Asthma in Child Care: What Centers Need to Know

by Kimberly Kostas, RN, BSN, CPN

As a pediatric nurse and the owner of PediNurse, LLC, I work closely with child care centers in Massachusetts to promote safe and healthy environments for children. One condition that child care providers must be especially aware of is asthma—a common chronic illness that affects about 1 in 12 children in the U.S., according to the CDC (2023). For children under the age of 5, asthma symptoms can be harder to identify and manage, making education and preparedness critical in early childhood settings.

What Is Asthma?

Asthma is a chronic lung disease that causes inflammation and narrowing of the airways, leading to episodes of wheezing, coughing, chest tightness, and shortness of breath. These episodes, known as asthma attacks or flare-ups, can be triggered by things like:

• Allergens (dust mites, pet dander, pollen)

• Respiratory infections

• Cold air

• Physical activity

• Environmental irritants (strong odors, cleaning chemicals, smoke)

Young children may not be able to describe their symptoms clearly, which means child care staff must be trained to recognize signs and respond quickly.

Why Child Care Providers Must Be Asthma-Aware

Massachusetts child care regulations (606 CMR 7.11) require that programs be prepared to handle medical emergencies and manage chronic conditions. Since asthma can become life-threatening without prompt treatment, it's vital that licensed child care centers have asthma action plans in place.

Key Responsibilities for Child Care Centers

1. Obtain and Follow an Individual Asthma Action Plan (AAP): Parents should provide a written AAP from the child’s healthcare provider, which outlines daily medications, known triggers, emergency medications (like albuterol), and when to seek emergency help.

2. Maintain Proper Medication Storage and Access: Quick-relief medications (e.g., inhalers, nebulizers) must be stored securely but accessible immediately. Staff should know how to administer them properly.

3. Train Staff Regularly: All caregivers should be trained in recognizing asthma symptoms and administering inhaled medications. The American Lung Association offers asthma education programs, such as "Asthma Basics" (lung.org).

4. Limit Exposure to Triggers: Common in-classroom triggers like dust, mold, pet dander (from classroom pets), or strong cleaning products should be minimized. Use fragrance-free and asthma-safe cleaning supplies whenever possible.

5. Have an Emergency Plan: If a child is experiencing an asthma attack and their medication doesn’t help within minutes, staff must be prepared to call 911 immediately and follow the AAP.

6. Document and Communicate: Record all asthma-related incidents and communicate promptly with families. Ongoing communication helps improve care and avoid future episodes.

Asthma-Friendly Practices in the Classroom

Creating an asthma-friendly environment can make a big difference in children’s daily health and reduce absenteeism:

• Vacuum regularly using HEPA filters

• Encourage handwashing to reduce respiratory infections

• Avoid aerosol sprays and scented products

• Keep windows closed on high-pollen days

  
  

  

  
  

Helpful Resources for Child Care Providers

• CDC Asthma Information

• American Lung Association – Asthma in Schools

• Asthma and Allergy Foundation of America

Support for Massachusetts Child Care Centers

As a pediatric nurse and health care consultant, I help Massachusetts child care centers comply with health regulations and improve the quality of care for children with chronic conditions like asthma. If your center could benefit from custom asthma training, medication policy development, or a full health consultation, I’d love to support you.

Visit www.pedinurseconsulting.com for resources, blog posts, and to learn how to partner with us as your center's dedicated health care consultant.