Does my 5 year old need to see a Dr ASAP?

[Dabrat21]

Hi all,

I need some advice please on what I should do with my DD. Who has ‘difficulty’ breathing ‘episodes’.

my DD is 5. She had been in nursery since she was about 17 months old. Since starting nursery she had cough after cough, illness after illness. She has had really bad chest infections and also had bronchitis when she was about 3, which she had an X-ray for but did not have to be admitted to hospital. I was very worried at the time.

our GP then suggested she have an inhaler - a blue one, and if her coughs got really bad to try a few pumps to see if this helped. We use the blue inhaler for about 10 months but honestly I didn’t feel it made a difference. When she would have coughs sometimes it would be with a temperature, sometimes it wouldn’t. Coughing was worse at night and she would vomit from coughing so much.

since starting school, her coughs have got so much better. The first year she only had about 6-8 coughs/infections. Compared to previously a cough every few weeks. Then towards the end of term, she started doing this thing where she takes a deep breath, and look like she’s catching her breathe, but not necessarily after exercise. This could happen when she was just sitting down watching tv. I filmed her doing this and showed the dr, who prescribed a brown inhaler to be taken once in the morning and once at night ongoing. At this time my DD was 4 and the Dr said that she was too young for an asthma test to confirm. I read up about asthma (as no one in my family has it) and I decided to cut out nuts, she would often eat these whole as a snack. Since cutting them out, the breathing ‘episodes’ stopped. So we cut out using the brown inhaler and I had hoped she had grown out of it.

However this past week, the last three days she has complained to her teacher that she is finding it difficult to breathe but doesn’t look like she is struggling, no signs of wheezing or going red etc. but the teacher has of course given her the blue inhaler. I’ve contacted the doctor for an appointment but could only get one on the 20th March.

tonight the same thing has happened. Whilst she was going up for her bath, she wasn’t running or anything like that. She said her chest hurts and feels like ‘someone is stabbing her heart’ and that it feels tight. I gave her the inhaler and I believe it helped but only after administering it twice.

she hasn’t had any nuts and there’s nothing I can think that might have caused this to flare up.

she is otherwise well but has a dairy intolerance. Her chest bone does ‘indent’ a bit, I would say a little more than ‘normal’ but many doctors have seen this and never said it look abnormal.

what I’m asking here, is if I should get her to a doctor/a&e or a walk in centre over the weekend? I’m worried it’s getting worse and could lead to a full on asthma attack.

Does anyone have children with asthma? Does this sound like that? Any advice would be great appreciated.

thanks

My dds first asthma attack i couldnt hear a wheeze. Dr could with a stethoscope. Her tummy was sucking in below her ribs when she breathed. You can also sometimes see them using their neck muscles when breathing. If you see that they def need to see a dr (if the blue/reliever) inhaler doesnt help.

You should not have stopped her brown inhaler. Take her to a walk in tomorrow. If there isn’t one nearby, A&E.

This is a lovely empathetic post. Some of the earlier posts have been really harsh. Childhood asthma is really tricky at first- 5 years in I can now pick apart everything the OP should have done, but thinking back to those early days where inhalers were prescribed with no real instructions, no follow ups and an uncertain diagnosis, it was hard!

OP I'd ring 111 for advice. Articulate really clearly what has happened, and how she currently is. I have often been referred to our of hours GP appointments over the weekend to get DS checked out. And definitely in the future ask for an appointment with the asthma nurse at your GP to properly explain all the inhalers and put a plan in place. Means you have a better understanding of triggers, symptoms, and what to do at each stage (how many puffs of blue and at what point to seek what level of care).

@Tandora asthma kills every day

You may find you can see someone sooner if you explain to the GP receptionist that your daughter's asthma is flaring and you need to speak to the Asthma Nurse. When it comes to asthma, they are the experts in the GP surgery, and they don't mess around.

And every single child is referred to health visitors or school nurses. It's so child abuse and neglect isn't missed

And? Makes your post to a worried mother all the worse.
I hope you have a sharp and rapid rethink of your attitude if you are going to continue working with people and being responsible for their health and wellbeing.

Restart the brown inhaler if you still have it if not order one on Monday
At this age viral infections can trigger episodes of asthma / wheezing and the brown inhaler can really help at these times even if they are fine without in between
Contact 111 if you are worried over the weekend

I can't believe anyone would stop a child's asthma pump without medical advice, this is so so dangerous.

You are absolutely not a Doctor. No Doctor would ever come out with such scaremongering about being referred to Social Services and risk putting a parent off going to A&E in this situation. You are talking absolutely nonsense.

DS has had inhalers since he was about 2 following night coughs and a history of illnesses like bronchiolitis. He's had long phases of being stable and it is hard to focus on keeping up with the inhalers in those phases.

It was the 40⁰C weather that flared him up after a couple of years without issues. He ended up with a 111 call and ambulance after a couple of episodes of needing to use his blue inhaler in a day. He presents as chest tightness and reluctance to talk rather than obvious wheezing. Being older, he's got better at recognising the signs which helps with management and we have scope to adjust the dosage of preventer. His preventer has changed and he also has Montelukast. His last big flare was a year ago following a cold/ chest infection when he needed a short course of steroids to help settle it. Basically every time I opened the front door, cold damp air would hit him and you'd hear a tight gasp. In 2022, he couldn't go anywhere with air conditioning for the rest of the summer... or cope with exposed areas of heat.

It's hard to keep up with when they're young, have had long stable phases and advice isn't very clear about long term management. DS had regular reviews when he was little, but since Covid that's all faded as the practice has been under more strain.

When there's a flare up and the reliever (blue) inhaler isn't doing the job, they do need an urgent review. 111 have sent an ambulance to us on 3 occasions with either going to A&E or same-day GP review. Other medications can be required to calm it. The preventers work long term and need regular dosing to do their job well.

@ThreeMagicNumber would you like my gmc number ?

Childhood asthma symptoms look very different to what you might "expect" if you are only familiar with a more adult-style wheezing presentation.

Please use tha inhalers more. Don't muck about, children can get very ill if their parents don't use the inhaler treatments properly.

It may not be a coincidence that the tree pollen is kicking off.

It sounds like it could be precordial catch syndrome

Your daughter has asthma. She needs her inhaler to stay healthy. She might not like it, but its important you still insist on using it on her.

For peace of mind get an oximeter so you can read her oxygen levels. DD had -2 episodes in hospital, the first time, her only symptom was that she told me it hurt to breathe, Having no experience of asthma, I popped her to out of hours, Dr, took her oxygen sats and we were blue lighted to hospital, 2nd time was more evident she was having difficulties breathing as she had a chest infection. After this I think we would have been regular visitors but keeping an oximeter at home gave me peace of mind. It’s one of the best £20 I’ve spent,

This is going to sound ridiculous but when my middle daughter was around 9/10 she was diagnosed with “asthma”. A few months of intermittent inhaler use and she was over it. Took me until the following spring to realise she had essentially hayfever. Chest tightness/night time coughing. Daily piriton and she was fine, never got followed up by an asthma clinic or anything, she’s outgrown it mostly now. Just thought I would comment as you said it started up again out of the blue

Exactly, as an asthmatic for 40 years I still get caught out by it/miss the signs of it worsening and forget to bring my blue inhaler at times. I do a first aid course every 2 yrs at work, when they cover asthma they ask if any participants have it and a few hands always go up. A lot fewer go up when they ask who of us actually has our reliever inhaler on our person!
As I said in my earlier posters I don't think most GPS really give parents much information about the signs to look for or at what point to seek further medical help when handing out inhalers.

Not ridiculous at all, a person can have an asthmatic response to an allergy including pollen. It's great that you identified the allergen, makes life much easier.
I have an allergy to some fruits which causes an asthmatic reaction, sometimes needs my reliever. I developed hay fever in last couple of years with usually typical symptoms of sinus etc but on a rare bad day it will cause the tight chest etc so now I take a prescribed daily dose of antihistamine, up my preventative in high pollen season and use reliever when needed
All these things are very inter-related, my child has a peanut allergy which doesn't currently need an epi but if she were to develop asthma most likely they'd prescribe an epi because of the danger of triggering an asthmatic reaction on top of a strong allergic reaction
Even aside from the asthma part histamine is a v interesting thing (we'll to me anyway!), even our hormones play into it and reactions can lessen/worsen at times if the month, puberty, pregnancy, peri and post menopause - hence my newly developed hay fever

What stood out to me here apart from what other PPs discussed is the nut thing. What have nuts got to do with anything?

You say she’s dairy intolerant- what do you mean by this? Lactose intolerance is extremely rare in children this young. Or do you mean she has a non-IgE mediated allergy to dairy? Has she ever been tested for allergies or seen a dietician? Has she done the milk ladder?

With children who have asthma/ other allergies, it is very inadvisable to just randomly stop giving them common allergens like nuts unless they have had a serious reaction or an allergy is confirmed by a test. You could be giving her a serious nut allergy.

Sorry you’re getting a bit of a hammering on here, OP. I don’t mean to add to the pile-on but there are some big issues here. I think with the constant ‘the NHS is overwhelmed, never consult a doctor or go to A&E’ messaging we tend to get it can feel like you are doing everyone a favour by finding your own solutions. In this case, though, I think it would be wise to organise a full MOT for her with the GP to address the different stuff after you have sought urgent help for her breathing.

How’s she doing today OP?

Has she got a spacer to take the inhaler properly?

Maybe she needs to try a preventer inhaler, GP will prescribe if needed.

I would try an antihistamine as it helps my dd