For children with asthma, going back to school can mean a return to wheezing, coughing, and shortness of breath.

Asthma, a chronic respiratory disease characterized by attacks of difficulty breathing, is one of the most common chronic pediatric conditions in the United States. This diagnosis is shared by over seven million children from infancy to age 17. Symptoms are caused by inflammation and narrowing of the small airways. Asthma severity varies between mild infrequent symptoms to persistent daily symptoms. Even mild asthmatics, though, may experience severe asthma attacks.

Many children experience seasonal variation with more severe persistent coughing, wheezing, and shortness of breath during the fall, winter and spring months. Their symptoms are often triggered by chemical irritants such as cigarette smoke, common airborne allergens such as mold, dust mites, or cockroaches, and viral upper respiratory infections or “colds” which are frequently passed between students in classroom settings.

In fact, nationally, asthma accounts for about 10.5 million school absences each year. Many of these absences may be preventable. Here are a few things families can do to give their children with asthma their best chances of participating in all the new school year has to offer:

  Visit your pediatrician. Bring all of your child’s asthma medications and be ready to discuss your child’s symptoms.

• Ask your doctor about spirometry, a safe test offered in some practices that can help evaluate your child’s airways. Spirometry may be especially helpful in assessing older children and adolescents who may under-report their symptoms.

  If you and your doctor decide that a daily medication is needed to control your child’s airway inflammation and prevent an asthma attack, be sure to use it every day as prescribed.

Ask your child’s doctor for a written “asthma action plan.” Post in a prominent place in your home and share a copy with your school nurse.

Keep the air your children breathe clean. Don’t allow anyone to smoke in or around your home or car. In Boston, the Boston Public Health Commission’s Healthy Homes program can help you to reduce environmental triggers in your home such as mold, dust mites, or cockroaches. You can call (617) 534-5966 or email for more information.

 Remind children to always cover a cough or a sneeze with the crook of their elbows. Hand washing reduces the risk of catching colds that trigger many asthma attacks. If your child is sick, keep him or her home from school so others don’t get sick, too.

Encourage everyone in your household to get the flu vaccine since children with asthma are at high risk for hospitalization from influenza.

Huy Nguyen, M.D., is the medical director at the Boston Public Health Commission and a pediatrician at the Dorchester House Multi-Service Center.