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September Asthma Peak

Canadian researchers have found that the September back-to-school period brings a dramatic increase in hospitalizations for children with asthma. This increase starts after the return to school and reaches its peak in September. This period is now recognized as the September Asthma Peak.

Being ready for the September Asthma Peak is one way to help ensure that your child will be spending more time with friends at school, and less time at home, or worse – in the emergency room of a hospital. 

What Causes September Peak?

Research shows that more than 60% of children admitted to emergency rooms with asthma also suffered from rhinovirus (the common cold). Rhinovirus and other respiratory infections are common triggers of asthma symptoms, especially among school-aged children. Other studies suggest that up to 85% of childhood asthma attacks may be triggered by viral infections. These attacks are also associated with a rise in seasonal allergens and reduced compliance with asthma controller medications.

Why September?

Kids returning to school in September face increased exposure to viral infections. These can be a significant trigger of asthma symptoms. Children may also be exposed to allergens such as dust mites, moulds, animal dander and pollen. September is also ragweed season. All these allergens are potent asthma triggers. This is why it is so important that your child’s asthma be adequately controlled year-round.

Asthma Resources

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Asthma & Allergy HelpLine

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Asthma At School

Learn about how you can manage your child’s asthma at school.

Prepare Your Child for September Asthma Peak

Asthma Canada has gathered recommendations to help our community prepare for the back to school season and September Peak to protect those living with asthma. 

Schedule an asthma check-up with your health care provider before return-to-school, even if it’s just a virtual appointment to review your child’s inhaler technique. Develop or update a written Asthma Action Plan with your healthcare provider, and make sure to provide a copy to your child’s school.

Speak with your child’s school about their asthma policies including inhaler use and make sure policies are in place to create a trigger-free environment for learning, exercise and play.

Ensure that your child has their reliever medication on hand or accessible at all times. Read more about Ryan’s Law.

Make sure you child is taking their asthma medications as prescribed and don’t stop unless advised by their healthcare provider to do so. 

Refill or renew your child’s asthma medication prescriptions. We recommend having a 30-day supply of medication on hand.

Help your child understand their asthma. This includes knowing their triggers and how best to avoid them, and how to use their medications properly. Review their inhaler technique. Make sure they know how to use their Asthma Action Plan, and what to do and who to go to for help in case of an asthma attack at school. 

Demonstrate correct hand washing technique and explain the importance of frequent hand washing always, but especially while both influenza and COVID-19 viruses circulate.

Encourage your child to practice wearing a face mask at home for about 20 minutes, so they can get used to the feeling. Experiment with different materials and styles of face coverings to find a comfortable option for your child. If your child is having difficulty breathing while wearing a mask, it may be a result of poor asthma control or anxiety. Schedule an appointment with their health care provider right away if this is the case.

Teach your children healthy ways to cope with stress and anxiety. Strong emotions and anxiety can trigger an asthma attack.

If your child is eligible, ensure they receive COVID-19 vaccination.

Ensure your child, and everyone in your home, receives their influenza (flu) and pneumococcal disease vaccinations as appropriate.


Is your child’s asthma controlled?

Proper asthma control is key to staying healthy with asthma and preventing possibly life-threatening asthma attacks. Everyone with asthma should be able to achieve good asthma control. If your child is having trouble staying symptom-free or have any of the signs of poor asthma control listed below, we highly recommend speaking with your healthcare provider as soon as possible.

Signs of Poor Asthma Control:

  • Frequent breathing difficulties, including coughing or wheezing most days
  • Asthma impacting sleep; if asthma wakes your child up at night, their asthma isn’t controlled
  • Inability to exercise without experiencing breathing difficulties
  • Relying on the reliever (rescue) inhaler more than 2 times per week
  • Severe breathing difficulty or inability to wear a mask or face covering
  • Recent asthma attack or hospitalization

What to do if your child’s asthma is poorly controlled

If your child’s asthma is poorly controlled you need to speak with your healthcare provider. Uncontrolled asthma is very serious and could lead to a life-threatening asthma attack. It’s vital that you take your child’s asthma seriously and recognize when symptoms aren’t properly controlled. Over time, poorly controlled asthma can cause permanent damage to your airways that cannot be reversed. This is called ‘airway remodeling’. It is important to have proper treatment for your asthma to avoid this permanent damage.

The Importance of Your Child’s Asthma Action Plan

An Asthma Action Plan is an effective tool that can be used to help manage your child’s asthma and help ensure that it stays adequately controlled. List your child’s triggers, daily medicine needs and the reliever/rescue medicines they may need for quick relief during an asthma attack, or when signs of an attack begin to show.

Kids Asthma Action Plan [EN]

Kids Asthma Action Plan [FR]

Controlling Asthma

Understand what good asthma control means.

September Asthma Peak: Quick Facts

  • With the start of a new school year, kids are in close contact with each other and germs, like the common cold. Colds are the most frequent asthma triggers in young children, causing up to 85% of exacerbations.
  • Low use of appropriate asthma medications may fuel what is known as the “September Asthma Peak,” the spike in children’s hospital admissions due to serious asthma attacks aggravated by colds. Low use of medications or sub-optimal control of underlying inflammation can also increase asthma attacks throughout the school year.
  • Epidemics of asthma exacerbations requiring hospital treatment occur annually during back-to-school in both the Northern and Southern Hemispheres.
  • Compliance and filling of asthma controller medications decreases during the summer months causing airway inflammation to return. Even when children with asthma display no symptoms, they must continue their medication to avoid inflammation.
  • The viruses responsible for the majority of “September Asthma Peak” asthma exacerbations include the rhinovirus, coronavirus, influenza virus, parainfluenza virus and respiratory syncytial virus (RSV).
  • School-aged children have on average eight colds per year, which can translate into about one asthma flare-up per month if a child’s asthma is not well-controlled.
  • Approximately 20-25% per cent of annual hospital admissions for asthma of children in Canada occur in September.
  • On average, the hospitalization rate for school-age children peaks 17.7 days after Labour Day – around week 38. (Preschool kids peak 1.7 days later.)
  • Because the cold season can last for several months, parents should be extra diligent about adhering to an asthma management plan throughout the year. 

Sara's Ready for School

Back to School brings sick days and visits to the hospital for children. Learn how to avoid September Peak through proper asthma management. [Click here to download in French].