Parents of Asthmatics: How do you decide when to send your child to school?

[Anonymous]

DC coughed all night long, with inhaler and 2 steam showers in the middle of the night. Coughing fits this a.m. Now fine, except for the occasional coughing fit. DC is in PreK -- stayed home today. Coughing fits are scary, long and tiring and would be disruptive to class. DC tired, so probably wouldn't learn effectively. School has great nurse who will adminster the inhaler so that is not an issue -- although the inhaler doesn't always stop the fits. I think I made the right call, but I don't know . . . how do you decide? I am assuming that the decision changes a bit as the child get older. As long as we stay on top of the meds, it doesn't usually progress to wheezing -- DC much more prone to coughing fits. Thoughts?

[Anonymous]

Does your child regularly take an inhaled steroid?

Honestly, your DC's asthma seems not well controlled. And I say that as a nearly life-long asthmatic myself. Why doesn't the inhaler always stop the wheezing/coughing??

Because of this, the wheezing, I would be very conservative and NOT send my preschool, K or maybe even 1 to school unless everything was awesome with the lungs that day. The school nurse may be great but she's not trailing around your DC during recess.

[Anonymous]

Thanks. She does take an inhaled steriod all year. She doesn't wheeze -- just coughing usually, which rarely progresses to the wheeze. It is viral induced so she has been great this year when she doesn't have a cold . . . just missing a lot of school when she does. Good point about recess.

[Anonymous]

My DD8 has asthma and i have never kept her home for just the cough. She'd have been home for weeks at a time. Send in the rescue inhaler and have the nurse administer every 4-6 hours.

[Anonymous]

All depends on the child I think. Mine is well-controlled by a nebulizer when he gets sick (he's only 3 so no inhaler yet). If he were miserable though, even for certain periods during the day, I'd keep him home.

[Anonymous]

My DS is 4.5 and has asthma. He is on a maintenance steriod and rescue inhaler (as needed). If the rescue inhaler doesn't take the cough/wheeze away for a decent amount of time....he says home.
Both for medication dosing and for watching. Asthma can escalate very quickly. My DS has been hospitalized for asthma attacks for days and it is very scary.

[Anonymous]

OP - are you using a spacer? I found it made a big difference in getting my meds in (me, not a kid).

I agree that your child does not sound well-controlled. The coughing is your child's way of using additional muscle power to get the air out (asthma's more about exhaling than inhaling, but since you can't get air in unless other air gets out, it is all the same).

[Anonymous]

OP: My coughing asthmatic is now 6 and in K. First off, hang in there. I feel your pain and have been there for weeks at a time.

Now, for the advice: I made/make my decisions day by day. On the worst of it, when he was really too tired from coughing all night, I'd keep him home. If he wanted to go and I thought he could handle it, I had an arrangement with Pre-K to let him nap in the middle of the day if he needed it. One of his Pre-K teachers was asthmatic herself and flared at the same time as him, so she was very conscientious about his needs.

I will say though, that when he was 5, we switched pulmonologists b/c I and pediatrician felt that he wasn't yet well managed. New pulmo. has us using nebulizer rather than inhaler and some different meds than before. Mine is all cough and very little wheezing b/c of an underlying condition, so different meds target cough better. Now, inhaled meds usually take a day or two to really kick in, but that's much better than the weeks at a time we used to be dealing with. He's also finally growing, so that's helping a lot.

[Anonymous]

Those of you with school aged children 9K or above) -- how are the schools handing your child's frequent absences? Are they understanding?

[Anonymous]

I am 14:33 above. My DD is a third grader. Once they get above K, IMO, it is hard to keep them home for just the cough. They miss class instruction and they get behind on homework. That's why I said I don't keep her home for just a cough. I find that she self regulates for recess (and really, they don't get that much recess or outdoor recess in the winter at our school) and I have occasionally written a note to have her sit out PE if her cough is really flaring. She had H1N1 in October and I swear she coughed until January (secondary infection and several rounds of antibiotics). I just sent an inhaler and had the nurse give her a dose at lunch. She was far from the only kid with a persistent cough in her class.

[Anonymous]

My son is Pre-K and I keep him home when he has trouble. As he teacher said, it is pre-K. I know it is a tough decision, but I always try to follow my gut instinct, more times than not it is right.

[Anonymous]

I'm 23:22 above. In the spring, when I talked with principal about potential of missing school, she was not at all understanding. Then all the H1N1 hoopla began. He missed a lot of days in end of Nov through Dec. time frame. He is only in K, but no one has questioned it.

Of course, it didn't hurt that his K teacher was quite literally scared by his cough . As she put it, his cough is bigger than he is. (I tried and tried to warn her...sigh)

My bigger issue was getting everyone on the same page about him getting medicine before PE. Teachers forgetting, nurse not making sure it was happening, etc.

[Anonymous]

OP. 30 years ago, I, also an asthmatic, missed 30 days of half day K. How do I know? At the end of the year, the teacher announced how many days each child had missed, and I have never forgotten. I'm assuming if I don't do better as a parent I may be arrested or something these days, but, amazingly, I eventually learned to read, write, spell, add and subtract. I don't remember missing a ton of school after early elementary, but I still wonder if the amount I missed would be problematic these days (maybe 8-9 days a year). Thanks for all the advice/insight. I guess I just have to take it day by day, and work with the school. My child's cough has also been known to frighten people so that may help. . .