3 year old son with mild asthma... when to medicate?

Ashley - posted on 10/28/2010

My son has been admitted to the hospital 5 times since he was 8 months old. My son too is prescribed Albuterol (Neb and Inhaler) to be used as needed and Flovent as his daily controller med. I use his Albuterol puffer for when we're out and about if he's starting to get a runny nose. And I use his Nebulizer as soon as I notice and cold like symptoms. Because my son's asthma always starts out with a cold. So the sooner I start the less severe his attacks are. Another thing that sets off my son's asthma is Smoke. Doesn't matter what type. He's also allergic to dogs and cats. So if you have either it is best to vacuum everyday. Whether he's allergic to them like my son is or not. Because sometimes in asthmatic children it doesn't take much to set off their attacks.

Annie - posted on 03/02/2010

Thanks, guys! @ Valerie, his triggers are flowering trees and he is mildly affected by grass (when people are mowing), but increased physical activity and cold weather affect him too. We have talked with his pediatrician but have not seen an asthma specialist. Until this point I assumed that his pediatrician would let us know if that was necessary. I don't know how you managed to get an inhaler for your 2-year-old, because I was informed that they wouldn't prescribe an inhaler-form of his medicine until he was 4 (which is in May). It would be so much more convenient to give him his medicine if he had an inhaler. He HATES having to sit to take his nebulizer treatments as the shortest one, the preventer, Pulmicort takes about 10 minutes and if I have to give him both the Pulmicort and the Albuterol, it can take almost 40 minutes. He's an on-the-go kind of kid, and if I have to fight him to take it, he just gets himself that much more worked up, which doesn't help matters. I will definitely ask his ped at his next check-up if we need to see a specialist. Thanks for all your help. :-)

Michelle - posted on 12/21/2009

I was told to start preventative meds when my youngest son started showing signs of allergies bothering him as his asthma is triggered by infection caused by allergies. My oldest son takes his year round as his asthma is more severe and has several triggers

Valerie - posted on 12/12/2009

Annie, you need to go back to your Dr for more instruction on how to manage his asthma. Have you seen an Asthma clinic? Do you know what his triggers are? Do you have an Asthma action plan? Do you know what your son's 'triggers' are? If you don't have an Asthma Action Plan, just do a google search for one to download. Go over it with your Dr to identify what triggers his Asthma attacks (ie allergies, cold weather, smoke, colds, animals etc) and what to do when his Asthma is well controlled, when his is starting to have difficulty (ie coughing, wheezing, shortness of breath, colds or allergies), or the final stage when his symptoms are continuing or worsening. Asthma Action Plans are usually color-coded like a traffic light: green for well controlled, yellow when he starts to show symptoms, and red for an Asthma attack. It sounds like your little guy and my Patrick have similar asthma triggers and symptoms.

My twins were 35 week preemies who are now 26 months. So far, Lily shows no signs of Asthma but Patrick was diagnosed with Allergy Related Asthma at 17 months. If his Asthma symptoms are well controlled (green on his action plan) like they are now: he is currently on Beclomethasone (Qvar - 2 puffs in the AM) as his daily Preventer/Controller inhaler and Singular (a nightly pill for his allergy symptoms). He does not take his Salbutamol (Ventolin) which is his Reliever/Rescue inhaler. I also use an over-the-counter children's Antihistamine as needed during the spring and fall allergy seasons as recommended by our Pediatrician.

If he has a cold, ear infection, respiratory infection, cold weather (we are in Canada - it was -35 today), or allergy seasons (poor guy is allergic to grass and trees) then we move into the Yellow portion of his action plan. For a minimum of 6 weeks (longer if his symptoms continue), he takes Beclomethasone (Qvar - 2 puffs in the morning and afternoon) as his daily Preventer/Controller inhaler and Singular (a nightly pill for his allergy symptoms). He also takes Salbutamol (Ventolin - 1-2 puffs up to 4x a day as needed), his Reliever/Rescue inhaler.

If his symptoms are continuing and/or worsening (shortness of breath etc) then we move into the Red section of his action plan and seek immediate medical attention. We only use the nebulizer when his symptoms are worsening in the Yellow zone. The Asthma specialist was very clear that the nebulizer was more of a last resort.

When he was first diagnosed last January, he was in the Yellow zone of his action plan for about 4 months. He has been in the Green well-controlled section over the summer but with the arrival of winter and the cold and flu season, we will be starting to move into the Yellow zone. We just reviewed his Asthma Action plan with the Pediatrician last week. If we can keep his Asthma relatively well-controlled, then next year we will like take him off both inhalers when he is in the well-controlled Green zone and he will just take the Singular.

There are some great books out there on Childhood Asthma and on-going treatment. I would strongly recommend that you take the time to read some of the more recent publications. There have been a lot of breakthroughs with new medications and controllers so anything more than a couple of years old may be out of date already. I went in with 3 pages of notes to talk to the Pediatrician.

From what I have read and discussed with our Pediatrician and Asthma specialist, is that Asthma is an ongoing, chronic condition. Meaning that even though your son is not coughing, wheezing etc, he still has mild inflammation in his lungs so it maybe necessary (based on your Dr's advice for your Action Plan) to use his controller medication on a daily basis and possibly treating his allergy symptoms. (Ezcema can be a sign that his Asthma symptoms could be worsening). The idea is to get him in the well-controlled Green zone, stabilize and then start to wean him off the inhalers until he starts to show signs and symptoms.

Good luck!

Chelle - posted on 12/09/2009

My son is 18 months and takes pulmicort once a day and his albuterol for his nebulizer is as needed and an inhaler too. I dunno about your son but I know when it's necessary to give him a treatment is when he is wheezing and his inhaler just isn't doing it for him. I can see when he is having a hard time breathing and he tends to get cranky too.