Inhaler not working for 13 month old

[RP2211]

Hi all,
My daughter has had a constant cough on a morning (and sometimes in the day) for nearly 8 weeks. After 5 I went to the doctors and they've tried her with a blue inhaler to see if it's asthma. This doesn't seem to have improved things and now she's picking virals up at nursery and swimming I'm not sure what's a viral cough or potentially asthma anymore. I just wondered if anyone else had their baby go on a blue inhaler and it not being successful? What were the next steps as I'm not sure what else it could be? She has her check up next week. Thanks in advance.

How often are you giving her the blue inhaler and how many puffs? My DC has asthma. It was regular use of a brown (preventer) rather than blue (reliever) inhaler that helped the most when he was first diagnosed and had the constant cough. Using the brown inhaler correctly means you should hardly ever have to use the blue.

Also, how are you giving it? Via a spacer with a mask?

Hi, thank you for replying. We've only ever been given the blue one and was instructed to give it once in the morning and once in the evening before bed. One puff in the spacer. I wondered why we were never given the brown inhaler but never questioned it at the time as I thought the GP was trying to work out if it was viral or asthma.

I’d take her back. It’s likely she needs a preventer inhaler (brown, purple or pink) as well as the blue. The instructions they gave you reflect how you told them she coughed in the morning- so you typically use a blue one right before you do or expose yourself to a trigger or when coughing/wheezing to alleviate the symptoms. So they obviously think something about her bedroom is triggering asthma. This is usually dust mites…have you taken any steps to make her bedroom asthma friendly?

In regards to swimming now causing coughing. She may also have exercise and/or chlorine fumes as a trigger for asthma as well.

So, in short, her asthma is poorly controlled and you likely need a preventer inhaler as well or be prescribed Montelukast as a tablet preventer and also instructions for using the blue when she has coughing spells.

www.nhs.uk/medicines/montelukast/

She coughs throughout the day too it's just not as regular as it is on an evening and first thing in the morning. She has anti dust mite sheets and weekly clean of her room. Is there anything else I could be doing to help with these symptoms? I'm at my wits end with what to do for the best. I never knew chlorine fumes caused asthma? Thank you for all of this information and advice. It's really appreciated. The words asthma being poorly controlled scares me, I just want her better.

I agree. You need to go back and request a brown inhaler. It's the only thing that helped me.

You’re doing fantastic at keeping her room clean. Only thing I would add is limit the number of stuffed toys in bed and make sure her favourites are put in a freezer overnight (or all day) 8-10hrs once a month to kill dust mites on them.

“Poorly controlled asthma” is how the HCPs refer to it when the current medication isn’t helping much and the asthma is still breaking through. Please don’t let it scare you. It just means they need to do peak flow and ask about how often you’re coughing or feeling breathless. How it’s affecting normal physical activity, and how much the medication is or isn’t helping. Your DD is on the lowest possible dose, there is way much more available for her so please don’t be scared.

Asthma is variable as you go through life, that’s why once diagnosed with it you get an annual review with the surgery to make sure the medication is still right for you. Some kids grow out of it, others it goes into remission and then comes back. I had asthma as a child, then virtually none in my twenties and then it came back (with a vengeance!) it’s same for my eldest DC, but my youngest DC is consistently asthmatic- their medication levels work and hardly ever need to be adjusted.

Best wishes