Leaving a Child With Asthma With a Babysitter: The Handoff Guide

A babysitter can handle an asthma episode — but only if you have given her the specific information she needs before you leave. A child with asthma who has an episode while in someone else's care and that someone does not know where the rescue inhaler is, does not know the dose, and does not know the threshold for calling 911 is in a serious situation that was entirely preventable.

This is the complete handoff guide for leaving a child with asthma with a babysitter — what to tell her, what to write down, and what to walk through together before you go.

What your babysitter needs to know about your child's asthma specifically

Asthma is not the same for every child. Generic asthma information is not enough. Your sitter needs the specifics for your child:

• How well-controlled is the asthma right now? A child whose asthma has been well-controlled for months presents differently than a child who had a hospitalization last winter. Give her the current baseline.
• What are your child's personal triggers? Exercise, cold air, laughter, smoke, pets, dust, viral illness, anxiety, specific foods? Not all asthma is triggered by the same things. Tell her the ones that actually matter for your child.
• What does an episode look like for your child specifically? Coughing? Wheezing? Chest tightness without obvious wheezing? Kids often say their chest feels "funny" or "tight" rather than naming breathing difficulty. Give her the words and behaviors your child uses to signal an episode is starting.
• What is the usual progression? Some children go from mild symptoms to severe distress quickly; others have a longer build. Tell her what to expect.

The rescue inhaler: exact protocol

This section of your handoff is too important to leave to a verbal mention. Write it down and walk through it:

• Where the rescue inhaler (albuterol) is — exact location. Not "in the bag." Which bag, which pocket.
• Whether your child uses a spacer — most children should use a spacer with a metered-dose inhaler. If your child uses one, the spacer is part of the rescue protocol. Make sure the sitter knows this and that the spacer is with the inhaler.
• The exact dose and puffs — typically 2 puffs at the start of symptoms, with instructions to wait 20 minutes. What is the specific protocol your child's doctor has prescribed?
• How long to wait before a second dose — if symptoms do not improve, most action plans allow a second dose of 2 puffs. What is your child's action plan specifically?
• The threshold for calling 911 — see below. Write this down separately so it is easy to find.

If the sitter has never used an inhaler with a spacer before, walk through it together while you are still there. Do not assume knowledge.

When to call 911 — write this down explicitly

Asthma can escalate quickly. The threshold for calling 911 should be written on the same sheet as the inhaler protocol:

• The rescue inhaler does not improve breathing within 15-20 minutes
• Breathing is rapid, labored, or the child is struggling visibly
• The child cannot speak in full sentences
• Skin is pulling in at the throat, between the ribs, or at the collarbone with each breath (retractions)
• Lips or fingernails are turning bluish
• The child says they feel like they cannot breathe
• The child is too short of breath to use the inhaler

If any of these are present, call 911 first. Then call you. Do not wait to reach you before calling 911.

Controller medications: what the sitter needs to know

If your child takes a daily controller medication (inhaled corticosteroid, long-acting bronchodilator, or montelukast/Singulair), the sitter needs to know:

• The name, dose, and timing of the controller medication
• That controller medications do not treat symptoms — they prevent them. If an episode occurs, the rescue inhaler is what she reaches for, not the controller.
• Whether a scheduled controller dose falls during the sit and whether she should give it

Environment considerations

Some home environments can trigger an episode. If the sitter is watching the child at your home:

• Tell her if there are known environmental triggers to avoid — the pet dander in a specific room, the dusty playroom, outdoor activities when pollen is high.
• Tell her the plan if the child wants to exercise vigorously — pre-treatment with the rescue inhaler is sometimes indicated before exercise for exercise-induced bronchospasm.

If the child will be at a different location (the sitter's home, an activity), make sure the rescue inhaler travels with the child. It should never be left behind.

What to leave in writing

• Your child's asthma baseline and current control level
• Personal triggers for your child
• Early warning signs your child shows before a full episode
• Rescue inhaler: location, dose, puffs, and whether a spacer is used
• Action protocol: puffs given, wait time, repeat dose if needed
• When to call 911 (list specific symptoms — do not write "if it seems bad")
• Your pediatrician and after-hours number
• Your cell and partner's cell
• Preferred hospital or emergency room
• Any other medications the child takes for asthma, with timing
• Insurance card or photo

Baton Pass stores medical conditions alongside allergies and medications in one organized profile. Your child's asthma protocol, rescue medication location, and emergency contacts are all in the same place the sitter looks for everything else.

Frequently Asked Questions

Should my babysitter know how to use a nebulizer?

If your child's asthma protocol includes a nebulizer as a rescue treatment, yes — walk through the setup with the sitter before you leave, exactly as you would with an inhaler and spacer. A nebulizer is simple to operate but unfamiliar to most non-parents. Do not assume she has used one before. Leave the assembled setup accessible, not buried.

Can my child use their rescue inhaler themselves with a sitter present?

Many children with asthma are taught to self-administer with adult supervision. If your child can do this, tell the sitter that the child knows how and her role is to supervise and confirm the correct number of puffs, then monitor. If your child cannot self-administer reliably, the sitter is the one administering — make sure she has practiced the technique.

What if my child has an asthma attack at school and the sitter picks them up?

School nurses handle asthma episodes under their own protocols, which you establish with the school at enrollment. If the sitter is picking up a child who had an episode at school, she needs to know: whether the child received treatment at school and what, whether you want the child brought home or taken directly to the pediatrician, and what symptoms to watch for in the car on the way. Put this escalation path in writing for the sitter.

How should I explain asthma to a babysitter who has never cared for a child with asthma before?

Keep it practical rather than clinical. "Her airways can get inflamed when she is around cats, gets really active, or when she has a cold. When that happens, she coughs a lot and her breathing gets noisy. The blue inhaler treats it — two puffs, wait 20 minutes. If she is not better after that, call 911 and then call me." A clear protocol is more useful than an accurate medical explanation.