is the most common chronic childhood disease.
• Children with asthma have sensitive, inflamed airways in their lungs.
• They are bothered by many things that start (or "trigger") their symptoms and make their asthma worse.
• Asthma can usually be kept under control, with a combination of medications and avoidance of the things that trigger symptoms.
• When asthma gets out of control and an asthma episode starts, the airways become very inflamed, the muscles around the airways tighten up, the airways start to plug up with mucus, and it becomes hard to breathe.
• It is best to try to keep airway inflammation under control to help prevent symptoms and flare-ups.

Below are the most common things that aggravate or "trigger" asthma. A doctor can help to determine an individual child's "triggers" through an examination, medical history and allergy tests:

• Allergens such as: dust mites, plant pollens, molds and mildew, animal dander, latex, and pests (mice, rats and cockroaches)
• Irritants such as:
  • Smoke from cigarettes, wood fires and charcoal grills.
  • Fumes from household cleaners, paint, perfumes, gasoline, and art supplies with odors
  • Cold air and sudden weather changes
• If asthma is not well controlled, exercise and activities that make you breathe harder such as laughing, yelling and crying can trigger an episode.
• Respiratory infections

Some triggers are very common in child care. For instance:

• Avoid stuffed animals that can't be washed in hot water and tumble-dried.
• Avoid arts and crafts materials with fragrances or fumes (e.g., some markers, paints and adhesives).
• Don't spray cleaning fluids into the air when children with asthma are present. To disinfect, dampen a cloth with a mild bleach solution and wipe surfaces clean.
• Avoid products with fumes and fragrances.
• Adjust outdoor time for cold-sensitive or pollen-sensitive children, and offer indoor activities instead.
• Avoid the use of latex gloves in routine, low risk situations and use only as mandated by Universal Precaution standards.
• Click here for more extensive information about Controlling Asthma Triggers at Home, at Child Care and at School

Each child should have an "Asthma Action Card" on file with you. The card should be filled out with specific information about the child and be signed by the parent/guardian and the child's physician. The card should explain:

• their triggers
• their medications and how to use them
• the symptoms that indicate when their asthma is worsening or getting out of control. (Early warning signs may include tiredness, coughing, and itching and progress to wheezing, struggling to breathe, and having a tightness that can be seen in the chest and neck.)
• What do in an asthma emergency
• Click here to get an Asthma Action Card.

• Long-Term Control Medications: These medications help to prevent asthma episodes by reducing chronic swelling and inflammation in the airways. They include corticosteroids, cromlyn sodium, nedocromil sodium and anti-leukotrienes. (These have a variety of brand names).
• Quick-relief medications: These are called bronchodilators because they open up the airways by relaxing tightened muscles. They include beta agonists and theophylline.

Some asthma medicines come in an inhaled form (to be used with an inhaler or a nebulizer). Some asthma medicines are tablets or syrups to be taken by mouth. It is very important to know how and when to administer medicines.

Asthma and Allergy Essentials for Child Care Providers© is a training program designed by AAFA to give child care providers the tools and knowledge they need to care for children with asthma and allergies and provide a safe and healthy environment for children with these chronic conditions.

Contact us at 781-444-7778  if you would like to schedule a training workshop at your child care site, or to find out the dates of upcoming workshops we are offering.

7. How can I learn more?

• E-mail us and ask for an "Asthma-Friendly Child Care Checklist" and an "Asthma Action Card" - info@asthmaandallergies.org
• E-mail us and ask how to participate in a child care provider workshop on managing asthma.
• See more extensive information about asthma and allergies on our national website at www.aafa.org