Your child may have a new backpack and back-to-school wardrobe, but are ready for a healthy start to the school year? For parents of children with asthma, there is even more to consider, as returning to school may mean increased exposure to asthma triggers that were less common during the summer break. Additionally, as the weather changes, respiratory infections are spiking, meaning your child may be at risk of a flare-up.
These factors are just a few that contribute to ‘Asthma Peak Week’ which occurs every year in September. “It’s been well studied that a few weeks into the beginning of the school year there is a spike in asthma exacerbations, emergency visits and hospitalizations,” said Dr. Frank Eidelman, Vice Chief of the Medical Specialty Institute and Section Head of Allergy and Immunology at the Cleveland Clinic Florida. “But we can decrease the frequency of asthma exacerbations during peak week by being proactive.”
We spoke with Dr. Eidelman about what causes Peak Week and simple steps you can take to protect your child so they can enjoy their new school year free of flare-ups.
What Causes Peak Week?
The third week in September is a whirlwind of triggers for children with asthma. The transition back to school can disrupt sleep schedules, daily routines and increase stress, all of which can contribute to poorer asthma control. Schools often contain an abundance of triggers for children with asthma such as cleaning chemicals, dust, pests, poor indoor air quality and even vehicle emissions from idling buses and cars. Outdoors, fall allergens like ragweed pollen and molds, can also cause issues for people with asthma.
Equally worrisome, a return to school means that students are spending more time in close proximity to each other. This allows respiratory viruses to easily and rapidly spread, often triggering asthma symptoms. “An increasing number of infections occur as the children get together,” Dr. Eidelman explained. “That spike in seasonal viral infections is the number one viral cause of asthma exacerbations.”
Children can be more susceptible to these triggers because, during the summer months, they may have reduced or stopped taking their prescribed asthma controller medications. “A lot of times kids are traveling, doing other things and feeling good over the summer, so they may slack off a bit on their controller medications,” Dr. Eidelman continued. “This is why I think it's important for children with asthma to see their doctor before the school year starts to make sure that they're prepared.”
Working with Your Child’s Healthcare Provider
Before returning to school, visiting your child’s healthcare provider to ensure their asthma is well managed is essential. During this visit, you have the opportunity to review their controller medications, how to use them correctly, and make changes if necessary. This is also a great time to go over your child’s Asthma Action Plan so that they can bring it to school as guidance for any adult who is watching them. “You want to be aligned, so everyone knows what to do if symptoms start up and what medication to take if things get worse,” said Dr. Eidelman.
“It is also a good opportunity to review which immunizations they have. For instance, seasonal flu vaccine is recommended for all children, but particularly for children with asthma.” Other vaccines such as COVID‑19, pneumococcal, RSV and DTaP or Tdap may also be recommended as they are the most effective prevention against severe infection. The American Lung Association offers guidelines to recommended back-to-school vaccines on our website.
Working with Your Child’s School
If your child has asthma, working with the administration at their school is key. Next to their usual school supplies, children with asthma should carry their quick-relief (rescue) medication and Asthma Action Plan. But before the year begins, make sure the school is aware of your child’s asthma diagnosis and fill out any required forms to ensure quick access to your child’s lifesaving medicine. It can also be helpful to review medication plans, possible triggers and school emergency protocols with the nurse and child’s teacher. “Most schools require some kind of medication authorization form that has to be reviewed and signed by their doctor. This allows the child, depending on their age, and/or the school nurse to administer medications in school should symptoms arise,” explained Dr. Eidelman.
Additionally, if the school is open to improvements, programs like Breathe Well, Live Well® and the Clean Air School Challenge can assist them in reducing asthma triggers and improving air quality in school.
Allowing Your Child to Run Free
Every child wants to be able to fully participate in class and at recess. But sometimes in an effort to prevent a flare-up, children with exercise-induced asthma find themselves sitting on the sidelines. But if their asthma is well controlled, there is no reason for this. “Avoiding all physical activity is not good for a child’s physical or mental health,” Dr. Eidelman clarified.
“We encourage all children with asthma to participate in regular physical activity but if they know it can be a trigger for them, they should use a quick-relief (rescue) bronchodilator before exercise.” Having physical educators, coaches or teachers aware of your child’s asthma beforehand can also help them monitor your child’s activity and determine when they may need a break or intervention.
“If you really think about it and you do due diligence in the late summer, it should decrease the risk of severe asthma exacerbations in the fall.”
Blog last updated: September 10, 2026
