Asthma at school and nursery

Making sure your child stays safe with their asthma at school or nursery can feel a bit daunting.

Your child may be going back to school or nursery for a new term, starting school or nursery for the first time or joining a new school or nursery. If your child has asthma, or suspected asthma, you may worry about how to prepare for this.

It’s important to make sure the school or nursery knows all about your child’s asthma, to make sure that everyone is clear about how to manage your child’s asthma well.

Book a meeting with your child’s teacher or keyworker

This can be a really useful meeting, where you can talk through important information about your child’s asthma. This might not be able to happen in person at the moment – you could ask if a telephone or video call is possible.

You might want to check if other people can be there too, like the school nurse or the headteacher.

If your child is old enough, you might want to bring them along too.

In the meeting, it’s a good idea to talk about the following:

Talk staff through your child’s asthma action plan and give staff a copy to keep.

Let them know what your child’s usual triggers are and explain how asthma affects your child. This includes their symptoms and signs that they need to use their reliever inhaler, like wheezing, coughing, difficulty breathing and a tight chest.

Make sure the school know how to contact you if your child has any asthma symptoms at school or nursery – for example, if they needed to use their reliever inhaler. It is also important that you let the school know if your child is getting asthma symptoms at home.  

Show the teacher or keyworker your child’s reliever inhaler and explain how to use it. All staff that have contact with your child should know how to look after your child’s asthma. This includes lunchtime supervisors and supply teachers.

Explain that if your child has a spacer, they must always use it, as it helps their inhaler to work better.

Download a school asthma card. A school asthma card includes contact details and essential information about your child’s asthma. Fill it in with your child’s GP or asthma nurse and take it into your child’s school.

Here are a few questions you could ask your child’s teacher or keyworker

• If my child is displaying asthma symptoms, such as a cough, will they be sent home from school?  
• How would you like me to let you know about any changes to my child’s asthma?
• How will you let me know about any asthma symptoms my child is having at school?
• What is your medical conditions policy? This covers how they will care for children with conditions like asthma.
• What is the school’s policy on attendance? This is a chance to talk about any concerns you may have about your child being too unwell to come to school, or if they have to miss school to attend appointments.
• What asthma training have staff had at this school?
• How will my child be included in, and kept safe during, school trips and sports day?

Don’t forget to tell school and nursery staff about our website, WhatsApp chat and Helpline. The more they know about asthma, the more able they’ll be to look after your child.

Ask about an Individual Healthcare Plan

Some children with medical conditions like asthma have an Individual Healthcare Plan (IHP).

This sets out key points about your child’s asthma, so the school knows how to support them. This includes their symptoms, medicines and what to do in an emergency.

Not all children with asthma need an IHP. It’s a good idea to have one if your child’s asthma symptoms often get worse, as this could lead to an asthma attack.

Your child’s headteacher has overall responsibility for IHPs, so they’re the person to ask if you think your child needs one. As a parent or carer, you can be involved in the drafting of your child’s IHP.

If your child does not have an IHP, make sure the school has a school asthma card for your child, and a copy of their asthma action plan.  

Manage your child’s medicines

Your child may need to use their medicines at school or nursery, especially their reliever inhaler (usually blue).

Make sure your child’s inhaler is in date, and kept in the original box with the prescription label attached and instructions included. It’s also a good to label your child’s inhaler with their name and class.

Make sure your child knows where their inhaler is kept and can access it easily – it shouldn’t be locked away.

If your child needs to take any extra medicines during school or nursery hours, make sure you've given written permission. This is something that can be recorded on your child’s school asthma card.

If your child’s school keeps spare emergency reliever inhalers, find out where they’re kept. Your child may need to use one if they can’t use their own inhaler.

Under normal circumstances, the metered dose inhaler can be cleaned. However, due to COVID-19, it may be safer to throw away the inhaler after it is used, rather than washing it. The spacer will always be thrown away, as it can’t be used by another child.

If your child’s school does not keep spare emergency reliever inhalers, tell them about the new national guidance. Find out more about the campaign for inhalers in school, and the new law passed in 2014 to allow emergency inhalers to be kept in school.  

Plan for asthma attacks

Staff that look after your child need to know the signs of an asthma attack and when to call 999.

The school should have a copy of your child’s asthma action plan which should list their asthma attack symptoms and step-by-step instructions on what to do.

Help staff understand that your child shouldn’t be left alone without an adult until they’re feeling better.

Your child should not be sent to get their own inhaler – someone needs to bring it to them.

When your child goes into secondary school, they should be managing their asthma themselves. As this happens, there are a few things you need to make sure your child does:

• They need to check that their reliever inhaler is in their bag before leaving for school every day. It should be kept somewhere they can get to easily at any time, like during PE or if they are on a school trip.
• Your child should know if their school has spare reliever inhalers, in case they lose or forget their own. However, they should not rely on this. It will always be quicker and safer if your child can get their own inhaler quickly and easily.
• Your child should know when they need to use their reliever inhaler.
• They should recognise the symptoms of an asthma attack and know when to ask someone to call an ambulance.

Having asthma in year 7 can be an especially risky time for children, because of the amount of change a child experiences when moving up from primary to secondary school. It can mean a new environment, with the potential for new triggers.

If your child is in secondary school, they might want to find out more about asthma in their teenage years.

Exercise is good for everyone, including children and young people with asthma. However, some people find that exercise and sport trigger their asthma.  Find out more about exercise as an asthma trigger.

• If you’re worried that PE lessons may trigger your child's asthma, there are a few things you can do:
• Tell their PE teacher or sports coach if they’re having symptoms.
• Make sure your child keeps their reliever inhaler (usually blue) somewhere they can always get to.
• Encourage your child to warm up before taking part in PE or sports day.
• Make sure your child and their teacher know they need to stop exercising if they start to get any asthma symptoms, take their reliever inhaler, and wait until their symptoms have gone before starting the activity again.

On sports day, your child may have extra triggers, like excitement and exposure to pollen. Find out about emotions as an asthma trigger and pollen as an asthma trigger.

Every September, more children are rushed to hospital due to their asthma than at any other time of the year. There may be a few reasons for this.

One reason is that lots of children get colds when they go back to school. This is one of the biggest triggers for people with asthma.

Over the summer holidays, your child’s asthma care can be disrupted – for example, they may forget to take their preventer inhaler more often. This means they may be more sensitive to triggers when they go back to school.

However, there are things you can do to help avoid a back to school asthma attack.

Research shows having a diagnosis of asthma is a risk factor in dropping a grade between mock and final exams.

Stress can be an asthma trigger, so it’s important that your child is controlling their asthma during exam season. If you’re worried about your child’s stress levels, speak to the school, or your GP, about how they can help.

Pollen is a common trigger for asthma too, and hay fever is worse during the summer months, when many children take exams. Cut your child’s risk of an asthma attack triggered by pollen.

We have more information to help young people with asthma while studying and taking exams.