Been prescribed an inhaler...just to see if it works!

[Mung]

My 9 month old DD has been prescribed 'Salbutamol inhaler'. I went to docs for them to listen to her chest which seems to be very noisy and wheezy and has been like that at least since Christmas. The doctor said that she couldn't hear anything. She began to suggest ABs, but DD had some only a month ago for an ear infection and it didn't help her chest. Now she has thrush because of them, so i am very keen to avoid them at all costs. So, she suggested the inhaler for her cough and to 'clear her airwaves'. She suggested going back in 2 weeks and if it hasn't cleared then she will refer DD.

I am really reluctant to use the inhaler, despite not knowing exactly what it is.

Can anyone shed any light on it and give me your opinions.

My daughter had a persistant caugh for months so she was perscribed that inhailer, and it worked. It was very good. When her caugh got better, we stopped using it and the cough came back. She is fine now. The inhailer really helped. It is much safer than antie biotics as there are no side effects that I'm aware of. You must take your Dr's advice, he knows whats best for your little lady. Good Luck.

salbutamol opens the airways

why are you relucant to use it?

I thought it had steroids in, but not sure where I got that from.

Its not, its a muscle relaxant - very widely used.

Inhalers are great as the medication goes DIRECTLY to the source of the problem - the lungs. As a result the amount of drug you need is minute in comparison to meds you have to swallow (and have processed by the stomach, go into the blood stream, and THEN get to the lungs). They have excellent track records, minimal side effects and are very very safe. Please do not worry on that score.

The other thing with inhalers most parents worry about is that it means their child is asthmatic. They may be - the thing is, until a child is much older they can't do a proper lung test (where they blow into a tube to measure peak flow) and as a result, it's very hard to diagnose genuine asthma. Not to mention that there are a number of other (short lived) conditions that occur in the very young that mimic asthma symptoms.

The good news is that many of those conditions can be treated successfully in the same way - with inhalers.

I thoroughly recommend looking at Asthma UK - it has lots of inhaler information for parents (and other users) and may go a long way to reassuring you. There is also a helpline which is excellent and has trained asthma nurses on the other end of the line.

One section on the site I think you'd find most useful is the section on inhaled steroids and their safety. I've copy and pasted the relevant part which may go someway towards reassuring you!

"Concerns about inhaled steroids

Many parents worry about giving their child steroids to treat their asthma. Here are some points to remember:

• The steroids used to treat asthma are called corticosteroids. These are a copy of those produced naturally in our bodies.
• They are completely different to the anabolic steroids associated with bodybuilders and athletes.
• Most children use inhaled steroids that go straight down to the airways, so very little is absorbed into the rest of the body.
• Your doctor should prescribe the lowest possible dose of inhaled steroids to get your child's asthma under control.
• Low doses of inhaled steroids do not cause side effects and have no effect on growth.
• It is important that your child is regularly reviewed by your doctor or nurse to ensure that they are using the lowest dose needed to control their asthma."

FAQ on steroids and your child

(and yes, Mung is right, the reliever inhalers are muscle relaxants, the preventer inhalers are the steroid inhalers - both very very safe and used extensively).

Sorry SMIRFGIRL is right .. sigh... I need to go to bed soon

Thanks for the info ladies. My main concern was that the Doctor seemed so blaze about it; very quick to prescribe it despite DD not coughing whilst in the room. Yes, the cough is annoying and she wakes at night, but I really dont think it is asthma. She said to use it for 2 weeks, but would the cough go in 3 weeks on its own anyway? I just don't want to give the inhaler to make my life easier, as DD will sleep better and be less grumpy. If it will truly help her then that is fine.

I think it'll truly helpful, personally. It certainly won't hurt to try. Especially not over a few weeks.

And to be honest, even if it just helps her sleep better and be less grumpy then it's going to help her recover more quickly anyway.

(Incidentally, only coughing at night can be an early sign of asthma, so don't dismiss it outright. Nine months old is way too early to tell though, so try not to stress and just see how the next couple of weeks go).

Thanks for all this info everyone.

My DS aged 6yrs was prescribed the blue inhaler yesterday as he has a persistent cough for months now that antibiotics and oral steriods have failed to cure.

We were told he was too young for a full asthma check but to try the inhaler for a couple of weeks and return to let them know.

We have started using it today so time will tell but fingers crossed!

Thanks again for all the info - it has been very reassuring and interesting reading

x x x

Really useful information RD. My DS now aged 2 started with a viral induced wheeze at 11 months. He was given salbutamol inhaler which did help a bit. After several months of re-occurance of the wheeze the GP prescribed steroid inhaler. Just like Mung, i was reluctant to use this but can honestly say the effects have been great and DS is much better for it.

Inhaler does not = asthma, it just opens up the airways. They are very often used in asthma because it closes up the airways but salbutamol is used for other respiratory problems so well worth a go.

I'm sorry smurfgirl, have just realised I spelt your name wrong as well when I corrected myself, I was obviously not fully awake last night.

I should say I am not medically trained, but I have had asthma since very young and educated myself well on the condition (as I'm a control freak ). 99.9% of the time when my asthma is under control I don't even notice that I have asthma. When it isn't well under control (often by my own folly because I've been lax with my preventer or just not taking it properly) then it can be quite scary so I'm rather zealous about how important it is to use inhalers effectively as it makes such a huge difference.

I did, for a time, have to give my ds1 inhalers for an infection which cleared... but he is not asthmatic.

I think there's a lot of fear around about asthma and inhalers, and I think a lot of that surrounds the misunderstanding of the word "steroids" thanks to media coverage of sports!

I was chatting to a mum outside the school gates only the other week who was trying to avoid using the preventer because it was steroid based and she thought it was bad for her son - in reality, regular use of the preventer would reduce his reliance on his reliever and keep his asthma under control.

I know myself that by the time you hear an audible wheeze the asthma symptoms have progressed quite a bit and lung function has been dropping long before that - but we're very lucky that while there is currently no cure for asthma, medically we are extremely good at treating it and feeling restricted by asthma (except in very severe cases) is pretty unnecessary.

Thanks for the info again. I am now going to show DH the thread to try and convince him that its the right thing to do.

The cough isn't just at night, but it does get worse at night. DD seems to have sudden coughing fits that spiral out of control and it really scares her. I now think that the inhaler really is worth a try and I am going to get it this afternoon.

Thanks again.

I wish there'd been a similar thread when DD was prescribed a reliever inhaler at 17m. We were worried as you are, Mung, but went ahead after some research and it has really helped (she had a persistent night cough and repeated chest infections and was becoming wheezy). Now she asks for the 'breather' (and the teddies have to have it too) but the symptoms have virtually gone and we'll probably stop it soon.

I am pleased to hear that your DD has improved, Chaotica. How long has it taken?

My dd 6mths was prescribed salbutomal and the other one (preventer) one doc said they had to be used together another doc said salbutomal on its own. There didnt seem to be a definate answer. Despite the constant coughs and wheezes we chose to let dd fight the coughs and wheezes herself. My concern was the long term effects of using steroids and other mucle controlling drugs on babies. At 20mths my dd has got strong enough not to catch every cold going she still gets a runny nose but she no longer gets wheezing and constant coughs. I also read that 'over-usage occurs a state of diminished airways response seems to result'. Therefore your lungs stop doing the job themslves much like your eyes with glasses (if abused). I am sure will get hailed with abuse but nothing new on this site and thought worth mentioning that we are not all for it. Best of luck with your decision its not easy.

By the way I am not saying not to get glasses if you need them!

Even if you dont use it immediately, it is something that is well worth having in your medicine cabinet in case you do really need it. It is amazing stuff.

I treid to use it today...what a joke! I have been given some huge plastic contraption with a little mask bit on the end. Just imagine what you would do if someone tried to put some plastic thing nearly as half as big as you over your mouth. So, it seems that I am not going to see the benefits, even if I really wanted to!
Any tips on keeping a mask on a child for over a minute (apparently need to leave a minute between puffs and breath normally) would be gratefully received.

You could let her play with it between doses. Encourage her to breathe on it without meds in.

RubberDuck has said all the medical stuff perfectly - so I won't reiterate that. However I would liek to make 1 correction - for hte record.

Long term high dose steroids can in some cases cause your adrenal glads to stop working. That said, this is normally with the higher doses associated with oral steroids - not the lower doses in inhalers. I only really point it out for accuracy.

Mung: yes, you've discovered the really hard bit! With ds1, he was a bit older, so we encouraged him with lots of stickers all over the contraption to make it less daunting, but even then we succumbed to bribery with chocolate buttons (to create some good associations with it). One chocolate button before and one choc button after.

But really your little girl may be a bit too small to cooperate for the chocolate reward... I'd recommend chatting to the asthma nurse at your surgery or phoning the helpline on the Asthma UK site - as I've found that the nurses are usually far more knowledgeable about the practicalities of taking the meds than the doctors!!

SlightlyMadShrek: yes, you're quite right... which is why inhalers are so good - teeny tiny doses, delivered directly to the problem.

Always far far better to get asthma properly controlled with inhalers, than to let it get out of control and have to have much stronger oral steroids to get it back under control again...

Afaik you have to leave a minute between puffs, but during that minute the mask doesn't have to stay on hte face. You put the mask on, puff, ten breaths roughly, take it off, wait a minute, repeat.