Parents with asthmatic babies... how often can you give the inhaler?

[2point4kids]

DS2 (7 months) just been given inhalers for ashthma. DS1 has it too, so it runs in the family.

DS2 seems to be worse than DS1 ever was though and I'm not sure how often is ok to give him the inhaler as he seems to need it quite often..

He has the brown steroid one morning and night (2 puffs each time) and the blue one as he needs it (2 puffs). He is seeming to need it every couple of hours at the moment. I gave it to him half an hour ago and he's wheezing a lot again and short of breath now. When is it safe to give another 2 puffs? Can I give more now or do I need to wait a bit longer?

One problem is that I'm not sure how much of it he's taking in as he doesnt like the spacer mask and tries to pull it off when I'm doing it!

bump

Not sure about babies, but with DS2 we are told he can have as much blue inhaler as he needs to stabilise him, but if it's needed more than 2-3 hourly, to seek further medical assistance.

If your little one is struggling after half an hour, I'd advise getting him checked over, tbh.

Hope he's feeling better soon.

Who has prescribed a steroid inhalers for your DS2?? He's very young to be prescribed them.

Does he look very short of breath or does he just sound wheezy?

Thank you.

He's only had the inhalers a couple of days and the Dr said if no improvement by Friday go back, so will go back and see him agai tomorrow I think.
I'll keep giving it every 2-3 hours in the mean time.
DS has got a nasty cold and its that which is makin him wheeze so much poor thing.

LaDiDa - perhaps I have got it wrong, he has a brown inhaler called Beclametasone, which I assumed is steroid but perhaps not?
He was given it because asthma runs in the family and he is wheezing/coughing and seems short of breath.
He has a bad cold, but DS1 (who is 3) always struggles with his asthma when he has a cold and this is why the Dr says he thinks it is also asthma.
The blue inhaler alone was not helping enough so Dr prescribed brown one to see if that helps him. If not, to go back Friday to see him.

Have his symptoms worsened from when the doctor last saw him, 2point4?

No, not worsened. I'd say he is very similar to how he was when he saw the Dr.
The DR said the brown inhaler takes a few days to kick in and help so I am hoping that he improves soon!!

It is a steroid. Steroid inhalers should only be prescribed in a child of his age by a respiratory paed or at least a general paed with an interest in resp problems or who has discussed with a resp paed.

I don't trust your doc's advice tbh as even salbutamol is of limited effectiveness in under one year olds.

It sounds like he has viral induced wheeze atm and may well turn out to have asthma as he gets older. Try up to 10 puffs of the salbutamol but you may need another pair of hands to get the seal on the spacer mask. Try to count his rate of breathing and look at his ribs and the bottom of his neck, is he sucking in with each breath and where? Is is able to be active?

I will look back at this later.

I think the Dr was saying that normally they dont prescribe the inhalers at this age because its hard to tell whether its ashthma or something they will grow out of. With DS1 having the asthma he said it was much more likely to be asthma and so could prescribe the inhalers now.

If they are limited effectiveness under 1, is there something else that can help instead until he is 1?

Do you think I should go back to see the Dr tomorrw as he said and ask to be referred to a paed about it?

He is still active. Grumpy, but active. He doesnt move about yet, but is waving his arms about and wiggling round when lying down.
I've had a look at his ribs and neck when breathing and I cant see anything unusual. Its hard to tell as he has a little podge around his tummy plus he wriggles so much!
He is breathing faster than normal though (with the cold) and it sounds like he is making anoise on the out breath but not the in breath if that makes sense.

How do I count his breaths? Is it the number of in breaths in aminute?

Hello again 2point4kids .

DS2 also had inhalers prescribed as a baby, but this was by the paed after he had bronchillitus (sp).

We were told we could give up to ten puffs of his salbutamol inhaler but really if he needed this much he should be in hospital.

Have a look at the base of his neck as if they are sucking in there it can be a sign he needs a little more help.

You may be as well to call NHS direct for advice if it continues. T'is that time of year for bronchie babies!

There is often little that helps under one. I'm not saying that your GP was wrong to try salbutamol btw, it's the steroids that I think are not a good idea without further more specialist assessment.

It's really hard to give advice over the internet without seeing the child but I feel uneasy about the steroids.

Count the number of in breaths per minute (or per 30sec and then double).

He is still bad this morning. Had a terrible night.
Am going to see the nurse practitioner this morning who is apparently the asthma expert at the surgery so I will tell her everything and see what she says!

Thanks for all your advice. I will update later

Saw the nurse and she was really helpful.
Explained to me exactly what the different inhalers do and why they are given.
She listened to DS and said she'd like to keep him on the steroid inhaler and give it a few more days as although its not helping yet, it will take up to a week to start having an effect.

In the mean time I can keep using the blue inhaler as needed and when he's bad to give 4 puffs instead of 2.

I made a tit of myself through worry and started crying in her office but she was ever so nice and is ringing me after the weekend to see how he is doing.
Have another check up booked for 2 weeks time as well.

She told me to not even think about his weight and him not eating while he is still unwell as although he's dropped lines, he's not exactly skin and bones lol which is reassuring.

I feel better now that I am doing the right thing and to stick it out a few more days till the steroids start helping.