Four year old diagnosed with asthma . .but is it?

Hi,

I am new to all this but just wanted some advice. My son now four currently has a preventer and reliever inhaler. He was born with a hole in his lung, and at 18 months had pneumonia. He has always had a night time cough from very young and the drs have said they thought he may have already had asthma which contributed to the pneumonia or possibly the other way around. He has had a reliever inhaler since, and was given a preventer due to heavy night time breathing and cough. He has also been prescribed three courses of steroids in the last 18 months. He has never had an asthma attack in the sense that I understand it, and tho there is a history of asthma in our family its my nieces and nephews. Over the last year he has been doing well, and I was advised to continue with his preventer just in case.

He has started coughing again at night, however without a wheeze. I have kept him home from reception today because he is also coughing constantly this morning. He doesnt seem ill but I have no idea whether this cough is asthma or simply a cough. If its asthma then I usually put him onto his reliever but how do I tell. And does he need to see the dr? We went through the same thing last year and I was told to just go with my instincts. I don't know how to tell what is asthma and whats just a cough and dont want to give him his inhaler if he doesnt really need it.

I apologise for this ramble but I'm not really sure what to do. Advice would be appreciated. I didn't know this site was here.

Julie

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Afternoon Julie, and I bid you a warm welcome to AUK.

There is no such thing as “standard asthma” symptoms. Yes, some people can have severe asthma attacks but on the other hand many people have milder symptoms that also require treatment using preventers/relievers.

Take me, I suffer from infrequent CVA (cough variant asthma) which affects the bronchial airways rather than the lungs. At certain stages, all three of my children have also suffered from CVA. Just as it says on the tin, the predominant feature of cough variant asthma is continuous coughing which can be relieved by using an inhaler.

Yeah, I know it can be difficult determining whether your 4 year old does indeed have asthma and therefore it is difficult to determine if he needs the asthma meds. A couple of things to bear in mind which may offer you some guidance. Firstly, he has been prescribed asthma meds by the GP so therefore it is likely that he does indeed suffer from asthma symptoms (probably more closely resembling CVA). And secondly, you can use your instincts but it would appear that nobody has bothered to tell you how. Well, if I was in your shoes (so to speak) I would monitor his cough before and after taking his inhaler(s). If taking the inhaler has made an improvement to his symptoms (e.g. less coughing) then I would say that it would be reasonable to say that he does indeed have asthma and taking the inhaler(s) has helped his asthma symptoms. If on the other hand, there is no noticeable improvement in his coughing, then I would suggest that you take him back to the GP and tell him that the meds are not making any improvements to his coughing. It could well be that his medication needs to be reviewed or he may not have asthma after all.

I am sure one of the more experienced regulars will reply soon with more specific advice/guidance.

I hope this helps a wee bit in the meantime.

Derek