by: Kathleen May, MD
For millions of children with allergies and asthma, fall pollens and molds and exposure to potential allergens and viruses in class can really take a toll. Asthma, which can be triggered by allergies and respiratory illnesses, is the number one reason why students chronically miss school. The American College of Allergy, Asthma and Immunology (ACAAI) suggests the following strategies to help prevent allergy and asthma flare-ups at school. 
- Schedule a fall check-up. Visit your allergist to be sure your child’s allergy and asthma symptoms are under control. If you suspect your child is suffering from allergies but have never taken her or him to see an allergist, fall is the perfect time to schedule an appointment to find out what triggers symptoms and develop a plan for treatment.
- Share the treatment plan with school staff. School staff, including all adults who supervise your child during the school day, should have a copy of your child’s treatment plan, which should include a list of substances that trigger your child’s allergies or asthma, a list of medications taken by your child, and emergency contact information.
- Ward off the flu. Have your child get a seasonal and an H1N1 (swine) flu shot, especially if he or she has asthma. Because asthma, seasonal flu, and H1N1 flu are respiratory diseases, people with asthma may have more frequent and severe asthma attacks when they have the flu.
- Tour your child’s school. Visit classrooms, the art studio, the gymnasium, the cafeteria, and other areas where substances that may trigger your child’s asthma or allergies may be present.
- Investigate class pets. If your child is allergic to animal dander, ask that class pets that could trigger a reaction, such as hamsters and rabbits, be removed.
- Meet with the school nurse, teachers, and coaches. Discuss how they can help in control your child’s symptoms. Signs of irritability or an inability to concentrate may be subtle signs that your child is having asthma or allergy symptoms. Ask school staff to identify when and where your children’s symptoms worsen, so you can work with your doctor to adjust the treatment plan accordingly.

- Discuss how to handle emergencies. With an allergist’s written recommendation, children should be permitted to keep inhaled medications with them at school; most states have laws protecting this right. Children who are at risk for a life-threatening allergic reaction (anaphylaxis) caused by allergies to certain foods or insect stings also should carry an epinephrine kit. Be sure that your child and school staff know how to use emergency medications and complete a permission form that allows school staff to administer medications, if needed.
- Make sure your child understands what triggers allergies or asthma. Discuss steps to avoid triggers while at school, such as sitting far from the blackboard if chalk dust triggers asthma.
- Discuss risks of physical activity. Work with coaches, recess monitors, physical education teachers, and PTA leaders who handle after-school sports programs so they recognize the major signs and symptoms of asthma, such as coughing, wheezing, and shortness of breath.
- Share food allergy information. Share a list of the foods your child is allergic to and safe alternatives with teachers, lunch attendants, the school nurse, and class volunteers. Don’t forget to alert your PTA leaders as well; food is often available at after-school activities.
Kathleen May, MD, is a board-certified allergist in private practice in Cumberland, Maryland. Visit AllergyAndAsthmaRelief.org to find an allergist near you, take a relief self-test for you or your child, and learn more about allergies and asthma.