Lots of kids have asthma. For kids with a certain type of asthma, called "cough-variant" asthma, coughing is the main symptom of a flare-up. Coughing may get worse at night, during or after exercise, in cold weather, or when your child is around allergens or other triggers. 

• Be sure to follow the asthma action plan.
• If you don't yet have an asthma plan, discuss it with your child's health care provider. Follow these important tips in the meantime:
  • Make sure you and your child understand the signs of a flare-up and what to do if one happens.
  • If your child is supposed to take a medicine every day, they should keep taking it, even if they feel fine and don't have any symptoms.
  • If your child starts to feel asthma symptoms, they should take the medicine prescribed for quick symptom relief. If they already take a daily medicine, the "quick-relief" medicine might be extra doses of the daily medicine or a different type. 
  • Make sure your child always has medicine available for quick relief of symptoms (at home, at school, etc.). Talk to the school nurse about keeping some of the medicine at school.
  • Refill medicines before they run out.
  • If your child uses an inhaler, be sure they always use a spacer with it.
  • Your child should avoid tobacco smoke and any known asthma triggers. If anyone in your house smokes, call 800-QUIT-NOW (800-784-8669) or visit smokefree.gov for advice on quitting. Make your home and car smoke-free.
  • If exercise triggers your child's asthma, talk with your health care provider about safe ways for your child to stay active.

Your child:

• needs medicine more often than prescribed
• has a flare-up and the medicine prescribed for quick relief of symptoms doesn't help

Your child has trouble breathing. Signs you might see include:

• The skin between your child's ribs and neck pulls in tight during breathing.
• The nostrils flare (open wide) with each breath. 
• Your child is breathing faster than usual.

Call 911 if your child is struggling to breathe, is too out of breath to talk or walk, or turns blue.

What is an asthma flare-up? An asthma flare-up is when asthma symptoms get worse. In kids with cough-variant asthma, this means they cough a lot more. Just like in other people with asthma, their airways are overly sensitive to some things (called "triggers"). Being around triggers can bring on coughing by making the airways in the lungs narrower, swollen, and filled with mucus. Asthma flare-ups are also called asthma attacks or exacerbations. An asthma flare-up can happen even when a person takes medicine to control their asthma.

What are common asthma triggers? Triggers can bring on asthma symptoms, but they don't cause asthma. Triggers are different for each person with asthma, but common ones include:

• viral respiratory infections, like the common cold or flu 
• allergies to things like dust, pollen, mold, and pet dander
• dirty air from things like air pollution, tobacco smoke, aerosol sprays, or paint fumes
• weather conditions, like extreme cold or heat
• exercise

How do asthma medicines work? Asthma medicines generally work in two ways:

• Some asthma medicines work right away to relax the muscles around the airways. This opens the airways and provides quick relief of symptoms. That's why they are sometimes called "quick-relief," "rescue," or "fast-acting" medicines.
• Other medicines work over time to ease inflammation, which reduces swelling of the airways and limits mucus production. A person usually needs to take these every day, even when they feel fine and have no symptoms. These are sometimes called "controller," "maintenance," or "long-term control" medicines. Some children who have mild asthma might use controller medicines only when their asthma symptoms increase.

Some children will get both types of medicines from one inhaler device. They might need to use this "combination" inhaler every day, with added doses from it when they have symptoms. Some older kids with mild asthma might use a combination inhaler only for quick relief when they have symptoms, or before they exercise. Your health care team will help you figure out which inhaler is best for your child, and how and when to use it.

Are all asthma medicines breathed in, or can some be taken by mouth? Some medicines that ease inflammation can also be taken by mouth. For example, the health care provider may prescribe oral steroids for inflammation during a flare-up, usually for 5–7 days.