Unsure about asthma diagnosis in toddler

[Thisismyfirstrodeo]

After an emergency trip to A&E last week, my 19m toddler was diagnosed with asthma. He's always been a little on the wheezy side when he's ill, and this winter has had a bit of a cough on and off for months (started in nursery and has had a lot of colds and flu etc.) so it's not entirely unexpected, but then again I know loads of kids that cough all the time and don't have asthma! He's never had bronchiolitus or similar though he has had some instances of rapid breathing with fever.

As we aren't in the UK, I was curious if this incident would have been diagnosed the same way there...

He has been given a lot of medication including Ventolin 4 times a day this week then Fluticasone as a preventer for 3 months - which doesn't seem recommended for under 5s in the UK. I'm in France where they go straight to the highly medicalised position for everything, so I am always cynical - and will get a second opinion from his paediatrician this week, but - does this sound like asthma for those that have experienced it with toddlers?

My DS was diagnosed at 8 months, very wheezy and struggling with breathing and crying. He had to be put on nuebuliser to get him stable. He had a spacer for ventolin, but given soluble steroids when he had a flare up, only once or twice a year. I would query medication given if you’ve read it’s not recommended for under 5’s.

Thanks, that's good to know. I was reading some threads which found they didn't diagnose younger babies in the UK so was leaning towards also the 'wait and see approach'...

As far as I know an asthma diagnosis isn't usually confirmed until age 5 in the UK, as many of the tests aren't possible in younger children. Under 5 it's more likely it'll be termed "suspected asthma". However inhalers etc can still be prescribed.

I've just googled NICE guidelines and that seems to be correct.

Asthma isn't diagnosed until age 5 in the UK, but asthma treatment is still given and we've been told he will likely be diagnosed when he's older.

My three year old has a Clenil preventer inhaler for use twice a day, and a Ventolin inhaler for when he needs it (basically every cold, so every 2-3 weeks for a few days in winter). We've had two bouts of bronch and three hospitalisations for breathing problems. Nothing since the Clenil was prescribed though, which is a huge relief.

My three year old has a Clenil preventer inhaler for use twice a day, and a Ventolin inhaler for when he needs it (basically every cold, so every 2-3 weeks for a few days in winter). We've had two bouts of bronch and three hospitalisations for breathing problems. Nothing since the Clenil was prescribed though, which is a huge relief.

My exact experience except we have only had 2 hospitalisations. DS is 3.5 and has 2 puffs of clenil twice a day. His dad has asthma but they still won't officially call it anything but viral wheeze as he cannot do the peak flow yet.

This is all very helpful thanks. So even without the official diagnosis of asthma I guess they would have prescribed the inhalers in the UK too. They said the asthma attack last week was counted as ‘severe’ in terms of his breathing and oxygen levels so that’s probably why after just one instance they decided he needed treatment. They’ve asked for him to use the preventer for three months so maybe they’ll reassess then if we need to continue and I’ll double check with his doc tomorrow as to the one that’s not for under 5s in the UK!

You've already got some good advice here.

My DS (also 19m) has been in hospital several times this winter with what sounds like the same thing as yours (Mine rocked a breathing rate of 82 breaths/minute and an o2 level of 89% at his worst!) Similar inhaler regimen, too. They said he probably doesn't have asthma (too young etc) but they have said he's has got bronchiolitis.

Apparently is fairly common in toddlers anyway, but they're seeing a ridiculous increase in severe cases due to all the toddlers having been locked down for their first winter & so having low general immunity to respiratory bugs.

Not saying your DS has the same, but maybe worth an investigate?

With asthma, the wait-and-see approach is very dangerous. Unless you have witnessed a full-on asthma attack, you can hardly imagine what it means to see a child being unable to breath, as if he was held under water. You can die from an asthma, and the ambulance might not get there on time.

The attack your DS had should be seen as a wake-up call. If it was severe enough to warrant a trip to the emergency, it is severe enough to apply preventative measures. Pollen season is starting.

Every country has their own protocol. Trust your doctors, not the internet, when it comes to health care.

Thanks Matcha, I do understand that and will absolutely trust the opinion of his paediatrician that I will see today, but unfortunately in France we really do have to at least query all the prescriptions that are given as they choose the most highly medicalised approach for every illness. It just felt a bit sudden as he’s never had an asthma attack or bronchiolitis so far at 19m despite many many coughs and colds and flus this winter but, there’s always a first time and it seems asthma definitely can flare up anytime really. I’m totally ignorant about it all so thanks for all your experiences and I will keep reading up on it!

My DS was diagnosed by doing peak flows for a week and documenting the result, then using a steroid inhaler and doing leak flows for two weeks. The difference was amazing.

It's not correct that children don't get diagnosed with asthma until ages 5 in the UK.

It may be a general rule of thumb but both my children were diagnosed well before aged 5.

Either way the treatment is the same and although it can be worrying the thought of a young child on regular medication it's so so important that asthma is well controlled.

My DD was 'finally' diagnosed at 4, after being poorly with croup and a wheeze every winter.

My DD (not yet 2), has had 9 hospitalisations, is on Clenil, Salbutamol and Montelukast. He is still not been officially diagnosed as 'asthmatic', yet is being medically treated as having asthma.

Sorry, DS (nearly 2)

Hi OP, in our experience - lots of trips to A&E with breathing difficulties / cough / croup, our son when he was 2 was diagnosed with “viral wheeze” and given a salbutamol inhaler + montelukast to use at home as “burst therapy” when he has a cold to reduce the risk of it getting worse.

He’s now 5 and I recently spoke to the GP who said he’s old enough now to probably be considered asthmatic, but to continue as we are for now. GP said monitor his inhaler use and if he’s needing it 3x a week or more for wheezing unrelated to a virus (ie he’s totally well but suddenly needs his inhaler) then they’ll add in a preventer element. Hope that helps.

Thanks all for your stories. The GP today was happy with the diagnosis and the specific inhalers prescribed, so I am too now. We will just use the preventer inhaler for 2 months rather than 3 and reassess as hopefully summer will be easier on the ole lungs. Hope they all grow out of it soon