does my son really need a nebuliser?

[lelait]

I would really appreciate some advice/opinions. My 2.5 year old, who often has asthma when he has a cold/cough, has just been prescribed a nebuliser to take pulmicort every morning & evening instead of a preventer inhaler (flixotide), after having croup.

It just seems like quite a big burden for him (doesn't like it) and us too if I'm honest. I would hate for him to get worse because we didn't do it, but from what I understand inhalers with a spacer should work quite well (or perhaps he is too young?). What would you do would do?
Thanks

He certainly isn't to young for a preventer inhaler, my son has been on one since he was about 8 months!

If your not happy can you ask for a second opinion?

go see an asthma nurse - asthma kills please dont underestimate it

Why is it a big burden

Did they explain to you why a neb is necessary? I can't claim to be completely up to date on this but afaik most studies have shown in children as you say, an inhaler with a spacer is just as good as a neb.

Presumably it's a burden because it's so much more time consuming/ difficult to get a 2.5 yr old to sit still for his neb twice a day plus having to take a neb with you wherever you go (holidays etc).

Thanks for the answers.
yeah the burden was trying to get him to sit and take it (compared to a shall we count to 10 with the inhaler) and finding something to take his mind off it (so far TV, computer - which I'm not so keen on last thing at night...).
I obviously don't want him not to be treated but from what I understood inhalers with spacers were effective and we were assuming the pediatrician was being a little to cautious - but don't want to dismiss it without reading up etc.
Ironically just last month we went to see a pediatric pneumologist ( spelling? - we're in france, so the asthma nurse is not an option) - when he was completely healthy (always the way) - she recommended to keep treating with the inhaler...

So the general paediatrician overruled the specialist?

well it was more her reaction to him having croup I think - I know nebulisers can be used for croup as well - but it was the long term use that we were questioning
(and like I say when we went to the specialist DS was as healthly as can be - not even a tiny cough!).
I did wonder if there was any proof that nebulisers help coughing?
I did think about trying to contact the specialist again - but don't want to go behind the back of the ped as we have a good relationship with her and want to talk to her first

I know DS had a nebuliser when he had croup and he isn't asthmatic. I think that the coughing caused by croup is different to normal coughing, it's something to do with the airway actually being inflamed. So possibly they are thinking to use it until the coughing stops? I think it would be worth speaking to both of them to clarify.

Thanks Bertie - how long did he use the nebuliser for?
DP has already called to question the prescription - so we wanted to make up our minds before calling again! I think perhaps waiting until the cough is resolved (not croup any more) might be an option...

Literally just the once in A&E, but it did seem to reduce the coughing massively. I know that croup can be particularly dangerous when coupled with asthma though, so perhaps they might recommend it for longer.

DS is asthmatic and had just one nebuliser when he had a bad croup attack. He had it on the ambulance then steroids when he arrived in A and E.

When DS has been admitted with his asthma before now we have questioned nebuliser for at home but here (or at least our local hospital) said other than in extreme cases they won't as if they need nebs they need hospital and inahlers should control it normally.

DS is asthmatic, and usually the inhaler works fine. However, we have had a few instances where he has gone from being fine to being very very wheezy (unable to complete sentences) in the space of an hour, and he did need a neb then. He also needed steroids quite often, but hasn't needed them (or neb) since being seen by a homeopath.

Oddly enough, his worse spells always seem to happen in September. I'm hoping nothing happens to him in the next few weeks.

It is maybe the added risk of croup then...
I'm going to have to stop reading stuff now as I'm just getting really stressed by it all (am def. not good at having sick kiddies)
Fingers crossed for everybody's little ones staying healthy

Nebulisers aren't used routinely at home in the UK - it is better to have regular inhalers via a spacer. Nebulisers can lead to people staying at home when they need to be assessed by a HCP and the doses used in nebulised therapy are much bigger than those used in inhalers, so shouldn't be used regularly except in severe cases, or in COPD. (and then you'd normally have a home nursing team visiting regularly).

I'm sorry Sidge that is not true as the mother of an asthmatic child and a health care professional who works with asthmatic children I can assure you that nebulizers are given to children especially small children. Many children will not cooperate with inhalers via a spacer but will take a nebulizer I used to read a book to my DS whilst the nebulizer was on. The dose is often bigger but provided the child is carefully monitored for side effects it is safe. No doctor is going to put a child at risk unnecessarily but the risks of not treating either the asthma or the croup are very serious.
Nebilized pulimort is also given to treat croup.

I used the word "routinely", happygardening.

NICE and AsthmaUK do not advocate the use of routine nebs at home.

Hi, sorry you are having this worry.

My DD3 uses a nebuliser every day, she is now three and has been using it for nearly two years. She has CF so obviously not the same as asthma but similar in some respects. She uses the nebuliser to open her airways and thin up mucus and this helps her to cough. I was also very unsure initially but it really does make a difference. She is rarely wheezy when she is using it regularly, but it broke recently and it took a week to get a replacement, and we really noticed a difference.

I understand your concerns about using it at bedtime and the tv etc, but to start with it was all we could do. Had to be bedtime so it just became part of our routine - nebuliser while watching one episode of Peppa Pig which was just the right length, then bath, milk stories etc. It has got easier, we can read the story while she uses her nebuliser now.

I know it's not the same, thing I just wanted to let you know its ok and honestly not so frightening as you think.

thanks again for all the messages. I think I have now managed to annoy both the ped & DP by worrying about it all (I'm good at worrying!)