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Allergy, Asthma, and Immunology

Levels of Asthma

What are the different levels of asthma?

As determined by the National Institutes of Health (NIH), the following is a guideline used by physicians to help determine the extent of asthma in your child. It is classified as "steps," because each child may step up or step down to different levels at any time.

The steps are as follows:

  • Step 1 or mild intermittent asthma
    This group of children has symptoms less than two times a week, do not have problems in-between flare-ups, and only have short flare-ups from a few hours to a few days. Nighttime symptoms occur less than two times a month.

  • Step 2 or mild persistent
    This group of children has symptoms more than two times a week, but no more than one time per day, and may have activity levels affected by the flare-ups. Nighttime symptoms occur greater than two times a month.

  • Step 3 or moderate persistent
    This group of children has symptoms every day, use their rescue medication every day, may have activity levels affected by the flare-ups, and have exacerbations greater than or equal to two times a week. Nighttime symptoms occur greater than one time a week.

  • Step 4 or severe persistent
    This group of children has symptoms constantly, have a decrease in their physical activity, and have frequent flare-ups. Nighttime symptoms occur frequently.



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Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.


Lucile Packard Children's Hospital
725 Welch Road
Palo Alto, California 94304
(650) 497-8000


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