Does anyone have a 2 year old with viral wheeze/asmtha?

[Lindsay8347]

Millie has been suffering with viral wheeze episodes from the age of around 1 year, she was prescribed the blue inhaler for these attacks and ended up in hospital 3 times with it and has also had a chest and throat infection on separate occasions. From 18 months (Jan 2020) she was given the brown preventer inhaler to have 2 puffs morning and night and just the blue inhaler for when she gets an attack. While we were on lockdown her chest was much better but it was summer and she wasn't mixing with anyone at nursery or germs. Since the 2nd week in August she's literally just been FULL of cold, wheezy, rattly, coughing etc. She's had to have 3 covid tests in 4 months because of these symptoms so she can go to nursery, a negative! The GP said we need to step up the asmtha treatment and prescribed her montelukast granules which I haven't given her after reading all the side effects and I'm not comfortable giving them her when she hasn't been physically checked by the GP. I don't really know where to go from here, she's in this awful cycle at the moment and we're only at the start of winter. I'm considering paying for a private doctor to get her properly checked. We also have an issue at home with a boiler that doesn't work properly so the downstairs is nice and warm but the bedrooms are cold, we also have a mould, damp problem as our upvc windows are failing. Are these also factors? Any advice or help would be greatly appreciated. Thank you

[Troilus]

Hi Lindsay.

I am sorry but I have no experience of asthma in one so young.

Generally speaking, however, damp and mould tend to be a bad mix with asthma. Some people with asthma have an allergy to mould spores, so it would be worth while trying to rid the little one’s bedroom of this.

Maybe some kind of electric radiator would help until you can get things sorted out.

Also, I would try Millie on the Montelukast. Nearly all medications can have nasty side effects but your GP will have taken this into consideration when prescribing this. There have been studies involving children and Montelukast which found that quite often children have been able to reduce their dose of the steroid inhaler once this is established.

I thought I’d just mention that the blue inhaler is not just for attacks, although you probably know that. You can give it to Millie whenever she is experiencing symptoms.

[twinkly29]

In addition to what Troilus has said, a physical examination probably won't result in anything different - much of what the GP suggests will be based on your observations/experiences of how she is over time which is actually the right thing - if they listened to her chest and right at that moment it was great and so dismissed everything, it wouldn't be terribly helpful.

[madamestephens]

My son was similar aged four and improved massively when he started Montelukast tablets just before turning five. It has definitely been worth it for us.

[Lindsay8347 in reply to madamestephens]

Thank you for your reply, we're going to begin these today and see where we go from here.

[Poobah]

I'm so sorry that Millie is having such a rotten time of it. There are published guidelines for the treatment of asthma and it looks like your GP is following that. However, it does call for monitoring appointments so that the efficacy of the treatment can be reviewed and stepped up, if necessary. The Montelukast is the next treatment step after the reliever and steroid inhalers. It should be reviewed after 6 weeks to ensure that it is having a positive affect on Millie's symptoms. If not, then it should be stopped. NB that Montelukast only works for a percentage of asthmatics.

The next stage would be a long acting bronchodilator/steroid combination inhaler. Again, a review will consider if this is having a positive affect. At this stage, your GP may consider a referral to a pediatric asthma specialist if the combo inhaler wasn't having the desired affect.

The GP can prescribe low dose course of oral steroids for more aggressive flares up of symptoms. He/she may also consider antibiotics.

As for the home, damp is not good for anyone and especially for anyone with chest problems. I'm wondering if Millie can sleep downstairs until the heating and windows are sorted? I would prioritise her room and the bathroom for heating etc. to limit exposure to mold spores.

I had asthma from a very early age and we didn't have central heating and so I got used to the cold, which didn't affect me, and we were lucky enough not to have damp. However, mixing with others certainly did - I picked up everything. I remember having oral steroids and hiding them, they were fowl. But they really helped if my mum could persuade me to take them.

I don't normally suggest supplements but vit D is very important for a healthy immune system. If Millie isn't getting enough sun, especially in the winter, then you may want to consider a children's vit d/k spray (better than tablets with unknown caking agents). It's a vicious circle in children with any illness- they don't go out much and therefore miss out on sunshine exposure.

All the best, I hope Millie feels better soon.

[Lindsay8347 in reply to Poobah]

Good morning Poobah

That's massively helpful thankyou, we're going to begin the montelukast today and review in 6 weeks and also get onto our GP for a follow up appointment - if they will actually see her due to the current situation but I'll cross that bridge when we come to it.

We're in the process of making the changes at home that we need to, so hopefully that will also help.

Stay safe, Lindsay

[Poobah in reply to Lindsay8347]

One other thing that really helped me as a child, my mum would paddle my back whenever I was struggling to breath or bringing up phlegm. Physiotherapy is so helpful. Here's a London centric service link, but it explains what a parent can do when their child has a chest infection. babyphysio.com/physiotherap...

You can also find useful physio advice on YouTube. Hopefully, if your GP does refer Millie to a specialist, the team will also have a physio. These days, more hospital respiratory clinics are multidisciplinary, so patients can benefit from various services.

[watergazer]

Hi sorry to learn of your worries for your little one, One of ours developed asthma at an early age but was controllable. I know that mould and damp can affect your lungs so can you move her to a better room? Also having washing drying in the house all the time can affect the lungs ( if you do this) best to have it in a room where the window can be open. Just some advice that I was given so if you already know please accept my apologies. Hopefully the new med will help x Anita

[Wheezy26]

Hi, so sorry to hear your little girl is having a tough time with it all!

I’ve suffered from severe asthma since I was 2 years old (now 26) and remember how scary it was for my parents when I was younger so completely understand what your going through.

I know that damp was a big trigger for me when I was younger and still now. I would try a dehumidifier for now as a temporary fix until you get it resolved as that used to help me a lot and should help with the damp.

Asthma always flares up in winter, well in my case and that’s where I find I get a lot worse and more chesty ect. I know she is young but was thinking with regards to cold I always wear a scarf around my mouth when out to warm the air up before it getting to my lungs by breathing it through the scarf?

Montelukas is something I’ve always been on and never had any side effects but this differs between each person. I think it is definitely worth a try but maybe if you see some changes or concerns stop it and get her checked over! I also personally don’t feel montelukas works for me but again everyone is different and I think it’s process of trying and failing to find the next thing!

It’s so worrying and scary for such little people to struggle breathing and you must be so worried! Fee free to give me a message (if you can do that on here) if you need and advice or just a chat and I can try help where I can!

Keep smiling and being strong! You have to be persistent with the doctors to ensure you get what you need! I’m getting recommend for a treatment now to burn the lining of the lungs and this is something my mum has suggested to them for years!xxx