18mo coughing and struggling to catch breath

[sircoughalot]

hello. DD is 18mo and about 5 months ago, following a bad bout of flu, was diagnosed with post-viral wheeze. The doctor described it as a restriction of her airways as a direct result of the flu she had had, and which could last for up to 6 years. it used to be referred to as "childhood asthma"

Doctor said if, when dd reaches the age of 10, she is still wheezy he would look to diagnose her asthmatic, but he was reluctant to at such an early age after a bout of flu.

ANYWAY dd has a brown inhaler (and a blue one which frankly does nothing) the brown inhaler calms her wheezing and stops her coughing all night as she was doing.

However this week she is teething and has lots of mucus. She will start coughing and really struggle to catch her breath in between coughs. It lasts about 10-20 seconds, but oftenIi have to intervene and tell her to breathe and copy me (which she does). I cant really descibe the noise she makes except it is like a fast gasp for air which is a noisy gasp....and then the next cough comes.

what would you do? is this an asthma attack (TBH i'd never considered that dd might be asthmatic, only that she had a narrowing of airways ) and i had no idea she could have difficulty breathing.

I am an intelligent woman, please don't shoot me down, i just feel so stupid.

Should i be worried about thse coughing fits?

[FluffyBunnyGoneBad]

If she's having problems breathing then phone an ambulance, let them check her over. She may need a nebulizer at the hospital.

[BlueBumedFly]

I agree with Fluffy, she may need medical care. If you take her in the car and she has a serious attack in the car you cannot do anything to help, an ambulance can get you there faster and paramedics can attend to her on the way. Don't feel stupid please, you know as a mother what is right for your DD.

Make sure you check for any blueing of the lips and nail beds. This would signify that not enough oxygen is getting in.

This sounds horrible for your DD and you, keep going with the controlled breathing with her, that is excellent but make sure you get medical advice. At the very least call NHS Direct and see what they recommend.

[WilfSell]

Have been there (still am really) with two children.

One thing I would try is checking you're giving her enough of the blue inhaler when she has coughing fits. I'm assuming you have a spacer? Are you holding the mouthpiece over her face so it 'seals'? How many puffs is she having?

We only realised after months of anguish with DS2 (and DS1 before that) when we finally saw an asthma nurse, that actually, in a severe coughing fit, they need quite a lot of puffs...

It doesn't have to be asthma to be 'asthma-like' and your GP is right that they can't fully diagnose it till later. FWIW DS1 has grown out of it entirely. But DS2 still in the middle and just trialling brown inhalers now.

We also find warmth helps - have spent fortune keeping heating on well into spring/autumn, always in a vest when he has a cold, no long spells outside when has a cold and always with a fleece and coat.

[WilfSell]

I wouldn't necessarily rush to A&E unless she is looking very pale/blue fingernails etc.

Ring NHS direct and let them listen to her.

And give lots (up to 10 puffs, 10 breaths each, shaking after each 2 puffs, making sure she is actually breathing it all in. Clicking the spacer if it is one with a solid valve.

Or wait for her 'big breath' in between breaths and just use the inhaler without spacer and fire it into her open mouth as she's about to gasp. This often worked best with DS2 when he was coughing.

While you're on the phone to NHS direct sit her up facing you, rub her back to warm it up and make sure she isn't chilled.

[FluffyBunnyGoneBad]

Sorry, I don't agree. Ds is asthmatic, he doesn't go blue in an attack but looks pale. I have seen children look flushed who have low o2 sats. If she's unable to breath then call an ambulance, let them decide what to do after she has been assessed.

[sircoughalot]

thanks all. Fluffy and Bluebum () her coughing fits are really far apart (i'm sorry i perhaps should have said this before) her last one was at 6pm and nothing since. She doesn't go blue, or listless and seems to be fine, its just the hideous noise that draws my attention to her struggling to catch breath. But thank you you have really highlighted to me how important this is. I will take her to the doctors tomorrow (at the very least) to talk it through with them, and of cours if it gets worse in the night I will just phone for an ambulance.

Wilfsell thank you for being so reasonable in your comments. DD is very good at her inhaler, we call it "breathing" so it is easy to tell her to do her "breathing" when she struggles to breath, with or without the inhaler. However she only uses the brown inhaler (with spacer) morning and evening (one puff) and the blue one as and when. I was only told to give her one puff so that probably explains why it's not working. I did suffer from asthma myself when pregnant so i am aware that you can give the blue inhaler as often as you want without effect, i just didn't apply that knowledge to dd The spacer fits well over her mouth with no gaps and she will huff and puff into it for quite a while (she loves it!).

Thanks ladies, knew I could rely on mumsnet

[lisad123]

i would call ambalance too. My dd is 18months and has a blue inhaler after 2 loads of broncheleist and a stay in hospital with pnemonia
She was sounds wheezy and struggling to catch her breath, she wasnt blue anywhere and her stats were low at 82%
We have to give 6 pumps of blue inhaler to have any real effect. HTH

[BlueBumedFly]

Can you sleep in with her tonight or have the monitor turned up really loud? Update us tomorrow with what the doc says.

AT the end of the day no matter what the doc says you are Mum and you make the calls!

[loobeylou]

OP, could it be whooping cough?

[sircoughalot]

monitor is always up loud bluebum, and i still (after all these months!) wake to her every snuffle. I will update you with docs advice tomorrow.

DH is here with me and he wants to say a big thanks to all of you for your sensible advice and for taking our concerns seriously

[loobeylou]

posted too soon !

.....it's the fast noisy gasp makes me wonder - is she immunised?

[LadyG]

I would take her to have her checked out-could be croup or asthma attack. You can never never be too careful with kiddies IMO. Does your nearest hosp have a special paediatric A&E? They are usually a nice calm environment and the LO is checked out very quickly.

[sircoughalot]

i wondered that loobey, when i was trying to describe the sound i was going to write "like whooping cough but with a shorter "whoop" and no barking cough!!"

But she has been immunised for whooping cough so I would hope it's not, and the coughing is few and far between, it's just scary when it happens. I will ask the doctor tomorrow though. I have a dictaphone to follow her around with so the doctor can listen.

[sircoughalot]

no paediatric A&E just general A&E with hideous aiting list. Right now she is fast asleep, no wheeze, no coughing since 6ish, so right at this minute i'm not overly concerned although i was earlier and am in general. Obviously I will nt hesitate to call for help if she continues in the night or gets any worse. I am cautiously hopeful that her night-time brown inhaler has helped her breathe easier as coughing was the main sign that she might be asthmatic in the first place (although a different type of cough)

[WilfSell]

If it is croup (and even if it is post-viral non-asthma, asthma-like symptoms!) sometimes a sit in a warm steamy bathroom can help.

[BlueBumedFly]

Sounds like you are doing all the right things. You know if she gets croupy then take her into the bathroom with the shower on hot hot and let the steam take effect whilst you call NHS Direct or your Out of Hours.

I also wake at every snuffle and DD is only teething this week! Flippin back molars thou!

I hope you all sleep tight. xx

[BlueBumedFly]

WilfSell - snap! Steam is a wonderful thing! We find just a bowl full of boiling water with olbus oil under the cot can work wonders.

[sircoughalot]

thanks again all, i'm off to bed now. bluebum dd is getting canines, thankfully molars all through! luckly for us the pain of teething helps her sleep, its just in the daytime she's miserable at least she's now able to tell me where it hurts so I can help.

Will post again tomorrow.

[sircoughalot]

had docs appointment at 3:30 today, typically she didn't cough once all morning despite me following her around with dictaphone

Doctor reiterated what all of you said really. Firstly don't worry about it whilst it's not happening, and when it does happen try 2-4 puffs of her blue inhaler. Secondly if she is truly struggling for breath after coughing fit has finished, or if coughing fit is prolonged, or if I am otherwise concerned phone for an ambulance as you can't take chances with breathing in babies.

thanks ladies

[luvaduck]

hi i will post later when have more time and have read whole thread

having just read the OP it really sounds like whooping cough which you can get even if immunised. (am a GP)

it is on the increase

will post later on this eve