Calling allergy/asthma parents

[citymama]

I've suspected this for a while, but today our pediatrician confirmed that 3 year old DD2 most likely has asthma. Every small cold turns into a wheezy night, every cough turns into croup and labored breathing. Last night she was wheezing and coughing pretty badly after a routine cold, and we were this close to taking her to the ER. We took DD in to the ped today and she responded well to the nebulizer treatment, and we've borrowed the nebulizer for the rest of the week and DH is out getting an inhaler and spacer for her.

Although I have asthma myself, I'm new to this as a parent. Does your toddler or 3 year old willingly take the inhaler with the spacer? How often do you find yourself using it? Any tips or warnings? DD2 was super wound up after the nebulizer treatment and her heart rate was up like crazy.

What helps your kid - in the short and long term? Any night-time relief suggestions? Are there boards you frequent for asthma/allergy advice?

And anyone here have a food allergic kid who has asthma? DD2 is allergic to tree nuts, but we dxed it at an early age (before 1) and have been able to avoid exposure thus far. I'm now worrying about what would happen in the event of exposure - does her having asthma make her more likely to have respiratory distress? I have air-borne allergies that trigger my asthma, but no food allergies.

Thanks for reading and any advice you may have to share.

[megs4413]

Does your toddler or 3 year old willingly take the inhaler with the spacer?

Mine always did. No idea why, so no help on getting a kid to use it.


How often do you find yourself using it?
when asthma is well-controlled and DD is not sick, we use it very, very rarely (less than once/month). when we were still adjusting meds and such, probably once a week.

Any tips or warnings?
make sure you keep mouth/nose covered and securely pressed to child's face while they take 4-5 deep breaths from the spacer. if you pull it off the child's face between breaths, they don't get the meds properly.


DD2 was super wound up after the nebulizer treatment and her heart rate was up like crazy. sounds about right. she may experience shaking in her hands as well. that always bothers my DD.


What helps your kid - in the short and long term? Any night-time relief suggestions? Are there boards you frequent for asthma/allergy advice?

we ended up moving to somewhere with less of the offensive allergens, which is kind of drastic. there were lots of reasons for our move, though, not just that one. it has made all the difference. for night time, I like to do the eucalyptis and humidifier. I don't frequent any boards.


And anyone here have a food allergic kid who has asthma? DD2 is allergic to tree nuts, but we dxed it at an early age (before 1) and have been able to avoid exposure thus far. I'm now worrying about what would happen in the event of exposure - does her having asthma make her more likely to have respiratory distress? I have air-borne allergies that trigger my asthma, but no food allergies.
my epi-pen kid is not my asthma kid, but I do know that his action plan specifically states that reactions can be worse if asthma is also a chronic condition for that kid.

[citymama]

Mine always did. No idea why, so no help on getting a kid to use it.


when asthma is well-controlled and DD is not sick, we use it very, very rarely (less than once/month). when we were still adjusting meds and such, probably once a week.

make sure you keep mouth/nose covered and securely pressed to child's face while they take 4-5 deep breaths from the spacer. if you pull it off the child's face between breaths, they don't get the meds properly.

sounds about right. she may experience shaking in her hands as well. that always bothers my DD.


we ended up moving to somewhere with less of the offensive allergens, which is kind of drastic. there were lots of reasons for our move, though, not just that one. it has made all the difference. for night time, I like to do the eucalyptis and humidifier. I don't frequent any boards.


my epi-pen kid is not my asthma kid, but I do know that his action plan specifically states that reactions can be worse if asthma is also a chronic condition for that kid.

thanks so much megs! boy, i have a lot of questions, huh? ;)

[MSWR0319]

My peanut allergy kid does not have diagnosed asthma, but has had a few episodes here lately that makes me wonder. It's my understanding that kids with asthma are at a higher risk for anaphylaxis. Our action plan specifically states that if you have asthma and ingest or even think you've ingested your allergen, to Epi. I'd check with the allergist for an updated plan.

[citymama]

My peanut allergy kid does not have diagnosed asthma, but has had a few episodes here lately that makes me wonder. It's my understanding that kids with asthma are at a higher risk for anaphylaxis. Our action plan specifically states that if you have asthma and ingest or even think you've ingested your allergen, to Epi. I'd check with the allergist for an updated plan.

Oh wow. Thanks for that info.

I'm so sad for DD2. :(

[ZeeBaby]

DD2 has had RAD (restrictive airway disease) since she was about 4 months. Whenever she has a cold she wheezes and has difficulty breathing. We have not had to use a rescue inhaler, but often use the nebulizer during cold and flu season. Pretty much daily from October to March. I feel like it is a daily struggle and a constant learning experience. We have "officially" gotten an asthma diagnosis, but I feel it is just a matter of time.

[egoldber]

Did they put her on a controller? An inhaled steroid (e.g., Flovent) vs. the bronchiodilator (e.g., albuterol). Most asthma docs will put your kid on a controller to reduce the need for the albuterol.

Older DD was diagnosed at 6 and she has been on a controller med of some sort ever since. When she is not, with every illness she ends up needing albuterol and often an oral steroid. The standard now is to be aggressive with the inhaled steroids (or to use something like Singulair, or a combo) to prevent that.

[Simon]

My peanut allergy kid does not have diagnosed asthma, but has had a few episodes here lately that makes me wonder. It's my understanding that kids with asthma are at a higher risk for anaphylaxis. Our action plan specifically states that if you have asthma and ingest or even think you've ingested your allergen, to Epi. I'd check with the allergist for an updated plan.
:yeahthat: Our plan says that same thing.

Ds2 has had asthma since before he turned 1 yo. It took us a long time to find the right combination of drugs to control things, as in more than a year of trying out different things. We transitioned to an inhaler around 18 months. He takes it well most days. In the beginning, we would do it in front of the TV or while another adult was reading a book so he was less focused on the inhaler. He is on 3 drugs year round and we move the level of his inhaled steroid up and down with the seasons. His asthma is viral induced so we move into our yellow zone at the very first sign of a runny nose or cough. Even before we hear any wheezing or anything. A nebulizer delivers waaaaaay more rescue medication (albuterol or whatever) than an inhaler plus spacer so we have a lot less of the jumpy energy using the inhaler.

[PZMommy]

My 2 yr old has severe asthma. He has been on a twice daily inhaled steroid via the nebulizer since he was a couple of months old. He also gets albuterol through the nebulizer as needed, which during cold and flu season is quite often. Since he has been on a nebulizer since he was so little, he doesn't know any different and takes it just fine.

[Kindra178]

DD2 has had RAD (restrictive airway disease) since she was about 4 months. Whenever she has a cold she wheezes and has difficulty breathing. We have not had to use a rescue inhaler, but often use the nebulizer during cold and flu season. Pretty much daily from October to March. I feel like it is a daily struggle and a constant learning experience. We have "officially" gotten an asthma diagnosis, but I feel it is just a matter of time.

Using the nebulizer is the same as using the rescue inhaler, just a different delivery method. In your case, an inhaled steroid daily make colds more manageable. Have you seen a pediatric pulm or allergist. Sometimes pediatricians just aren't aggressive enough in prevent the wheezing in the first place.


Did they put her on a controller? An inhaled steroid (e.g., Flovent) vs. the bronchiodilator (e.g., albuterol). Most asthma docs will put your kid on a controller to reduce the need for the albuterol.



Our experience too. In the summer, we stopped DS2's Flovent completely. Ds1 is getting one puff once a day. When we stopped DS3's Flovent, he coughs periodically throughout the day. We are trying to go down to one puff in the morning and two at night. If they have even the slightest inkling of a cold, we immediately up the dosage. We use a Xopenex inhaler plus spacer for beginning and end of colds, but we have found the neb just works better.

My twins have been using a spacer since they were 18 months so we haven't had any administration problems. The neb is a little different. We used to have hold them during treatments and watch tv. Now they might complain but are fine.

[AnnieW625]

DD1 used an inhaler with a spacer (also known as an aero chamber) from about 12 mos. until 3. Her symptoms started getting better right about 2/1/2 and hasn't needed the inhaler since. She had no issues with it. We use a humidifier at night when the coughing is bad now. We also eliminate dairy as soon as we think a cold or a cough is coming on.

I find it a little strange that asthma is an issue in the Bay Area because the air quality there is always so good. I never had problems there (or in San Diego) vs. the Sacramento Valley or here in the Southern LA basin area.

I hope your DD2 gets better soon.

[Simon]

I would also just like to recommend that you follow up with a pediatric pulmonologist. Near missed visits to the ER for breathing trouble says, to me, that she could probably benefit from an asthma action plan that outlines exactly what to do and when, with some plans put in place to help her handle colds better. There are lots of different options for controlling asthma and it I think its worth it to find someone who can talk you through your options and help you understand what treatment will best suit her needs.

ETA: I keep forgetting you asked about night-time relief. We haven't needed to use the rescue meds at night since we started the inhaled steroids except during very bad illnesses. Then we use the spacer unless he's really, really bad and we pull out the nebulizer. For us, its the last step before going to the ER. The spacer is much less intrusive than a neb and can be done while kids are sleeping.

[citymama]

Did they put her on a controller? An inhaled steroid (e.g., Flovent) vs. the bronchiodilator (e.g., albuterol). Most asthma docs will put your kid on a controller to reduce the need for the albuterol.


No, the ped. did not - she sent us home with the nebulizer loan and rx for spacer/puffer. My own asthma plan involves using a controller and rescue inhaler when needed, but as an adult, I have relatively mild asthma.




I find it a little strange that asthma is an issue in the Bay Area because the air quality there is always so good. I never had problems there (or in San Diego) vs. the Sacramento Valley or here in the Southern LA basin area.


As to Annie's question, the Bay Area has been awful for my allergies and asthma. I did best living in the Northeast, especially MA! It does get a lot worse in polluted/smoggy places, but the humidity seems to make it worse for some reason.


A nebulizer delivers waaaaaay more rescue medication (albuterol or whatever) than an inhaler plus spacer so we have a lot less of the jumpy energy using the inhaler.

Is this 100% confirmed? Our ped. said it was the same dosage, different modes of delivery. It would be good to know. I'm amazed people give the spacer while kids are asleep as I usually need to take a big inhale when I administer it to myself. Not so with kids?

BIG thanks to all and I appreciate very much the advice and BTDT experience.

[Green22]

I would also just like to recommend that you follow up with a pediatric pulmonologist. Near missed visits to the ER for breathing trouble says, to me, that she could probably benefit from an asthma action plan that outlines exactly what to do and when, with some plans put in place to help her handle colds better. There are lots of different options for controlling asthma and it I think its worth it to find someone who can talk you through your options and help you understand what treatment will best suit g.

Def go to a pulmonologist, they will help the most.

My 15 month da has extensive food allergies and was DC with asthma around 9 months. He is on daily Flovent 4 times a day (we use the spacer and puffer for this because he will not tolerate the special mask you need to use with nebulizwd Flovent. He is also on singular daily. This is new, after his second cold in about a month he had to get prednisone twice. The kid just cannot stop coughing. I am hoping the addition of the singular works. When he gets a cold, even before he starts coughing, I am directed to start giving him the albuterol every 4-6 hours. I do this at night as well. Usually around midnight/1 am, if he has been coughing, I will just go in to his room, offer him a drink and hold up up and rock him. Usually he falls asleep enough for me to do the puffer with the spacer.

I have found that the cool most humidifier and a raised mattress help him, but it doesn't make the coughing go away. He gets winded when running/playing when not feeling well so I try and limit that type of activity and he gets more screen time than he should.

When we first started the treatments, he was horrible. We did anything to try and get though them. We were told that using the spacer properly is just as effective as using the nebulizer properly (either with the mask or the pipe-type attachment) but if you were just blowing the nebulizer at his face, they would rather you do the spacer. We alternate. He sometimes is good and patient and sits for them, sometimes does not. When he does a treatment we let him watch a show (he seems to really be into backyardigans probably because it is totally mindless with no educational value) at night/around 7 or 8.

I still have a hard time dealing with it, and I had pretty bad asthma myself which is far more controlled now in my 30s. Good luck to you. It is a tough road, especially when they are sick with something like a cold. I wish I could make it go away. I hope your lo responds well to the treatment.

[egoldber]

FWIW our asthma doc told us there is no demonstrated improvement with the nebulizer vs. the inhaler with space. Although we did see an improvement in older DD when she switched to the Advair disk vs. the inhaler/spacer. There is a definite technique to it.



Every small cold turns into a wheezy night, every cough turns into croup and labored breathing.

To me, this sounds like she needs to be on a controller at the very least when she has cold symptoms. Some kids you need to hit them hard and heavy at the first symptom to prevent the wheezing and coughing.

[Green22]

Also with the spacer they don't need to take a big breath. There is a little flap (on ours it is yellow) and you need to watch it move 6-8 times per puff on the little kid spacers. The idea is to get them to the big breath, hold it in, let it out, but just breathing the air in works too. Or so I was told.

[Kindra178]

Def go to a pulmonologist, they will help the most.

My 15 month da has extensive food allergies and was DC with asthma around 9 months. He is on daily Flovent 4 times a day (we use the spacer and puffer for this because he will not tolerate the special mask you need to use with nebulizwd Flovent. He is also on singular daily. This is new, after his second cold in about a month he had to get prednisone twice. The kid just cannot stop coughing. I am hoping the addition of the singular works. When he gets a cold, even before he starts coughing, I am directed to start giving him the albuterol every 4-6 hours. I do this at night as well. Usually around midnight/1 am, if he has been coughing, I will just go in to his room, offer him a drink and hold up up and rock him. Usually he falls asleep enough for me to do the puffer with the spacer.

I have found that the cool most humidifier and a raised mattress help him, but it doesn't make the coughing go away. He gets winded when running/playing when not feeling well so I try and limit that type of activity and he gets more screen time than he should.

When we first started the treatments, he was horrible. We did anything to try and get though them. We were told that using the spacer properly is just as effective as using the nebulizer properly (either with the mask or the pipe-type attachment) but if you were just blowing the nebulizer at his face, they would rather you do the spacer. We alternate. He sometimes is good and patient and sits for them, sometimes does not. When he does a treatment we let him watch a show (he seems to really be into backyardigans probably because it is totally mindless with no educational value) at night/around 7 or 8.

I still have a hard time dealing with it, and I had pretty bad asthma myself which is far more controlled now in my 30s. Good luck to you. It is a tough road, especially when they are sick with something like a cold. I wish I could make it go away. I hope your lo responds well to the treatment.

Your experience mirrors mine, especially with ds3. He is a professional cougher. We are regulars at the ped and allergist. We are familiar with the pred (and the anger and the hunger). The allergist recommended that we administer .5 tsp of allegra or zyrtec every night. He had a terrible post nasal drip every day all year long. It caused coughing at night to the point of vomiting as well as limited eating. It was very, very helpful. He has gained weight and nighttime coughing has virtually stopped. In addition, get an air purifier. Also life changing. I wish we did this three years ago.

[ArizonaGirl]

Did they put her on a controller? An inhaled steroid (e.g., Flovent) vs. the bronchiodilator (e.g., albuterol). Most asthma docs will put your kid on a controller to reduce the need for the albuterol.

Older DD was diagnosed at 6 and she has been on a controller med of some sort ever since. When she is not, with every illness she ends up needing albuterol and often an oral steroid. The standard now is to be aggressive with the inhaled steroids (or to use something like Singulair, or a combo) to prevent that.

A big :yeahthat:

[BabbyO]

Both our boys are allergic to dairy, but Stachio was also confirmed as an asthmatic in the last year. We've been using a spacer/inhaler for more than 2 yrs - since he was 2 yo. Stachio used to fight it but has come to accept he must use it 2x daily. It is a maintenance med that is supposed to help reduce asthma symptoms. He does not have a fast acting inhaler at this time but his asthma usually only crops up after a cold which turns into croup. We've found that it was worth the $$ to have a nebulizer in home because his attacks were coming on SO quickly. We'd have less than 2 hrs from the first symptoms of croup to when we'd have to go to the ER to get an Epi-nebulizer treatment (Albuterol wouldn't cut it at that point). So now we have the nebulizer at home with prescribed albuterol. What we've found is that when we suspect or start to hear the croup symptoms, we administer just filtered tap water in the nebulizer and the concentrated "steam" is often enough to prevent us from having to use albuterol or more. The recommended steamy bathroom never seemed to really work, but this does and was recommended by our allergist.

As for getting the kids to cooperate with the inhaler/spacer and nebulizer - Once Stachio realized he was getting relief from the nebulizer, he stopped fighting it. The Spacer took a little longer, but it is just part of the routine now. Wish I had better words of wisdom.

[bigsis]

Does your toddler or 3 year old willingly take the inhaler with the spacer? How often do you find yourself using it? Any tips or warnings? DD2 was super wound up after the nebulizer treatment and her heart rate was up like crazy.

And anyone here have a food allergic kid who has asthma? DD2 is allergic to tree nuts, but we dxed it at an early age (before 1) and have been able to avoid exposure thus far.
I tried the inhaler with the spacer when my DS was about 3 and I could never get him to take it properly. I have since given up and used the nebulizer. I have never noticed anything different about his heart rate though :bag
My DS also has food allergies--wheat, dairy, eggs, nuts, shellfish, & other environmental stuff--no anaphylactic (sp?) reactions though. He just breaks out in hives and vomits. I say "just" bc it's not life-threatening. The only respiratory distress I notice is on the first onset of spring and/or fall allergy season. We're currently weaning him off the Singulair, but I see he needed it for a couple of days last week---bad environmental allergies. It's like his body gets used to it and then he's ok again.

HTH!