Asthma Question

Updated on March 02, 2010
K.B. asks from Portland, OR
18 answers

My 2 1/2 year old daughter, who had never had any significant respiratory issues before except a few colds and coughs, was diagnosed wtih a low-grade pneumonia and probable asthma 5 weeks ago. She improved with an albuterol inhaler and antibiotics pretty quickly and has had only a rare cough since then. Afterwards, her pediatrician recommended starting her on daily inhaled steroid therapy for prevention during the cold season, but as that was her first episode, we decided just to be vigilant and just see if it was an isolated incident.

Over the past two days, she has developed nasal congestion and a cough, which seems like a normal daycare cold to me. If we hadn't of gotten the diagnosis of asthma, I probably wouldn't think twice about it. I'm wondering, those parents who have a child with asthma, when do you decide it's time to start the albuterol inhaler? I did decide to give it a try, and she's received 3 treatments today. Her cough does seem a bit better, but isn't it possible that any kid with a cough might show some improvement by opening the airways? Any insight would be incredibly helpful. It's pretty likely she might have it (i had it as a child), but i'm just not sure I should be always start the inhaler every time she starts coughing.

Thanks!

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So What Happened?

I truly appreciate everyone's input. She had a cough-free night last night and i'm hoping this cold won't deteriorate like last month. If the cough worsens in any way we will check in with her dr and see about speaking with an asthma specialist.
Thank you all again, K.

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K.C.

answers from Seattle on

You need to give her the albuterol when she has and increase Work of Breathing. Increased Respiratory Rate, if she looks like she has to push air out, tight hacking cough, looking pale.

Asthma is a reaction in the lungs that cause them to tighten and narrow, making it more difficult to breath. After you give her the treatment her cough should get more loose. Also help her clear her nose, that mucus can drain into her lungs via her throat and cause her to wheeze.

The airways can only open so big, Albuterol won't do anything if the lungs are open.

Also it takes along time for pneumonia to clear up, long after the antibiotics are done.

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M.H.

answers from Seattle on

Interesting question...

Asthma is an inflammation of the lungs. It produces a very distinct wheeze (not necessarily a cough). Asthma can be triggered by congestion, exercise, or even just cold air. As an adult with asthma, i can easily tell if my symptoms are asthmatic or not. If you start paying attention to your child maybe you can develop some of the same intuition - post nasal drip with no wheeze - not asthma, trouble breathing or a deep dry cough - could be asthma.

One of the pulmonary specialists i saw said that albuterol would only help with asthma symptoms. This matches my experience somewhat, in that a hit of albuterol has a really profound effect if my symptoms are purely asthmatic, but a minor or no effect on problems caused by a 'cold' or nasal congestion. (I find, and i suspect that if your child really has developed asthma, you will find, that deep enough congestion often causes some inflammation, so the inhaler often helps a little.) When the albuterol works the effect is immediate and dramatic.

If you are suspicious that your child has developed on-going asthma, you can ask to get her evaluated by a specialist. You might notice that she has a lot more trouble breathing in the middle of the night than during the day, or that her difficulty is triggered by cold weather. If you really haven't noticed this type of ongoing problem, she may have just had inflammation caused by the pneumonia, and not true asthma, and may choose not to treat.

If your child is diagnosed with asthma the state of the art treatment appears to be steroidal inhalers. Because these are inhaled drugs they are effective while have relatively few side effects. Treatment compliance is a big problem with kids with asthma, and compliance can make a huge difference in their quality of life and how often they get sick. Compliance, in your case, may involve trying the steroidal inhaler. This is a commitment for a while, though, (perhaps a whole season), because the steroids are long acting preventative medicine. They are not used to treat symptoms, but rather to prevent them. Albuterol inhalers are used to treat symptoms, but do not improve health over the long term.

Treatment compliance also is affected by knowing how to use an inhaler correctly - which many people do not. Consulting with a specialist would also ensure that your family knows the proper approach.

As a warning - i do not know so many people who think that moving to a specialist is important, especially if you like your pediatrician, so know that while you read my comments. However, my experience says that they can be very helpful in truly nailing down the problem and a solution. I have also been led to believe, through visits to specialists, that asthma is often mis-diagnosed, and therefore mistreated, primarily because it is easy to offer someone an albuterol inhaler and see if it works - the cost is low and the potential pay off is high.

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D.S.

answers from Tulsa on

I'm asthmatic and don't wheeze. An asthma attack is a dry hacking cough a cold is a congested cough. watch for patterns cold induced asthma is going out in the cold and start coughing. She will quit when she enters a warm enviroment. If it last less than 5 min don't sweat it. I am also excercise induced. same thing. If shes sleeping a whole lot probably means she needs a treatment. IF she gets around chemicals and coughs watch the length of time she coughs. If I go down the detergent isle at the store it sets me off but not for long.
Also watch pollen levels and real windy days. The 5 minute rule is fairly safe. With a cold she will get a runny nose asthma she won't. Watch her and you will figure it out.I would also suggest about.com asthma site. That is where I got 90% of my asthma answers. I know some moms in here don't like web md but they have great and the most current info out there on asthma. Asthma sets in and don't go away with cold meds. If you give her cold meds and cough isn't better give her a treatment. Asthma usually sets in for at least 3 days if not longer week is normal. hope this helped.

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L.B.

answers from Richland on

My daughter was diagnosed with asthma at the age of 3. We almost lost her to her first asthma attack. We went with the normal routine of steroids and daily meds. What I found was that her immune system was breaking down little by little and she was getting sick more often and worse reactions.
2 years ago I found an amazing company that allowed me to go "green" without extra household expenses. It is super affordable, works better then other cleaning products and smells good too. After 2 weeks of using these amazing products my daughter was totally asthma free. Within one month she was off of all her asthma meds. We have not had to deal with asthma now for 2 years!!
I would love to share more with you!
www.livetotalwellness.com/beathom

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N.I.

answers from Portland on

Hi K.,

Asthma can be caused by fragrances and fumes from the soaps and laundry detergent you use on or for you baby. There was a study that says there was over 250 toxins in a newborn baby due from what is in the environment and we get this from what is around our house and is in the air we breathe and through the placenta since it was newborns. I know lots of baby's who get over "asthma" with just changing their detergent and household cleaners. Roger Barnett is the CEO of Shaklee and before he bought the company his son had "asthma" and was in the hospital and went through the whole gamet of steroids and treatment and was in the hospital for at least two days getting him stabilized and they found out they (The Barnett's) were making their son sick with the cleaners they were using. They changed (and bought) Shaklee and now their son has absolutely no problems. Sloan Barnett has a book out called "Green Goes with Everything".

If you are interested in learning more please contact me.

N.
Health and Wellness Coach

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C.C.

answers from Dallas on

Remember allergies and asthma are different. Allergies are treated by an allergist and asthma is treated by a pulmonoligist. I have both conditions. So far my son who is 4 only has asthma, and actually was diagnosed with Reactive Airway. They don't like to diagnose "asthma" until a child is 5 years of age or so. When he gets a cold, it goes straight to his lungs/airways. He gets a daily preventative/Flovent and we have a nebulizer on-hand with Pulmicort and Albuterol/Xopenex. We started using these products after a couple of rounds of Orapred and a trip to ER that lead to hospitalization for 3 days. Your question is a good one. I saw two pulmonologists before we chose one. They were both good, but one said that if your child has been prescribed Orapred (prednisone/invasive steroid) more than once, then it is time to consider a preventative. As far as daily nebulizer treatments, well, we only do that once cold/breathing symptoms have set in. We do not do this on a regular basis. If it were me, I would tell my pedi since we are considering daily treatments, I think it would be best to check in with a pulmonologist. Ask him/her why they would not suggest this specialist.

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A.T.

answers from Portland on

I have had what was diagnosed as asthma since I was a child only to find out that I was allergic to mold instead. But the main symptom was always a cough. Steroid inhalers are pretty big medicine for such a little person, so I would try something else more natural first. What worked for me was accupuncture & homeopathy. Since she probably won't do accupuncture at 2, homeopathy might work well, also getting her tested for allergies by a naturopath. Dr Peabody in Beaverton is great with kids & does the best allergy testing & is affordable. And our homeopath is also wonderful & affordable & has helped our son many times. If you'd like her number just email. Good luck.

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K.K.

answers from St. Louis on

my son is 2 1/2 as well, he has had asthma since he was a baby. we have done the breathing treatments all the time. His asthma is triggered very easily. Whenever he gets sick, with a cough and/or runny nose, i know to get the medicine ready because it almost always (95% of the time) turns into him wheezing and coughing badly. We have him on a daily treatment once a day, it is Pulmicort and he takes it through the nebulizer. His pediatrician said that this will most likely lessen any flare ups, of course there is ALWAYS a possibility of an asthma episode occuring, but the daily treatments can help prevent it from getting too bad. Then if he does start showing signs of the wheezing and other syptoms, we do the Xopenex every 4-6 hours depending on how badly he gets. I would say if the steroid does not make her crazy (when my son gets REALLY bad we have to do an oral steroid and it really makes him crazy, like i call it liquid crack for babies, because no more than 5 min after i give it to him, he is off the wall and he can not control himself) then i would give her the inhaler because i dont think it will hurt anything. I would rather give it to her and find out later that it had nothing to do with asthma, than not give it to her and her have an attack or an episode or anything. and honestly, you can ask her if she thinks she needs one and see what she says. when my son has a little cough i always ask him how his breathing is, like i will say, does it hurt to breathe or cough, or do you need a treatment to help with your breathing, and he normally does a pretty good job of telling me if he does or not. good luck! and if you have any other questions, please feel free to message me~ i hope everything turns out ok.

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M.P.

answers from Portland on

My granddaughter, 9, has had asthma since she was a baby. An asthma attack, i.e.; wheezing, difficulty breathing was always triggered by a cold. (not as often now) She used the albuteral as soon as she started having difficulty breathing. My granddaughter was prescribed a preventative steroid inhaler for daily use after she was hospitalized with asthma. Everything I read and both her pediatrician and allergist say to not use an inhaled steroid unless the asthma is out of control. Steroids can have serious side effects.

One event with a possible asthma diagnosis does not warrant using a steroid inhaler, in my experience. I suggest you question her doctor and express your concern after doing some research on the Internet. It's possible that her doctor is not familiar with current asthma care.

Coughing does not indicate that her airways are constricted. If she is coughing and has other symptoms such as wheezing, shortness of breath, even difficulty breathing that is not eased in other ways, then a rescue inhaler could be helpful. Using a steroid inhaler while she's coughing does not relieve symptoms. I think the steroid inhaler improves the health of the airways.over time.

You definitely should not start the inhaler every time she starts coughing, even if it's the albuterol. The reason a child coughs with an asthma attack is because the airways are constricted and not because they contain mucous although they may also contain mucous when it's a cold that has started the attack. Normal children also cough but only because the airways contain mucous or are irritated but not because they're constricted.

You do need more clear guidelines for use of the two inhalers. They are very much different from each other. One is to open the airways. They other is to improve the health of the airways by reducing inflammation. And I do not understand the necessity for the use of either one for your daughter. Is it possible that he wanted to use the steroid inhaler for a short period of time to reduce inflammation?

Here are some web sites that may help you have a better understanding.

http://asthma.about.com/od/treatmentoptions/a/tx_medguide...

http://asthma.about.com/lw/Health-Medicine/Conditions-and...

http://www.guardian.co.uk/lifeandstyle/besttreatments/ast...

I notice a difference in the use of cold. There is cold as in temperature and cold as in an infection. An infection is what frequently starts an asthma attack for my granddaughter. If she uses her rescue inhaler, Albuterol, when she first notices her symptoms the attack is aborted then with just one use. For her the first symptom is a tight feeling in her chest. If she doesn't use the rescue inhaler until she begins to wheeze she may have to use the inhaler several times with 15 minute wait in between use.

If a person's asthma is under control, i.e. Albuterol treatment stops the attack it does not last 3 days. An attack lasting that long would indicate the asthma is not under control and in my granddaughter's case indicated the need for hospitalization.

Coughing may be the first indication of asthma difficulty but coughing does not necessarily mean that asthma or constricted airways is the cause. I have pollen, dust, mold allergies and often cough without having mucous. I do not have asthma.

Asthma has different causes and many symptoms, some of which are common to all asthmatics and some of which are not. I just do not understand just as you, why your daughter needs inhalers.

When my granddaughter had her first attack before she was 1yo she was not prescribed an inhaler. It was after the second trip to the ER in a months period of time that she was given a prescription and that was only for Albuterol.

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D.D.

answers from Seattle on

I had asthmatic symptoms due to food allergies for many years- particularly dairy caused mine. Doctors for some reason refuse to test ANYONE for food allergies, though they cause A LOT of problems, including Asthma.

If I were you, I would take her to a good Naturopathic doctor and find out if there is really anything to worry about. My neighbor down the street had a child with severe asthma symptoms until SHE realized that the cleaners in the home - particularly chlorine, were things she could not use around her child.

If I were you I would figure out what had changed from before and after the Asthma symptoms. Did you use a new laundry detergent? Did you get an air freshener you didn't have before? They can cause all kinds of respiratory problems. Did you get a new cleaner that you are using in the house?

The different between a cough and Asthma is that Asthma makes you unable to breath properly, so you start taking deep breaths, and start to look very agitated. A cough is just a cough. My asthmatic symptoms actually didn't have much of a cough.

Using a Naturopath you can get to the root of the problem instead of administering steriods.

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K.G.

answers from New York on

Hi K.,
Have you ever considered getting rid of the products in your home that have harsh chemicals like phosphates, formaldehyde, etc. My daughter did not have asthma but had severe allergies and had trouble hearing in school. Since I switched over to Melaleuca's products and her allergies were completely eliminated. As for your daughter having healthier products in your home could definitely improve her breathing. If you want to know about our products, please feel free to contact me. This month they have a promo which is $1.00 to become a member and shop for products at 30/40% discount until March 17th!

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K.D.

answers from Portland on

ASthma should not be treated lightly. I know steroids seem scary but the alternative is not breathing.

My daughter has asthma. Her first attack came on so severely and so unexpected we are quite lucky we didn't lose her.

One of the leading causes of death in children is untreated asthma.

Please don't wait and see. If you're uncomfortable with any of the treatments go see a pediatric allergy/asthma specialist. GP/pediatricians are great but a specialists really knows all the alternatives.

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G.D.

answers from Anchorage on

I agree with everyone that asthma is a serious issue that needs attention...my father & my older sister have astma & both have almost died b/c of astma attacks being very severe. However, you said nothing about your daughter having coughing/gasping for air/hard to breathe issues...as a mother you just "know" the difference btw. common cold like symptoms & extremely hard to breathe symptoms...you gave no reason for me to believe that is the case...it still may be asthma...something to stay on top of for sure. But, I don't think you should use medication when it is not necessary. Just my opinion.
A lot of times asthma is misdiagnosed...could be, like some of the other responders stated, due to allergies...food, cleaning supplies, mold. We are military & therefore were stuck in a 1950's house one time that had a TON of mold. Anyway, the few months we were there my oldest son seemed like he had a cold...EVERYDAY...and labored breathing...but, ONLY while we were in the house...go outside & w/in 5 minutes he had no symptoms & of course they returned as soon as we walked back in the door. Obviously after we moved out of the house all symptoms were gone:-)!
One more thing to check that is a big misdiagnosis for asthma...enlarged adnoids. My youngest son's are touching & he is having surgery next month...they are causing his airway to be 90% blocked when standing up & 100% when laying down. Where it is similiar to asthma is that his breathing is VERY labored & always out of breath, breathes w/ his mouth open, instead of thru. nose, his nose has constant clear discharge...looks like a faucet of clear snot coming out...ALL day long. So, you may want to get an ENT to take a look in her nose & see if it is obstructed.
Of course, this is just if symptoms continue. She may just have had a cold after the pneumonia.
Good luck!!

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C.S.

answers from Las Vegas on

We all have asthma in our home. My little one has a nebulizer and inhalers. We never really gave her the maintenance treatments, as we just watched her breathing. However, most colds did result in a series of treatments, about 10 days.

Keep in mind, a plugged sinus can result in an ear infections as well.

I think it just rough during those toddler years.

Best of luck.

M.A.

answers from Dallas on

K.,

I would suggest if you have any concerns that you find a asthma/allergy specialist. If it is asthma he or she will be able to regulate it better.

My youngest has asthma and we go to a specialist. I had asthma as a child and one thing I did not know is that a sinus infection or anything like that can irritate the asthma. Once the sinus infection is cleared up the asthma will be back under control. He or she will also be able to educate you on when to use the inhaler and when to bring them in to be seen.

Hope this info helps!

Take care and God bless!

M.

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K.K.

answers from Portland on

I would go with your gutt here. A cough does not mean she needs an inhaler. You can tell if it's a cough that is restricting her oxygen... is she gasping for breath? Is she coughing all the time or just when she lays down, laughs, etc? When she breathes, does it sound and look like (watch her chest and tummy for this) she is trying to get air through a juice box straw?
An inhaler may help her when she is sick... if she has a coughing attack, if she is having trouble sleeping at night due to coughing, etc. But I would only give it to her when she actually shows signs of needing it, rather than at certian points during the day.
My son has asthma, as did I as a child... even though he definately has it, I still feel the steroid inhalers are too freely used and can have too many other side effects.

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M.H.

answers from Seattle on

Hi K.,
I would first recommend that you take her to an Asthma specialist, not a pediatrician for this issue. My 18 month old son has asthma. My ped (whom I adore) recommended the same thing. I brought G to the asthma specialist (Northwest Asthma and Allergy-they could probably recommend some resource in OR) and he said that that recommendation is "old" thinking and it's not a good idea to expose your child to too much steroid use directly.

That said, he does recommend that we use a nebulizer 2 x per day whenever he has a cold as a preventative. But we do not use the albuterol. That is for rescue breathing only. We use pulmacort which is slow acting and reduces inflammation. Plus, the mist helps the cold/cough symptoms. It is also a kind of steroid, but not a strong as albuterol. And he explained that the preventative is giving him about 1/50,000 of the steroid dose he would get if he had an emergency and had to go to the hospital.

I think both our kids have the kind of asthma they'll grow out of, but they should see a doctor who specializes in asthma in the way no pediatrician does.

Good luck,

M.

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