Children living in cold homes experience worse outcomes. This paper considers some of the findings from the Warm Well Families (WWF) study, which aimed to explore factors influencing the abilities of households including children with asthma to keep warm at home in winter. Individual and group interviews with children, families and professionals were conducted and home temperature and humidity measurements were taken. The experience, knowledge, beliefs and attitudes of adults living in households with children with asthma affect the choices they make. The concept of a ‘trade-off’ is used, to describe the complex process by which families in fuel poverty are juggling competing priorities in order to make decisions. The paper explores three participant families in detail, through the use of case studies, to illustrate the trade-offs made and the impact of those trade-offs on a family’s ability to keep warm and well at home. It is argued that policy initiatives and interventions need to engage with the full range of decisions families make, and the constraints on these decisions, in order to reduce the impact of fuel poverty on the wellbeing of families.