Neb Treatment or Inhalerr? ETA - :)

Oh poor baby! There is nothing worse then feeling helpless and listening to them sounding so miserable. It does sound like asthma (been a live long sufferer myself). You don't necessarily have to be "bad off" to request or get prescribed a nebulizer. It's just simply a better means to distribute the medicine and will provide longer relieve. You are not being paranoid but want to get it under control for you and your kiddo. I'd certainly ask the Doc (or maybe try an Asthma/Allergy Specialist) and consider taking other procautions as this allergy season has started off with a bang and could be aggravating the symptoms, so I'd keep windows closed and perhaps purchase an air purifier for the baby's room.

My son also suffers from asthma, although we only have an unofficial diagnosis now. It drove me crazy when I would ask specific questions and get no answers. The doctor kept saying that patients who suffer from asthma are having lots of problems now because of pollen. So my son should take nebulizer treatments now just in case. That was what I got every time I took my son to the doctor for a cold. The common cold can be a trigger for asthma. Just about anything can be a trigger. Some common ones are cigarette smoke, pollen, house dust, pet dander, cleaning agents, and vigorous exercise. He finally told me this, "I can't give you an official diagnosis because it will make problems later for insurance coverage if he is diagnosed now." Let me clarify a little. We live in Japan and the government pays all medical expenses for children under school age. Once they start school, parents start paying a percentage of the fees. Once you have an official diagnosis for a condition, it makes insurance more difficult to get and more expensive. I have also heard that doctors in the States don't rush into diagnosing asthma in children. I have a friend who is a pediatrician. And he basically told me the same thing, it has to do with insurance coverage later. My son started having nebulizer treatments and oral medication for wheezing when he was around 18 months old. The doctor never even considered giving us an inhaler until he was over 16 kilos (35.2 pounds) and able to follow simple instructions. I don't think most one year olds are capable of following instructions that well yet. I have never heard of an inhaler like a mask. I've seen the type you put into your mouth and the type you insert into your nose. If I were you, I would definitely ask the doctor about the possibility of using a nebulizer. The nebulizer treatments really help my son to get a full nights sleep when he has a cold. Now if they would just make a nebulizer that was easier to clean. I hate cleaning all those little parts, but am so grateful there is this type a treatment available. It is the worst feeling in the world to see your little one not be able to breathe well. hang in there M., and remember you are your child's voice now. Keep asking until they take you seriously!

I am under the impression that an inhaler is rescue. Only for quick relief. I think your baby need longer lasting relief. In this case, i would say a nebulizer is better. I would let your ped know that the baby is not getting the relief that is needed long term.

Poor little one, so young to struggle. I have asthma, it is not fun!

For that age of a child, I would think a nebulizer would work best..

The inhaler takes the participation of the child.. If I remember correctly they are to blow out, then inhale as the inhaler is pushed and hold the meds in their lungs for a few moments.

Also remember the spring is a really bad time with all of the pollen the blooming everything..

I would suggest you purchase an electric filter for your child's room. Keep up with changing out the filters.. They can fill up a lot faster during this time of year.

Also if you have carpeted, consider getting rid of them.. I do not care how good your vacuum is, it still holds onto everything that is an allergen.

Keep any pets out of your child's room.. make it a sanctuary for your child.

We have both the inhaler and nebulizer for my grandson..... he is not quite 4 1/2, though. BTW... we have the same spacer/chamber for him that you showed.

Some doctors feel that the nebulizer works better, because the treatment goes on for longer.

He had been using the nebulizer as needed for several years, and just this year one doctor prescriped Zopenex inhaler (a new type of albuterol, apparently), hoping it wouldn't make him so jittery. It doesn't make him as jittery, but doesn't work as well as a standard albuterol (rescue inhaler). However, he had a really bad spell last week, and we spent most of the evening/night at the ER, in two different trips... the last time, they did a 1 hour neb treatment! (They also gave him steroids, and a prescription for steroids).

I would suggest taking her back to the doctor.... try to time the visit so it is at the END of the wait time for the next treatment. Did they show you how to look for retracting? That is also an indication of poor lung function/breathing difficulties.

Frankly, I think the nebulizer works better for little ones... it is hard to teach them how to breathe in, even using the chamber with the inhaler. Unfortunately, some kids don't want to sit still for that long (the 15 minutes usually needed for the nebulizer).

My son was diagnosed with reactive airway disorder around 14 or 15 months. They treated him with albuterol using a nebulizer. It happened so frequently at first that we just bought a nebulizer to keep on hand. He is now 4 years old and rarely uses it anymore. I think the last time may have been in early fall of 2011. Usually when a child is croupy or wheezy the doctor/nurse will have you sit with your child in a steamy bathroom, so this was even more concentrated than that because it creates steam. I would ask your doctor if this might be a better option for your child. Also, my son recently had his adenoids out because he was such a heavy breather and seemed congested all the time. You may inquire about this too or go see an ENT doctor for a chest X-ray if this keeps up. It has made all the difference for my son.
Good luck!
A.

Wow, I feel for you. I recently posted on an episode my 3 yr old had with asthma. When he was having pretty severe symptoms and had to go to the ER, the nebulizer treatments were what finally helped them. I also coincidentally (as in like, not in a good way!) used to work at a respiratory specialty pharmacy that did mostly nebulizer prescriptions, and so I know a bit about how and why they work. Especially with infants, it is hard for the medication to get deep into their lungs because they don't yet know how to take deep breaths on command. The nebulizer vaporizes the medication and makes it easier to get into the tissue in the lungs. I know how you feel about the machine - it is scary because it seems like only really sick people need to use medical equipment (at least that is how I felt). But there is really no difference in using the inhaler or the nebulizer but for the way the medicine is delivered. It is a very standard thing for babies who are taking breathing medications to use nelulizers, in fact some doctors won't even think of giving inhalers to babies for the reason that the meds are not as effective, and therefore it is hard to tell if they are working as prescribed. As long as the doctor prescribes it, the insurance should cover it no problem.

And one tip, although it sounds harsh.... but if your baby is struggling with breathing and you think he/she needs the inhaler, they are much more likely to inhale the meds if they are crying. And please don't mistake me, I'm not saying make your baby cry, but just keep that in mind if they are crying it will help to give the inhaler at that time. Don't mess around if you are worried about your child's breathing and the wheezing is continuous, get your child to the doctor or the ER. It is so terrifying - I jsut went through this and it was really hard. You can read my post if you want, people had great advise for me. Best of luck!

A nebulizer produces a mist with the medication in the mist. So it runs for 5-10 minutes and the patient breathes in the mist through the mask. I would think a nebulizer would be substantially better than just an inhaler, even the type you have.

Even my son, who was almost 12 at the time, was given a nebulizer to take medication when he was recovering from pneumonia. Only got the inhalers for when he went back to school, because he couldn't very well haul the neb machine around at school for the doses he was supposed to take during the school day. (He was directed to dose every 4 hours for about a week or so, and he was cleared to return to school after 3 days at home).

Sounds like asthma.
Hopefully there are no smokers in your home. Any pets?

I have Asthma, since childhood.

During bad bouts of it, I have used both a nebulizer AND an inhaler and/or Prednisone.
There are many types of medicines which are inhaled and many types of inhaler meds.
Some are "corticosteroids" and some are not.

The reason a person wheezes, is because they airways are inflamed and thus, constricted. Thus, breathing is difficult. It is not due to mucus. It is the constriction of the airways. Thus, a person "coughs."

Inhalers, are as I said, different kinds. Some are "maintenance" inhalers, and some are "rescue" inhalers. Each has its own, behavior and purpose.
With inhalers, it is not a one sized shoe fits all. Each individual is different. Hence, some may use one type of inhaler, and another person uses another type.

Though wheezing/asthma can be triggered by environmental aspects, this is not always the case. Keep that in mind. And, some people get Asthma triggered, by having a cold or the Flu. Or by stress. Or when the weather is cold. And while "sick" with Asthma, it can also develop into Pneumonia etc. Because the lungs are weaker. So you must safeguard your child, while Asthma is in its active or acute, stage.
Keep her away, from people that are sick.

Bear in mind, that Asthma attacks are like being suffocated. The person cannot breathe. Hence, the body/blood stream/lungs, lack oxygen and the body is not properly oxygenated at ideal levels.
And you cannot predict, an Asthma attack. Or lack of breathing.

IF your baby, ever turns blue in the lips or fingernails... this MEANS, that the child is not getting, adequate Oxygen levels. And this is cause, for taking her to the ER. Pronto.
Likewise, if your baby is breathing very shallow and quickly and her lungs suck in... you NEED to get her to an ER. Right away. Or call an ambulance.

Also keep in mind, that per Albuterol based inhalers.... there is also, a liquid form. Which is often used for children.

ALSO keep in mind... that with Inhalers... these things are often, mis-used. Meaning, people often take too many "puffs", thinking that more is better. But that is false and not the proper rationale of inhalers. Taking too many puffs, can lead to overdose. Dosage, and proper use of inhalers, are very important.

You need to take your baby for a follow-up, or to an ER, or to a Pulmonologist.

You did not say, how old your baby is. But keep in mind, that baby's lungs are immature. And can therefore, be affected more. Baby's and children, sometimes display different symptoms, than adults.

Also bear in mind, that medications/Inhalers, sometimes you have to try different kinds, to get the best "fit" for your child.

Also, think about getting an air purifier for your home or for her room.

For a baby, they cannot use an "inhaler" properly or ideally.
Because, they are young and they need to exhale, then inhale it, then HOLD there breath for 10 seconds. A baby cannot do that.
Hence, maybe that is why, the inhaler is not working as well.

A nebulizer is a tool basically that pushes room air/oxygen through tubes into a little cup like device. The medication comes in a plastic vial and is mixed with sterile water. You twist the top off the vial and put it in the little cup like device. Then turn the machine on. The moisture from the water will often help the goo in the lungs to be moister and easier to cough up. The medication takes longer to get in and seems to me to just get where it's going and stay there better.

The medication is not so concentrated. It has less sudden side effects. Xophenex is really better for kids since it is purer and causes less side effects.

Sometimes I will buy just vials of sterile water from the pharmacist and use that without the meds. If I have a dry cough it is about the same as standing in the shower with the head set on steam.

I think the nebulizer works better for kids but it does take longer and sometimes they want the mask off their face and they will fight it. THIS IS GOOD TOO, the crying means they are breathing deeper so the med actually goes much deeper.

I am surprised that they gave your baby the inhaler instead of the neb. I thought the inhaler was for older children. My daughter has been using the neb since about 9months old and she is 4yr now. She only uses it during 2 seasons a year most likely due to seasonal allergies but she is on the pulmicort for preventative and albuteral as needed for a quick relief of coughing. I have never actually heard her wheeze but has it for coughs. I dont want to say what you hear isnt wheezing but I knkow when my daughter was little she would have rumbly in her chest and it wasnt wheezing it was junk that she couldnt cough all the way up and spit out so maybe that is what you are hearing. I dont really know just a thought.

Hi Momma,

My daughter used a nebulizer after several trips to the ER and urgent care with a bad case of croup. You can definitely request one, and should, in case you need to maintain her asthma.

I wish you good luck with this. It's really difficult to have to listen to your child wheeze and have a hard time breathing.

All the best,
L.
P.S. Just on a side note, the medical supply store will have all sorts of fun looking inhaler masks (ones that look like animal faces) if your child still needs one when your baby is a toddler.

Usually kids under 2 years old get the nebulizer. Yes it takes longer, and many kids hate it, but as mentioned, it has the added benefit of the humidity factor that goes into the airways and loosens up phlegm.The inhaled albuterol/xopenex and inhaled steroids are I believe licensed for bigger kids, not sure if 2 or 4 years old, but get used in kids of all ages, especially to have handy in an emergency or trip outside the house, where the nebulizer can't be used. The turbohalers like pulmicort or advair are for kids older than 6, since they actually have to forcibly inhale the puff of medication.Pretty much all insurances will cover a nebulizer in a kid less than 2, after that they may argue that they can use the mask and spacer with the inhaler (it's totally useless in kids, and even not very efffective in adults! without the mask/chamber). Like someone mentioned, are you completely sure the noise you are hearing is wheezing and not a lot of phlegm? Sometimes with coughing it clears right up, while wheezing won't. At any rate, if she is definitely wheezing, and by what you mentioned of coughing and wheezing spasms, it might, she should definitely be on a bronchodilator like albuterol, preferably xopenex, since it has less side effects like rapid heart rate and jitteriness, on an as needed basis, AS WELL as an inhaled steroid, like pulmicort/budesonide(generic) twice daily for an undetermined period of time, sometimes a few weeks/ months, sometimes longer. The steroids address the second part of the problem, which is inflammation of the airway. That is on top of the oral steroids that it seems she is almost done with (unless the steroids you mentioned she was almost done with are inhaled as well??) In which case, then she would benefit from a 5-7 day course of oral steroids.Usually the nebulizer has to be given either at the doctor's office or sent to you to your home by your insurance. If you go the ER or Urgent Care, they most likely can only prescribe the inhaler version of the medications. Good luck with your little one.

The nebulizer worked much better for my daughter. She started on it when she was 2yo and used it every day, sometimes every few hours, for years. We bought the nebulizer and put it to good use. It saved us from having to go to the emergency room and was worth the investment.