Fostering a Child With Asthma

Around one in eight children have asthma, so sooner or later a child with an inhaler in their school bag will come to live with you. People ask us about this before they have even filled in a form. Can I manage the medicines? What if there is an attack at two in the morning? Most carers learn this in an afternoon and then stop worrying about it.

Please note: this is general information, not personal medical advice. Always follow the action plan written by the child’s own GP or asthma nurse, because it is tailored to them. The guidance here is correct as at October 2026 and follows the joint BTS, NICE and SIGN asthma guideline (NICE NG245, November 2024) and Asthma + Lung UK advice on child asthma attacks.

The two inhalers, and why the difference matters

Here is the most useful thing on this page. Most children with asthma have two inhalers doing completely different jobs. The preventer, often brown or orange, is taken every day whether the child feels wheezy or not, and works slowly on inflammation in the airways. The reliever, usually blue, opens the airways within minutes. The preventer keeps a child out of hospital. The reliever gets them out of trouble today.

That is where things quietly go wrong. A child feels the blue inhaler working, so they remember it. Nobody feels the brown one working, so it ends up at the back of a drawer. If you do one thing here, make the daily preventer as boring and automatic as brushing teeth.

A blue inhaler on its own is no longer the plan

This changed recently and plenty of adults have not caught up. Asthma + Lung UK is now blunt about it: no child should be on reliever-only treatment, because relying on a blue inhaler alone carries a greater risk of a fatal attack. The inflammation underneath needs an inhaled steroid. For most newly diagnosed children aged 5 to 11 that means a low-dose preventer twice a day alongside a reliever. For many young people aged 12 and over, one combined inhaler now does both jobs, taken daily and used again for symptoms, an arrangement clinicians call MART.

So if a child arrives with a blue inhaler and nothing else, raise it at the first GP appointment. You are not second-guessing anyone. You are asking the question the guideline itself now asks.

What to do if a child has an asthma attack

Learn these steps now, because you will not be reading a website while it is happening. For a child using a blue reliever inhaler:

• Sit them upright and help them stay calm. Do not let them lie down.
• Give one puff of the blue reliever every 30 to 60 seconds, up to 10 puffs in total. Use a spacer if there is one in the house, because it gets far more of the medicine into the lungs.
• Call 999 if the inhaler is missing, if 10 puffs have not helped, or if you are worried at any point.
• If the ambulance has not arrived after 10 minutes and the child is no better, repeat the puffs.
• If they are still no better and nobody has arrived, call 999 again.

The dose is different for a young person aged 12 or over whose combined inhaler is also their reliever: one puff every one to three minutes, up to six puffs. Do not give ten rapid puffs of a combined inhaler. And if you are caught out with the wrong inhaler in your hand, a blue reliever is safe in an emergency even when the child’s usual reliever is a combined one.

You do not have to be certain it is serious before you call. Asthma + Lung UK tells carers never to think they are wasting anyone’s time. Phone 999 if a child cannot finish a sentence, if the reliever is suddenly needed far more often than usual, or if their lips or face look pale, grey or blue. And know this: a chest that has gone quiet is not a chest that has calmed down. Wheezing that stops while a child is still working hard to breathe is a reason to call.

Afterwards, ring your supervising social worker and book a GP appointment even if the child seems fine: same day if you managed it at home, within two working days if they went to hospital.

The action plan on the fridge door

An asthma action plan is a single page written by the child’s GP or asthma nurse. It lists their daily medicines, what to do when symptoms creep up, and what to do in an attack. Get one at the first appointment if the child does not have it, then stick it where everyone can see it and keep a photo on your phone. Asthma + Lung UK publishes one written for children and a separate one for young people on a combined MART inhaler; use the child version, because the doses differ.

Then book the annual asthma review and keep booking it. A yearly check on inhaler technique sounds like a formality until you watch a nine-year-old use a spacer for the first time and realise how much medicine had been going nowhere.

School, and the September problem

September is the dangerous month. In England, emergency asthma admissions for children aged 5 to 14 rose from 304 in August to 1,363 in September, a jump of 348%, on figures Asthma + Lung UK published in August 2024. The reasons are ordinary: colds going round a new classroom, and six weeks of holiday during which the daily preventer slid. If a child moves in over the summer, that is the moment to get it back on track.

Schools in England have been allowed to keep a spare emergency salbutamol inhaler since 1 October 2014, under the Human Medicines (Amendment) (No. 2) Regulations 2014, with Department for Education guidance following in March 2015. It is a discretionary power, so not every school holds one, and it needs written consent recorded in the child’s individual healthcare plan. Ask the office whether the school holds one, sign the form, and check that plan is in place. This is the sort of detail that working well with a child’s school comes down to.

The triggers you can actually do something about

Pollen, cold air and other people’s colds are out of your hands. Several things are not. Nobody smokes indoors or in the car, vapes included, which is a condition of approval anyway. Damp and mould get reported rather than wiped and forgotten. If there is a cat and the child reacts to it, have that conversation early.

Keep a rough note of what sets a child off, because patterns show up faster on paper than in memory and the asthma nurse will ask. Put the autumn flu vaccine in the diary too. Otherwise asthma sits inside the ordinary business of looking after a child’s health.

Asthma should not shrink a child’s life

This is where carers sometimes overcorrect, and it does real harm. A child with well-controlled asthma can play football and stay over at a friend’s house. If their plan says to use the reliever before exercise, use it before exercise. Send the inhaler, tell the other adult where it is, then let the child get on with it. Children in care have usually had enough taken away from them already. The aim is a child who forgets about their asthma most of the time, not a child who is watched. The same goes when asthma sits alongside additional needs: manage the condition so it takes up as little room in the child’s day as possible.

The paperwork side

You will keep a medication record: every preventer dose, every reliever puff, with the date and time. It takes seconds and it is what the asthma nurse reads. The delegated authority agreement made when a child moves in should name asthma medicines specifically, because vague is what leaves a carer standing in a pharmacy at five o’clock on a Friday.

You won’t have to do this alone

No carer is expected to arrive knowing any of this. You will have your own supervising social worker, and someone on the phone out of hours when it is late and you cannot decide whether to ring 111. Training covers medicines and paediatric first aid. Ofsted inspected us in July 2025 and rated us Outstanding in all three judgements, and there is more on what support our carers receive.

On money: we pay one fixed weekly fee per child while a child is living with you, currently 479.50 pounds for a child under 11 and 507.50 pounds for a child aged 11 or over, plus an enhanced fee of roughly 100 to 200 pounds where needs are higher. It covers the cost of caring for a child and a reward for your work.

Plenty of carers wondered whether they could cope with a child’s asthma. Then it happened, they followed the plan on the fridge door, and they found they could.

Frequently asked questions

Can I foster a child with asthma if I have no medical background?

Yes. Nearly all of our carers started with no health training. What you need is the ability to follow a one-page plan and phone for help early. Our training covers medicines and paediatric first aid, and your supervising social worker will go through a child’s asthma with you before they move in.

Am I allowed to give a child their inhaler myself?

In almost all cases yes, and in an attack you should act immediately rather than ring round for permission. What gets agreed in writing is who consents to what, through the delegated authority agreement made when a child moves in.

What do I do if a child has an attack during the night?

Exactly the same steps as during the day, set out above. Then ring our out-of-hours number, which is answered by someone who knows the agency rather than a call centre.

Will a child’s asthma stop them doing sport or going on school trips?

It should not. Well-controlled asthma is compatible with sport and with residential trips. The reliever goes with them and the supervising adult is told where it is. If asthma regularly gets in the way of ordinary activities, that is a sign the treatment needs reviewing, not a sign the child should do less.