Q. What can I do to more actively prevent my child's asthma attacks?

A. What a great question! I wish more parents would ask it. Preventing symptoms in an asthmatic child, rather than just treating them when they occur, is the best way to fight asthma in children.

First you need to have some idea of what triggers them. It could be cold weather, exercise, common colds, allergies, or exposure to cigarette smoke or other pollutants that irritate the lungs. You may already know your child's particular triggers; if not, ask your pediatrician about how you can figure them out. For some kids, allergy testing (usually done by having a skin-prick test) can be very helpful.

The next step is to look for ways to avoid the triggers. For instance, if it's dust mites, keeping the house (especially the bedroom) relatively free of dust by removing rugs, curtains, and extra stuffed animals, cleaning frequently, and using hypoallergenic pillow and mattress covers can be helpful.

Some triggers are harder to tackle. We live in New England, so avoiding cold weather in the winter isn't an option. And, of course, it's nearly impossible to dodge the common cold. That's where medications come in. Inhaled steroids and leukotriene antagonists are most commonly used; my patients have had great success with them. Depending on the severity of your child's asthma, your pediatrician may recommend that he take them every day or that he use them at the first hint of either a cold or the worsening of asthma symptoms.

Ask about a written "Asthma Action Plan," which tells you exactly what to do depending on your child's symptoms (all doctors have access to it and can customize it to your child). It's highly recommended by specialists, and can go a long way toward helping your child live a wheeze-free life.

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