Toddler & respiratory problems

[hoosll]

16 month old - we are now entering the second winter with wheezing, steroids, etc.

The problem is that as a toddler he is resisting the things that can help him...

Does anyone have any ideas for getting a toddler to accept his nose drops, inhaler, aspirator, etc.?

 

[KristaTX]

Have you taken him to see an allergy/asthma specialist just to find out exactly what is causing his symptoms? What preventive medications is he on? He may already be on everything he can be prevention-wise, but if he's not, that might help control the symptoms and help prevent acute situations.

 

[kellyg403]

16 month old - we are now entering the second winter with wheezing, steroids, etc.

The problem is that as a toddler he is resisting the things that can help him...

Does anyone have any ideas for getting a toddler to accept his nose drops, inhaler, aspirator, etc.?

In my experience, my ds14 is a severe asthmatic and has had problems since about his 2nd month of life. We went through times where he was really good about his medicine, and times where it was tough to give it to him! We found during the hard time...around 16 months to 24 months..if we made it a quiet time, read a book during his treatments. We spaced out the oral meds..steriods etc so that we weren't giving all his meds at the same time. The nose drops and aspirator..thats a tough one. I wouldn't want those as an adult! I know the dr. said the crying and fighting part are actually good because it opens the lungs to take the meds better. Ds was always pretty good about most things, but he cried during the nose drop/aspiration part until we stopped around 2 1/2. At that point, we were able to learn the blow our nose technique!

Good Luck..I know how hard it is.

Kelly

 

[hoosll]

Yes, we have done that. The problem is to try an administer his meds, etc.

He fights us now, whereas when he was an infant he was easier to handle ...

He is very verbal, I hoped someone might have some strategies that have worked with little ones.

 

[Pixie Dust for Me!]

I used to have to give my DS prednislone syrup which trust me is pure evil! It would hit the back of his mouth and he would then projectile vomit. Now he takes a "melt away" form of prednisone that he can actually take!

My only advice is to maybe give him a bit of control over when he takes the medicine. What I used to do is tell my DS when he was 3ish that he had to take his medicine and that I would set the timer and he needed to take it before the timer went off or he would have a time out. I told him that no one likes taking medicine but that we have to do it from time to time. I also made sure to take my yucky tasting medicine (like cough syrup) in front of him and make a horrible taste so that he wouldn't think that my medicine tasted good. I also made sure to have a "chaser" that he could have right after taking his medicine (like a juice popsicle or his favorite juice or something) to "chase" the bad taste away.

Now with the nasal drops and aspirator...I just told him that it HAD to be done and that afterwards I would play his favorite game with him or read his favorite book to him!

Good luck!

 

[kellyg403]

I used to have to give my DS prednislone syrup which trust me is pure evil! It would hit the back of his mouth and he would then projectile vomit. Now he takes a "melt away" form of prednisone that he can actually take!

Good luck!

And that is the truth! I made the mistake of saying..here let mommy show you its not so bad. My goodness I could taste that stuff for days! If it wasn't for the fact they have to have it, I would have stopped giving it that day just on taste alone.

OP, is it an option to possibly give the treatments when he is sleeping? We did this with ds. His first treatment in the morning and last treatment at night we took the mask off and did a "blowby" while he was sleeping. The dr said this was an option since they take deeper breaths when sleeping. That might help alleviate some of the fighting. Those masks seem to bring out the worst in the kids since they don't like to be confined. My grandson is probably the best baby I have seen take his treatments. He will be 2 in Nov and he straps that mask on and plays with his toys like its another day in the park. Hopefully, your guy will learn its o.k. and eventually learn to take it without fighting.

Kelly

 

[Green Tea]

That was a tough age for the neb. But, as hard as it is to watch them so upset when the mask is on, they are getting the medication into the lungs really well when they are upset.

 

[SandrainNC]

My youngest was about 16 months when he started having to get the nebulizer treatments. He would scream and have fits and I had to hold him down (which was not fun for him or me). Once he start to cooperate more and wasn't crying, our pediatrician insisted we use the mask. The mask still made him cry and scream. I asked the respiratory specialist at the hospital (he had pre-pneumonia or something like that so was admitted for a few days) which is better - the mask and screaming or me blowing it in his face and his not screaming since that is what they do at the hospital - just blow it in their face. She said the ideal of course is him putting it in his mouth, but the blowing in his face was better than his screaming and crying with the mask because he would be taking shallow breaths and the medication doesn't go into his lungs. I have had a few doctors say that when they are crying the mediation works better, however the respiratory specialist said that is not true. She said hardly any medication gets in when they are breathing shallow when they are upset, which makes a lot of sense.

We started letting him hold it himself and that seemed to make him happier. We sit him in front of the tv and hand him the nebulizer thingy. He does really well now.

Sandra

 

[JessicaR]

I totally sympathize with you. I can remember being where you are now and it was very frustrating and stressful.

Maybe some of this will be helpful.
Nebulizers that are newer can reduce the time they need to sit. It used to take us about 20 minutes to administer a full treatment now with the newer compressors its like 5 minutes.

Get some longer tubing and move the machine far away from him. The noise the machine makes could upset him. We used to hide it too.

When my son was old enough to reason with we made up games that involved him having to wear the mask, called him super hero and space characters.

When he was out of sorts and really sick we especially needed him to stay calm so when he fought us we did not force the mask issue and we placed the tube at his mouth and nose and I cupped my hand around it. It does work!

I always read to him his favorite stories or we watched his favorite movie. I also allowed him to pick a treat for after the treatment and he looked forward to that sometimes. I would have small surprises kept in the house as rewards.

Remember when you get uptight they do too! Try your hardest to not let him see you stress.

Sometimes he would cry through the whole thing and I learned that when crying they grab more air and more albuterol as well. Tears are not always a bad thing.

Also try holding him in your lap prior to the treatment sometimes that relaxes them enough to get through it.

Eventually they comply It takes time and soon they just know its helping them and they need it.

What kind of nose drops? My son was on Nasonex and I would just lay him down and kinda just do it no warning since that worked him up tremendously.

My son had/has issues with liquid oral medications and would immediately vomit after getting the dose into him. Finally and it was ridiculous the only thing that worked was administering it with a dropper into his cheek bit by bit over a period of about 1/2 and hour. I was Queen of mixing it with whatever the doctor said I could to disguise the taste. Eventually he learned at a VERY early age to swallow pills and thank God for that.

If I think of any other things that may help I will post again! You are not alone. Hang in there Mom it will get better.

 

[mookie]

You got some great advice here. My ds is also on a neb in the winter mos. He's 16 mos too!

Last year, the first week was rough. Once he got into the routine, it made it a bit better. I ended up doing it at night right before bed. I'd put on his favorite show, and even though he'd fight me for a few minutes (wrestling is more like it!) he eventually calmed down, watched his show. A few times he even fell asleep!

I'll probably start up with the treatments again next week, so I'll let you know how it goes. my guy is pretty stubborn, and now that he's bigger, we might be in for a long process of settling in with another season of the neb.

 

[eh24fan]

My 21 month old has to do the nebulizer thing too. The very first time was in the ER and he loved it! He was fascinated by the hose and tube blowing the "smoke" in his face. He was about a year old at the time. At 16 months, when he started having to do it at home due to bronchiolitis AGAIN, he was less than happy about the situation. Now, he's more receptive to it, as long as we let him hold it in front of his face. Yeah, he tends to wave it around more than he should and tends to keep it too far away from his face. But the way we see it, some is better than none. None is what we get when we fight him and force him and hold him down while he screams.

We never had a mask for him. He has only ever had the tube thing. A mask would never fly with this one.

 

[Mickey'snewestfan]

DS was on the nebulizer 4-6 times a day from about 2 months on, so he was very used to it by your son's age. However, that didn't mean that he wouldn't get bored and try and resist. We did 2 things that really helped:

1) The TV only came on when the nebulizer was on -- usually this was a distraction.

2) We did many of his treatments when he was asleep. His doctor was the one who pointed out that we didn't need to wake him up for middle of the night treatments -- the logical next step was to wait for his bedtime treatment until he was asleep, and to try and sneak one in before he woke up in the morning. Daycare didn't really have the manpower to hold him for 20 minutes, so they always did his midday treatment during naptime -- it worked like a charm.

Good luck!

 

[RNMOM]

Be gentle but firm. Health and safety are not bargaining issues for children, IMHO.

Hold him while he is getting nebulizer treatments, try to distract him with reading books, gently play and such. Nose drops suck. I know this from experience. They tickle and itch. Try putting the drop against the inside of the nose just inside the opening and allow it to run down.

Any medications you might just have to force him in the beginning but soon he will begin to understand he has to do this and hopefully will become more relaxed. Do set up a reward program if you like that technique. I used to give my youngest son 3 M&M's in a paper cup with his meds. If he took the medicine, he got the reward. It helped to get the taste out of his mouth and was a reward. If he was particularly grouchy I would let him choose the color of candy he got. Kids just don't like control taken from them especially when they are just beginning to discover they have some!

Always follow any medicine or treatment with a big hug and a thank you. Try really hard to always end it on a warm fuzzy note even if you are ready to ring their little neck.

Good luck and if all else fails, talk to your doctor. There might be options.

 

[Aristomommy]

Yes, we have done that. The problem is to try an administer his meds, etc.

He fights us now, whereas when he was an infant he was easier to handle ...

He is very verbal, I hoped someone might have some strategies that have worked with little ones.

For DD and DS, the nebulizer wasn't a problem. When you say an inhaler, do you mean a nebulizer or do you take an inhaler with a spacer? I would think with a young child it would be a nebulizer. Anyway, DS liked to pretend he is an airplane pilot or driving a tractor, which helped him focus. We also got a mask that looks like a dinosaur, which distracted him. Our Pulmonologist has great books about asthma and one of them talks about medicines, wheezing etc. in kids terms. I'll try to find the title for you.

The steroids taste nasty and take your breath away. I found out not to get the generic, but always insist on the pediatric version like Orapred that has a better taste. Put it in the fridge and it masks the taste. Have your DS eat something first and it will not come up as easily. Also, use a syringe instead of a cup or spoon so you can squirt the medicine further into the mouth.

DS hates any kind of drops and sprays. Sometimes we have to hold him down and he will not like it. But he has gotten better, because we don't "give him an option" so to speak. I remain calm and explain that medicine is to make him feel better and Dr. so-and-so wants him to take it. We also did sticker charts, or talked about plans for after the medicine.

HTH

 

[Poppinsme]

I'm a Registered Respiratory Therapist (21 years). My specialty is children. I work NICU/PICU. And I have Asthma/Bronchitis.

Myth: The worst thing you can do is have a child scream when they are taking a breathing treatment. The bronchodilator is NOT getting into the lungs because you are screaming or crying. Think about it. All your air is being cried or screamed out. They have done many tests on this and it has been proven that you don't want any crying or screaming.

Use a blow-by if possible on children who cant handle a mask. A blow-by is just holding the mask or blue corrugated tubing close to the face and letting the aerosol blow into the nose or mouth. Babies are nose breathers and do well with blow-bys. Thats what I use on babies.

MDIs(puffers, inhalers) are fabulous for treatments of Bronchodilators. If the child can handle this. We give treatments to babies with a mask and spacer and the little ones handle it quite well. Also it IS the best way to give a breathing treatment, period. Better distribution to the lungs if done correctly.
I have taken 8 hits(puffs) on my MDI to get relief from an Asthma attack. Whatever it takes.

Nose drops are always hard. No good answers for that.

We also use a dragon mask at work. The mask is in the shape of a dragon head and sometimes this really makes the child think they are taking a "cool" thing. Ask your pediatrician for one. We also try to take the babies mind off of the treatment, distraction, make it a good pleasant thing if possible. It can really be hard. And as a child you have times like I did when you got sick of the dreaded treatments.

 

[RNMOM]

Poppinsme, I have to ask for clarifycation about the number of puffs you have taken. 8 did you say??

It is possibly to overdose on albuterol and using more than prescribed can be lethal. Perhaps we could clarify this?

Here are a couple links regarding overdose.

http://asthma.emedtv.com/albuterol-inhaler/albuterol-inhaler-overdose.html

http://www.rxlist.com/cgi/generic/albut1_od.htm

 

[Mrs. Chamberlain]

And that is the truth! I made the mistake of saying..here let mommy show you its not so bad. My goodness I could taste that stuff for days! If it wasn't for the fact they have to have it, I would have stopped giving it that day just on taste alone.

I know. The taste is terrible. I've been put on prednisone a few times. When I was little, my mom tried to put it in ice cream and I would eat around it. (I had the prednisone pill) I hated it. It's hard to have asthma when you're smaller. I remember that I didn't have enough of an attention span to do anything. But it will get better.

 

[lsherman]

my son had to start taking neb treatments when he was 13 months at the time he loved barney so we had him hug bareny really close while we gave barney med and kida drifted it towards my son.

you should take him to allergy dr, for 6 years it was in and out of hospital just because he was only giving him cold med and not checking what is acsually causing the problem.

We now know he is very allergis to mold, which we lived in a old trailer that had mold problems underneath the furnace.
and mice, several different trees, pollen , rag weed, and a few other things.
he is now 9 and last school year he was in public school and they had a class pet, that sat next to his desk, and his asthema was horrible, then kids were teasing him saying his coughing is annoying, and he kept throwing up everyday. The teacher claimed it ws not from there gerbil in the class room. I took him to the dr and they said his lungs were over half way shut down. his lungs were in the condition of an 80 year olds.
We then put him in a rpivate school and have not have any trouble with his asthema since.

Sorry so long just get him checked to see why this is happening to him, itis very scary.

 

[SandrainNC]

Myth: The worst thing you can do is have a child scream when they are taking a breathing treatment. The bronchodilator is NOT getting into the lungs because you are screaming or crying. Think about it. All your air is being cried or screamed out. They have done many tests on this and it has been proven that you don't want any crying or screaming.

Yep, that's exactly what the respiratory therapist told us at the hospital.

Sandra

 

[Poppinsme]

Poppinsme, I have to ask for clarifycation about the number of puffs you have taken. 8 did you say??

It is possibly to overdose on albuterol and using more than prescribed can be lethal. Perhaps we could clarify this?

Here are a couple links regarding overdose.

http://asthma.emedtv.com/albuterol-inhaler/albuterol-inhaler-overdose.html

http://www.rxlist.com/cgi/generic/albut1_od.htm

This is late because I just worked 4, 12 hour shifts.

In an emergency situation with my asthma I WILL take how ever many hits on my MDI that I need to open my airways. It could be life or death for me. Yes there is always possibility of an overdose with any medicine. But I know how critical it is to breath as quickly as possible and get to an ER. At an ER I can get an hour long treatment or back to back treatments with steroids. My dear Friend who was a Respiratory Therapist and who had severe asthma died in the parking lot of a local hospital because he couldn't make it to ER. In a life or death situation I would not hesitate to use my MDI. Also in many ERs they give now multiple doses of MDIs to patients. It works.