Asthma in toddlers, experienced people this way!

[NomDeClavier]

DS (2.5) was prone to chest infections, or what we thought were chest infections all last winter, and ended up in hospital with pneumonia. He also got a diagnosis if asthma at the same time, possibly linked.

As far as we can tell it's triggered by mould, dust and any kind of respiratory infection. He's come down with the first cold of the season and predictably we've been up all night with breathing difficulties and have used his inhaler, which helps, but he now hates the face mask and spacer, and it just makes him cry inconsolably which isn't helping the attack.

Granted he's a terrible two and can cry because his duvet isn't straight or his cars aren't lining up nicely but I can't seem to calm this crying and it's making his breathing worse.

What can I do to make the inhaler less scary? We have a puffer song and I put it on my face and one of his cars but he screams if it's anywhere near him.

Do I give it to him even if he's crying and the sibs are catching in his throat? He doesn't seem to be breathing in that effectively and I'm not sure it's working. His breathing is better when he calms down again though but whether that's the crying stopping or the inhaler kicking in I don't know.

I tried calling the specialist asthma nurse, who's lovely but a bit useless because she's always unreachable, but I could do with some advice from people who've been there.

Oh Nom it is hard isn't it?

When mine won't take it, we wrap them in a big bath towel and hold them still to give it.

I use a spacer too for my inhalers which I think helps because they see me doing it and perceive it as normal.

You just have to be calm and firm, because the screaming and panic and thrashing is partly caused by the lack of oxygen - that is why you are noticing he is calmer afterwards.

Do you have a preventative for him, or just a reliever?

We went through this at first. I think it was the three-separate-hospital-admissions-in-the-space-of-seven-weeks which helped get the message through that no you really really just have to put up with this mask. I wouldn't recommend that path though. Something which really did help was finding a way to make the inhaler time less distressing: Select a favourite book of his, and say I'll read this to you but only while you are having your breathing medicine. Literally only one word/sentence/page per breath taken with the mask properly on the face (depending on the length of the book and how many puffs he needs to take). At first you will almost certainly need one parent to administer the medicine and one to read the book, but once the child understands the bribe and is cooperative enough not to wriggle, you should be able to find a particular configuration of arms,legs&child where you can administer inhaler with one hand and read a story with the other! Alternatively you could try the same with a favourite TV show if you can work out a way to cuddle your child with the spacer mask in one hand and the DVD remote in the other - and you press the pause button whenever the mask comes away from the face and the play button whenever the mask is on the face, so he only gets to see the show properly if he has his medicine?

You could also try this story book or similar to help him understand a bit better? Aimed at 4yo+ so a 2yo may not understand all of it, but the pictures may help.

I was a child like this, and I didn't get an inhaler until I was about five - before this, i was given ventolin syrup. I think it still exists, and it might be worth seeing whether you could be prescribed for in those sort of emergency situations where your son is distressed and not making his breathing any better.

In the meantime, do practice/play with the inhaler when he's only a bit wheezy, or not in distress. I don't mean take it when he's well of course, just make it seem less scary and less associated with times when he can't breathe.

Reliever only ali, or at least for the time being.

Will investigate ventolin syrup too. It's just really difficult to gauge how much is going in when he can't breathe and is trying to escape the mask so it slides off his face.

I really would like to avoid multiple admissions, iris! The book looks good. We tried the DVD if he sat with the mask on idea but tbh I think he was past that point already. Might try it to acclimatise him to the mask without the inhaler on the end.

Feel better knowing I'm not alone in the battle against the evil A. I really feel for him :( I know how scary it is when you can't breathe and I know he has to take it but I'm getting distressed because he's distressed :( and that probably makes it worse.

Nom It is so hard in this situation - I have been there too. I agree with all the advice given and hope that you can find a way to get your son to accept the mask. Have you tried a game with his teddies so he can hold the mask himself and 'help' the teddy to breathe?

I know it is easy to say and it is terrifying when you are seeing your child struggling for breath, but the calmer you are, the faster the attack will pass. If you can appear to your DS to be in control and matter-of-fact about it, he is likely to calm down a lot faster. As I say though this is a lot easier said than done. However, try and reassure yourself with the knowledge that the reliever has helped before and so will help again. My DD is 17 and I still get that familiar rise of panic when she is wheezing, it never goes away.

My DD was prescribed ventolin syrup but this was about 15 years ago, so I don't know whether they still prescribe it. I was told that it wasn't as fast-acting as the inhalers as they are taken directly into the lungs but it may be worth asking about. I also seem to remember that it was given 3 times a day when she was wheezy and DD didn't complain about the taste so it must have been ok.

Good luck - asthma is a horrible illness.

Yes Nom getting him to acclimatise to the spacer and mask without the actual medication would be a good idea - if you haven't been given a preventer then you are basically only using the reliever when he's poorly and in distress, so getting him to get used to it when he is feeling OK might well help him to see it as a normal thing. Good luck!

i agree with everything else here lots of playing and praise. Also what spacer do you have? When DS was younger (he was diagnosed at 11 months) he wouldn't entertain the volumatic but would use the smaller spacer. He is back with the big one now at 3.8 other than when we are out and about.

I would also look into getting him a preventer inahler to try to stop it getting to the stage where he feels shit and then you are trying to get him to use the inahler.

No, my DD won't use the volumatic spacer either (looks like this here ) but will use the Aerochamber ( here )

We leave it around and she puts it on teddy and in time she has just become more used to it, I hated that stage where we just had to hold her down to get the inhalers done, horrible for all concerned. It does get better though, good luck.

Try that volumatic pic again here

Definitely keep the spacer around and practice with it when he's not wheezy.

But when they're bad, you just have to pin them down and get on with it, horrid though it is.

3 out of my 4 kids get wheezy. Ds1 is now nearly 7 but used to get really hysterical as a toddler when he was wheezy. He got better as he got older but we had some grim moments when he was small. On the plus side, they have to take deep breaths to make all that noise, so the drug will be hitting the spot if he's crying. Alibarbar's recommendation of a large towel is a good idea to keep the flailing limbs tucked in.

My 2 yo DTS has a daily preventer and is fine with that but still cries and thrashes around if I have to give him puffer when he's wheezy. When they're wheezy they're not always in the best mood to be bribed / negotiated with, ,so sometimes pinning them down and getting on with it is the best option.

Can you let him put stickers on it? This worked for a friend of mine.

Stickers on the spacer in case you were wondering.....

Weathered veteran here. If you don't have an aerochamber do get one. When DS was a baby they weren't available on the NHS and were £25.00 but it was the best £25 I ever spent.

This is what a specialist asthma nurse at the Royal Brompton advised us.

The aero-chamber is smaller and therefore more the medicine gets inside the baby more quickly and more easily because it isn't floating around a great big spacer.

It is important you see your child take breaths when using and make sure breath isn't being held, etc..

The first breath takes in about 40% of the medicine, the 2nd 20%, the 3rd less and so it goes on. If you are prescribed two puffs and you can only see your child getting 1 breath then you need to give four or five puffs.

OP if you haven't an aerochamber they are much easier and it would be worth getting your lad used to it before he gets upset; as an aside because it's so small and so manageable it's easier to keep a small child still and calm in one arm whilst using it with the other.

But he needs to get used to it because if he has asthma he needs to have a preventor and that needs to be given every day twice a day.

With my little one it was the occasional puff of air escaping that used to put her off using her inhaler, she was afraid it would go into her eyes so we used to use swimming goggles to 'protect' them. We also let her pick a sticker to put on her space after each puff, that was when she was 2.5 yrs, she is 4 now and takes it just fine