Asthma

[cookiemonster100]

Hi all,

Could I get your advice on my LO?
Over dec he had a chest infection which cleared with anti biotics however his breathing was really rattly. When I took him back to the docs they gave him a inhaler which helped clear his air waves.
He is currently teething / cold / toddler type lurgy currently and his breathing sounds rattly & he is coughing a lot. I gave him the inhaler a couple of times today.

Over this & the previous occasion I have been asked a few times if he is asthmatic (one being the local pharmacist & another who is a family friend who is a medic). I have thought this deep down but the GP don't seem too concern.
How do I go about getting him diagnosed / investigated further. I feel like I need a compelling argument to get my GP to take me seriously. At the moment the impression they give me is that they think I am an over anxious first time mother.
I would just like to know so we can deal with what we need to or eliminate it. Or am I being a over anxious first time mother ....

How old is LO?

Asthma isn't diagnosed in very young children as it doesn't work the same in the very small respiratory system as it does when older.

In older children and adults, the triggers are usually dust, allergies or overenthusiastic exercise. In under-4s it's more likely to be triggered by viruses and colds.

If symptoms are well managed with the inhaler you have, then stick with it but make sure you have regular reviews (there will be trigger points for how often inhaler X is needed meaning that inhaler Y is prescribed instead. It may be that all the symptoms fade and inhalers aren't needed any more.

He is coming up to 16 months old x

Ok. Well then the GPs have decided that the best policy is to wait and see. They will not diagnose/investigate further as in most cases the symptoms will be well managed by the inhalers you have and will fade as he gets older. If that is what happens in this case, no further action is needed from them except renewing the inhaler prescription when needed.

If symptoms aren't being well managed they will certainly act. The danger sign to look out for is evidence that he's needing to put in additional muscular effort to breathe in, characterised by the flesh between his ribs and in the hollow of the throat. I hope your GP has given you clear instructions about how much inhaler to give and what other paths you can take. (a&e is not an overreaction if the inhaler isn't having the required effect)

If symptoms aren't being well managed they will certainly act. The danger sign to look out for is evidence that he's needing to put in additional muscular effort to breathe in, characterised by the flesh between his ribs and in the hollow of the throat. I hope your GP has given you clear instructions about how much inhaler to give and what other paths you can take. (a&e is not an overreaction if the inhaler isn't having the required effect)

this absolutely. If this happens, take him to a&e - they'll check his oxygen levels then he'll either require oxygen and inhaler or they'll administer inhaler and monitor how his breathing is then and how much effort he's making. They'll see how long they can 'stretch' him to next needing it and depending on that may admit him to a ward.

It is common for them to be run down after chest infections but you do need to watch the signs. If he's admitted to the ward, you will probably be offered a follow up at hospital to check him and therefore see a paediatrician rather than the gp. With us, Ds' viral wheeze began at 11 months and almost every time he gets a cold we end up in hospital, sometimes overnight, sometimes not but always get admitted inevitably. It's so hard but they don't diagnose asthma at this age, a lot grow out of it by 4/5 once their lungs are bigger and you may even notice an improvement next winter. It doesn't sound like he is bad atm if he's not having to make extra effort to breathe but be sure you have clear advice from your gp on this - if he doesn't know, see another gp.

There are other signs that it could be asthma - eczema, if there is asthma in the family, coughing at night or when exercising, but ultimately they can't diagnose until they are older even if - like with my DS - they treat it the same way as asthma, just not under that name.

At this age, respiratory symptoms do not always mean asthma, you can get so-called 'happy Wheezers', children who habitually wheeze with colds and viruses. Some children can get bronchiolitis caused by RSV (respiratory Syncytial Virus) which causes immature airways to go into spasm. The 'tracheal tug' defined above is a good indication that you need to access medical help, either an urgent GP appt or Out of hours/A&E. Always make sure you have a 'blue' inhaler to hand and a 'spacer' commonly known as an 'Aerochamber' which delivers the 'opening' aerosol (or puffer) as effectively as possible.
It does not particularly help to jump to early diagnoses of asthma at this stage, as, as has been explained, these symptoms do not necessarily go on to evolve into asthma. Just keep vigilant esp during colds/viruses, keep well stocked with (ideally 2 Salbutamol inhalers...one for the house, one for the baby bag or car for example), and trust your instincts, if you feel he is struggling or coughing lots and lots and esp if the puffers are not making much difference, get some help.

Thank you all for responding. We did end up in A&E last night as he was really struggling to breathe. grammar the doc said exactly what you have posted about being a happy wheezer. I am quite cross with our GP as I hadn't realised I could have given him up to 10 puffs on the inhaler. I had only been giving him 4. The children's hospital were brilliant so we are well informed for next time.
Thanks everyone for taking the time to respond x

Glad he's ok now. I was in the same boat when my PFB was that age and I hadn't yet discovered MN so I felt very alone and very very guilty that I didn't understand what was going on (the gp had prescribed a puffer but hadn't bothered explaining how to recognise symptoms, how many puffs to give and under what circumstances to go to A&E)