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Asthma attack
If your child’s asthma suddenly gets worse (asthma attack), they will need urgent treatment. Signs of an asthma attack include:
- Being very wheezy
- Coughing
- Having a tight chest
- Finding it hard to breathe
- Being too breathless to talk or walk
- Sometimes there is no obvious cause for your child’s asthma attack. The most common triggers are viral infections (coughs, colds, and chest infections), emotional anxiety, and exposure to airway irritants such as cigarette smoke.
What should I do if my child is having an asthma attack?
1. Sit your child upright
2. Keep them calm and reassure them
3. Refer to your child’s action plan and follow the instructions.
A child asthma action plan will help you and your child to manage their asthma.
When should you worry?
If your child has any of the following:
● Not improving despite using their inhaler according to their action plan
● Breathing very fast, too breathless to talk, eat or drink
● Working hard to breathe, drawing in of the muscles below the ribs, or
noisy breathing (grunting)
● Breathing that stops or pauses
● A harsh noise as they breathe in (stridor) present all of the time (even when they are
not upset)
● Is pale, blue, mottled or feels unusually cold to touch
● Difficult to wake up, very sleepy or confused
● Has a fit (seizure)
● Has a rash that does not go away with pressure (the ‘Glass Test’)
You need urgent help
Go to the nearest Hospital Emergency Department or phone 999
Keep your child upright and reassure them
Get your child’s inhaler and follow your action plan
If your child has any of the following:
● They need increased doses of their inhaler for more than 2-3 days
● Breathing a bit faster than normal or working a bit harder to breathe
● A harsh noise as they breathe in (stridor) only when upset
● Dry skin, lips or tongue
● Not had a wee in last 8 hours
● Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
● Temperature less than 36°C in those over 3 months
● Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or NHS 111 – dial 111
Continue to follow your child’s action plan while seeking advice.
If symptoms persist for 4 hours or more and you have not been able to speak to
either a member of staff from your GP practice or to NHS 111 staff, recheck that your
child has not developed any red features
If none of the above features are present:
Watch them closely for any change and look out for any red or amber symptoms
Continue to follow your child’s action plan while seeking advice
If your child has other symptoms associated with their asthma attack, you might want to look at our information on sore throat, cough, earache, diarrhoea and vomiting or our other pathways.
Self-care
Continue to follow your child’s action plan while seeking advice
Page Last Updated 14/11/2025, 09:47
Asthma attack prevention
The most common triggers are viral infections, emotional disturbance and exposure to airway irritants such as cigarette smoke.
Things you can do to reduce the chance of your child having an asthma attack:
1. Get your child’s asthma under control
Children with poorly controlled asthma are much more likely to have an asthma attack. Make sure your child follows their action plan.
Signs of poorly controlled asthma:
● Needing additional doses of inhaler 3 or more times a week
● Wheezy after exercise
● Persistent night-time cough
If your child has symptoms of poorly controlled asthma they should be reviewed. Make an appointment with their GP or asthma nurse.
It is important to have a yearly asthma review with your asthma nurse or GP. Everyone with
asthma should have an action plan.
2. Get the inhaler technique right
Watch these Beat Asthma videos on how to help your child use their inhaler.
Your child’s asthma will not be controlled if their medicines are not getting into their lungs.
If your child has been given a spacer:
1. Check the inhaler contains medicine and shake. Reliever inhalers have a maximum of
200 doses but will continue to fire when empty.
2. Remove the cap.
3. Fit the inhaler into the end of the spacer.
4. For spacer with mask, place the mask over the nose and mouth and ensure a good
seal. For spacer and mouthpiece, place teeth around the mouthpiece and seal with
lips. Most children over 3 years can use a mouthpiece.
5. Press the inhaler once and encourage the child to take 5 slow breaths or count to 10
slowly whilst they breath normally through the spacer.
6. Shake the inhaler and repeat steps 4 and 5 if more puffs are needed.
See your practice nurse or doctor if you are not sure whether your child is using their inhaler properly.
3. Avoid triggers where possible
Even when adults smoke away from their children, smoke on their clothes and hair can
make their child’s asthma worse.
4. Your child should have an influenza immunisation every autumn (the flu jab). Flu viruses can trigger asthma symptoms. Current guidelines in the UK recommend that high-risk groups such as people with severe asthma should have a flu jab each winter.
Return unwanted inhalers
Help reduce inhaler waste by returning used or unwanted inhalers to your local pharmacy to dispose of safely. Inhalers should not be placed in household waste because the plastics cannot be recycled.
Follow these tips to help reduce waste:
- Check your inhaler stock before ordering more
- Request inhalers at least three days in advance when running low
- Use inhalers as directed by a healthcare professional
- Return used and unwanted inhalers
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Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.