PITTSBURGH (KDKA) — In schools and homes across America, the third week of September is notoriously known as “peak week.”

“She actually tells me ‘Mommy, my inhaler. Mommy, I need my medicine,’” says Josephine Melendez, the mother of a 4-year-old with asthma.

“This is definitely the busiest time,” says Dr. Deborah Gentile, an allergy and immunology specialist with the Allegheny Health Network. “Visits, both inpatient and outpatient, tend to peak this time of year.”

The reason? Asthma attacks because of certain seasonal triggers.

“All the kids are back in school. They’re spreading respiratory viruses. Our pollen and mold counts are peaking,” Dr. Gentile says.

She often has to adjust medicines and walk through what to look for and what to do in case of an asthma attack.

“We want them all to have an action plan,” she says. “If your child is starting to use their rescue medication more than twice a week, then we definitely want to be told. Because that’s evidence that they’re out of control and need to go on better controller medication.”

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To prevent symptoms from getting out of control, make sure your child carries an inhaler. The school should have one on hand, too.

Avoid triggers, like dust, smoke and pet dander. Wash hands and avoid sick people. And watch your child for symptoms.

“The first thing you usually see is some coughing and some exertional symptoms of shortness of breath and not keeping up with other children,” says Dr. Gentile.

“Literally, 24 hours around the clock, I’m monitoring her,” says Melendez.

If your child is having trouble breathing, don’t hesitate to use your rescue medication. If you see nostrils flaring or neck or stomach muscles contracting, those are signs of respiratory distress. Call 911 for emergency help.

Dr. Maria Simbra