My two year old got diagnosed with this last week and was given an inhaler. It isn't working out well. Going back to a different pediatrician today. Anyone else dealt with this? If so, how long did it last and what medications was your LO given? When did you start to see improvement? We've had coughing for 6 weeks now, inhaler for over a week.
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A few times between my LOs. Albuterol nebulizer treatments, inhalers, humidifers....it usually lingers for 3-6 weeks for us.
I hope your LO feels better soon! -
Bronchiolitis is not treated with beta-agonists (albuterol). The best treatment is suction and oxygen if they need it. Hopefully you have a Nose Frida or it's equivalent.
There are new AAP guidelines on bronchiolitis that encourage providers to stay away from albuterol and steroids. Sorry your provider hasn't caught up to the recommendations.
Watch for signs of dehydration and respiratory distress. Let me know if you have further questions.
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When my LO had it, her cough lasted for at least a month after we started treatment. My Ped also said take her out in cold air if we could, as it helps the constriction of airways or something?
It sucked and LO was up 4-6 times a night coughing and crying for literally months (because as soon as she started getting well, she got another virus at daycare and was basically sick from January-May with no more than a 2-3 break of wellness occasionally.
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@Mrs. Jacks: INTERESTING. Albuterol is just what we were given...though my aunt is a respiratory therapist and she said that's what they generally give. We do live in a rural area, though, and I'm not always sure we get the news very quickly here. The advice nurse on the phone seemed to think some sort of oral liquid might be available.
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@Anagram: Oh man, that is exactly what I'm afraid of--endless illness! Although cold air seems to make his cough worse, so we've been avoiding it.
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@Eminthevalley: we were given it last year, too. It did help Los sleep slightly better, somehow although most kids get hyper.
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@Eminthevalley: it seemed to help my LO 1 when she had it 2 years ago. LO 2 used an inhaler more recently...I'm not sure what the med was!
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@Eminthevalley: I should blog on the new guidelines. Here they are for you to read, but news does move slowly in the pediatric world. We academics tend to learn about these things first.
http://pediatrics.aappublications.org/content/early/2014/10/21/peds.2014-2742.full.pdf+html
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@Eminthevalley: I second @Mrs. Jacks: My LO has had it more than once and ends up hospitalized because she can't keep her O2 up, but at the hospital all they do is suction (sometimes deep suction) and O2.
We LOVE the Nose Frida to decrease all of her symptoms once we are home. -
@Mrs. Jacks: After reading all of this I don't even know if he has bronchiolitis! It was a not our normal pedi we saw last week as we went to urgent care. We'll see what our regular doc says today...we do not have a Nose Frida, but his nose isn't very stuffy. It more of the cough + a lot of congestion in his chest. Would a Nose Frida help with that?
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@Eminthevalley: It wouldn't help so much. I hope your regular provider is able to help you sort it out and help your little one feel better!. B'litis usually only lasts about 10 days to 2 weeks, peaking at day 5.
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@Mrs. Jacks: Thanks for your help! Hm, he's had it for about 6 weeks. Although it's hard to tell if it's all one thing or if he is just getting one virus on top of another, because he has had a day or two here and there with no coughing. I HATE winter!
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@Eminthevalley: Most likely it's multiple infections. There is a viral respiratory panel that we run to tell you exactly what it is. But they probably don't have that in rural areas either.
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@lizzywiz: I'm so sorry you had to be hospitalized. It really sucks... pun only sort of intended.
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@Mrs. Jacks: Man, there is a lot of sucking involved! I never realized how much snot pediatric nurses deal with. One time, since we had been down the road before, they were going to discharge us with oxygen and I was secretly glad they didn't because it gave us more time for the nurses to do the sucking instead of me
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@Mrs. Jacks: I didn't know those were new guidelines! That's been the case in my experience for the 7 years I've worked at a children's hospital. Sometimes albuterol seems to make bronchiolitis worse!
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@lizzywiz: I am not looking forward to the first time my new baby gets sick! I'll be so frustrated without my wall suction I am used to having at my disposal at work
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@Mrs. Jacks: my sister's 3 month old has it currently, and they have been given a nebulizer (I think) to give her every 4 hours. I sent her the PDF--thanks for sharing.
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@junebugsmama: In the academic medical setting, we've already been practicing this way (at least from the time when I started training in 2000)... but it just hasn't disseminated outside the ivory tower. So a group convened last year to create the guideline after careful review of all the evidence. Some colleagues of mine were actually on the committee. It was great that they formalized the approach that was supported by all the evidence and had been ignored for so long by all the pediatricians who felt like they just had to do something like albuterol and steroids....
And yes, albuterol can make things worse by creating V/Q (ventilation: perfusion) mismatch that makes the child transiently hypoxic (have low oxygen for a period of time). It can also cause a child to be unnecessarily tachycardic (fast heart rate) due to the beta agonist effect. (translated into English for those who aren't medical, not for junebugsmama!)
I'll definitely have to write a blog post on the topic so that at least our hellobee mamas are informed and can educate their pediatricians!
Can you tell bronchiolitis is my bread and butter
?
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@Mrs. Jacks: you should write a post! I noticed there have been like at least a post per day about rsv lately and I bet that happens every year!
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This is all very interesting! @Mrs. Jacks: Are there still viruses for which prescribing albuterol is indicated? DS had a respiratory virus a few months ago (possibly one of the enteroviruses that were going around) and was prescribed a small amount of liquid albuterol. I'm curious whether my pediatricians are up on the latest medical research.
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Following because I'm curious about albuterol use and LO has what I think may be bronchiolitis.
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wow, this is so helpful! LO was diagnosed with bronchiolitis and an ear infection yesterday -- yay for daycare! *sarcasm*
He is 4 months old...I feel so bad for the little guy, but he seems content. The coughing sounds awful, but only wakes him up in the middle of the night -his naps are fine otherwise. Mom and dad, on the other hand, can't sleep at all because we're waking up every time he coughs.
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@Beehive: Liquid albuterol is no longer really used for children. Sometimes kids have reactive airway disease in response to a virus (they especially did with Enterovirus D68), but under the age of two, albuterol is less likely to be effective. If there is a strong family history of eczema and asthma and the child is definitely albuterol responsive, there are rare cases where it may help.
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@Mrs. Jacks: when you say liquid albuterol, do you mean via nebulizer? Interesting because D's GI docs prescribed him albuterol but when we went to see pulmo they stopped it in favor of atrovan and pulmocort (neither of which is accomplishing anything from what I can tell but that's another story). Sorry to threadjack!
@Eminthevalley: I was going to recommend you talk to @lizzywiz: - glad she's already chimed in!
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@Mrs. Tiger: no I mean the syrup that you give by mouth. Totally ineffective, maybe dangerous.
The atrioventricular is to dry up his secretions which I can see might be helpful in your case and the pulmicort you won't see the effect, because it works over the long term, but it's important to keep giving it :). His issues are slightly different than these other kids.
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@Mrs. Jacks: Thank you, that's so interesting. No more liquid albuterol then!
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An update...took the little guy to the doctor and it is most likely allergies! What??? Could also be multiple viruses caught one after another. He got tested for RSV & flu and those came back negative--I think that means no bronchiolitis? Waiting on his chest x-ray results. I opted to test for everything because I didn't want him to be given another medication without knowing for sure what it is.
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