Asthma in Children: Knowing How Bad an Attack Is

Overview

It can be hard to know if your child is having a mild, moderate, or severe asthma attack. The following chart may help you. Talk with a doctor if you can't tell how bad your child's symptoms are.

In most cases, you can take care of your child's symptoms at home by looking at your child's asthma action plan. The plan tells you what symptoms to watch for, which medicine your child needs to use, and when to call a doctor or seek emergency treatment.

Gauging the severity of your child's asthma attack

Factor	Mild attack	Moderate attack	Severe attack
Peak expiratory flow	80% to 100% of personal best	50% to 79% of personal best	Less than 50% of personal best
Breathing	Normal or slightly faster	Faster than normal	Rapid, and your child may appear preoccupied with breathing. They may want to sit upright to help with breathing.
Breath	Mild or no shortness of breath; can speak in full sentences	Short of breath; can speak in short phrases or parts of sentences	Very short of breath; speaks in single words or short phrases
Chest	Does not use or slightly uses chest muscles to breathe	Uses chest and neck muscles to breathe. The skin between, under, and above the ribs collapses inward with each breath.	Uses chest and neck muscles to breathe and may open nostrils wide; may clutch at the chest
Skin	Normal skin color	Pale skin color	Very pale or bluish skin color; may sweat more than normal
Wheezing	Wheezes while breathing out	Wheezes while breathing in and out	Does not wheeze while breathing. This means there may be little or no air in the airways.
Alertness	Normally alert	Normally alert	Not as alert as usual and may appear anxious

It is important to treat your child's asthma attacks quickly. If your child does not improve soon after treating an attack, talk with a doctor.

• During attacks, stay calm and soothe your child. This may help your child relax and breathe more easily.
• Don't underestimate or overestimate how bad your child's asthma is. It is often hard to know how much breathing difficulty a baby or small child is having. Seek medical care right away for babies and small children who have asthma symptoms.