Help - nighttime coughing!!

Hi

Looking for some advice. My son, Alfie is 34 months and suffering from a terrible night cough. He had difficulty breathing a couple of weeks ago and GP provided steroids for three days and also an inhaler. Was told he was too young for tests to confirm it was asthma but she was pretty sure it was. He is now coughing every night which is also triggering the wheezing! I have been trying to give him the inhaler but I am finding it very difficult to (1) get him to keep the mask on his face and (2) work out if any of the medicine is actually being breathed in by him! I am an asthma sufferer myself but am getting very distressed myself at feeling so useless in being able to help my son!!

If anyone has any tips or advice on how to handle this or how can I help his night coughs please let me know.

Thanks

Alfie's Mum (AKA Heather) xxx

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Hello Heather,

It is difficult to diagnose a child as young as Alfie however, a good history taking & examination goes a long way.

There is no test for asthma for the young or old. But a children's doctor after taking the history would be able to consider blood test to look at his immune system to see if their is any evidence to suggest it is asthma or not. We dont like to label children unless we are sure as the label will stick with them for often ever.

However, let talk about the inhalers.

You will take quite a few weeks to get him 'desensitised' as we call it.

So try having the large spacer & his mask out in the room at all times.

You should pick it up randomly thoroughout the day & 'use' it (ie pretend) infact get the rest of the family to do it. You can always wipe the mask with a bacterial wipe when they have used it if you are worried about getting anyones bugs

Put it down, dont say anything to him

Let him watch you doing it he may have seen you using your spacer so he will wonder why is she using mine

He should & will start to do it himself

Dont, as you might think praise him to start off with but just let him do it & acknowedge that he has with a nod or smile.

then gradually start to say things like good, well done. What you dont want to do too soon is make him self concious & stop. Then start to really praise & clapp etc.

When you have to give him his drugs, try doing it with him sitting between your legs with you both watching CBBC's or video or singing a song he likes, playing a game to distract him. Get others involved singing or doing anything to distract him so he does not realise he is breathing because obviously.... he will be breathing! When a little gets in he should feel better & it will get easier

You will never get loads into him at this age but just do your best until the desentisation kicks in.

Give him a break between puffs, let him go do something else as it does not all have to be given at the same time then call him back for the next one

If you feel that he really did not get the last puff do it again, as both of his inhalers are very safe drugs, You should not tho keep doing it at every dose but if you work with him he will come round. I bet he never walked the first time, used a beaker the first time but does not so it will come.

Just remember it is not 10 breath - 1 puff that is not good. Try one puff 6 clicks of the large spacer or 4 flutters of the small yellow spacer. The slower the deeper the better but he wont do this at his age even if he does get better at it so do your best.

They do not get more when they cry & dont force it as it only makes life more difficult. ALso please check the information leaflet to see how long you need to wait between one puff & the next as some drug companies it is 30 seconds others it is a minutes. So if you dont wait that time you wont be giving him the full dose.

Finally try to find a nurse who can do this with you face to face so they can see how it is going & give more personal advice.

I do hope this helps

A

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Thanks Ann. Very helpful information. I will persevere with him just now and hope, like you say, in time he gets used to it! I appreciate how strange it must be for someone as small as him.

Heather

[Thomass_mum]

Hi

Ann's advice is brilliant so nothing to add to that. Just wanted to let you know I struggle too with giving my sons medications, hes been taking them for quite a while now but the days he decides to play up it is not easy trying to give him them. He has regular inhalers and has 3 puffs in the morning and 2 at night between them. Bizarrely he seems to actually prefer his nasal spray being given to having the mask for the spacer on.

Jenny x

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Thanks Jenny.

I have heard many people say nasal sprays seem to be taken easier but Alfie doesn't have one. Do you know if they can be bought from the chemist or do you need a prescription from the GP?

Heather

[Thomass_mum]

His nasal spray (flixonase) is on prescription and I think is more related to trying to stop his snoring than the asthma tbh. He has nedocromil and seretide inhalers for the asthma, he used to be on montelukast granules as well but he had to stop those because of the behavioural problems they caused.

x