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Would you use nebulized albuterol on your 3 month old?

post #1 of 28
Thread Starter 
I need your advice mamas. DD's been seriously congested since birth. In a scary trip to the ER last month she was diagnosed with bronchospasm - lung inflammation characteristic of asthma. Her ped gave us a nebulizer with a drug called albuterol, for asthmatic children, although he doesn't necessarily think she has asthma.

I haven't used it yet, felt it was too harsh... side effects include tremors, agitation, palpitations, etc. Frankly, I'm scared to try it.

Instead, I got a super-powerful air filter and am using all the standard fare - aspirator, saline, humidifier. I am also seeing a ped chiro that says that her lymph drainage is blocked and he can clear her up in 3 weeks. It's been one week and today she sounds worse than ever.

I contacted Herbs for Kids... they don't reccommend their formulation for under 6 months.

I am sorely tempted to try the albuterol. I'm starting to feel irresponsible for not effectively treating this problem! :

Should I wait 2 more weeks to see what the chiro does? I'm skeptical even though he seems confident. Am I doing permanent damage to DD's lungs by letting her wheeze through her days?

Thanks for reading mamas.
post #2 of 28
you know my ds was diagnosed last week with bronchio-something (which is bronchitis in infants) from a cold virus that went into his lungs. he was so congested and phlegmy that if he started crying he sounded like he was choking. the ped gave us a prescription for albuterol.

i felt wierd about using it (thinking...does this mean he is going to have asthma? i know this is a stimulant. how bad is it?). but i did. very sparingly. i used it once a day for 4 days. they said i could do it every 4 hours (no thanks). after that he wasn't having labored breathing anymore. it helped

granted my ds is 10 months old and 25 lbs. they gave it to us in a regular inhaler form with a tube/face mask to put over ds's face to administer it. 3 months old seems young but with the nebulizer you could control how much she gets. only hold it in front of her face for a couple of seconds

i think you have to go with your gut. or maybe try it once and evaluate whether you think it is helpign or harming

good luck.
post #3 of 28
My DS was prescribed Albuterol for wheezing when he was sick a few months ago. He was 10 months old at the time and they gave us the inhaler with a mask attachment. He hated the mask being on his face and fought us like crazy the 1 time we tried it. He did get some into his system, just not the dosage they said. We didn't use it after that because of his reaction to the mask and the fact that he got pretty cranky after a little while.

I myself have asthma and use Albuterol at times (usually only when sick). It doesn't usually cause all the bad side effects you mentioned, but I will tell you from my own experience that it does cause me to be jittery (sp?) and sometimes I get a slight headache for awhile. I think DS had the similar effects.

I agree with the PP, go with your gut on this. The wheezing DS had cleared up on his own with the other remedies we were using, but I am in no way implying that you shouldn't do what you feel is necessary for her. The chiro thing may end up working BTW, but they usually take longer to get the desired benefits. (I'm a chiro user too).

Hope she gets to feeling better. Good luck mama!
post #4 of 28
I would use it -- asthma and lung inflamation is NOT something to be screwed around with. The fact that your DS has an inflammation now doesn't in any way mean he does or will had asthma later, but if you let his lungs stay inflamed, he could be at a much greater risk for developing it because it could damage the alveoli (the little air-exchange sacs in your lungs).

I would start with the nebulizer, but maybe with like half a dose, or a shorter period of time breathing (depending on what kind of nebulizer they sent you with and how it works...). Start small, and see if it's helping and what the side effects are and how he handles it -- and keep up everything else you're doing in the meanwhile.

Good luck to both of you, and I hope you're feeling better soon.
post #5 of 28
It sounds like your gut is torn between waiting out the alternative healing method, and using the quick fix. If the quick fix works... What I know about babies and lungs is that their lung tissue regrows completely every 3 days. If she's sounding worse, that probably means the infection is loosening up (if it's sounding looser). Which is GOOD! What you are doing is working.
Do yourself a favor and do whatever you need to to not carry any guilt. If you give her some meds to help clear up the infection, that doesn't mean that going back to the chiro for the final visits isn't worth it. Healthy vibes for you both!!!
post #6 of 28
I would use it. Not being able to breathe well can cause serious damage. My three year old has asthma and we do use the albuterol every four hours when he is sick (colds bring on his asthma symptoms). He was 8 months old the first time we had to use it. I hope your little one feels better soon.
post #7 of 28

I have asthma as a result of scar tissue in my bronchi from pneumonia I had when I was ten years old. If anyone could have done anything to prevent that scar tissue from forming (and thus prevent my very uncommon, non-allery-based asthma) I sure as heck would have wanted them to!

I would use it twice a day (morning and evening) assuming that she showed no symptoms in between. You can use it as often as four times a day, but if it's not necessary it's not necessary; my own albuterol prescription is prn. I'm with the previous poster: asthma is not something to mess around with. While your child is not technically an asthmatic now, it could certainly be in his future .

When I was pregnant, I was concerned about taking my albuterol until someone pointed out to me that every time I had an asthma attack, my baby was being deprived of oxygen, too. That snapped me out of it in a hurry; oxygen deprivation is much more dangerous to the brain and body than the albuterol is. The side effects you mentioned only happen to me when I have chest pain for a reason other than wheezing (in other words, when I'm not actually having an asthma attack, I've just pulled a muscle becuase I'm fat or I've got thrush or something). Very little of it is ever absorbed into the bloodstream, peek serum levels are very low. The effects of even brief oxygen deprivation are much more severe than the potential side effects of albuterol.
post #8 of 28
I am using the liquid form on my 6 month old 3 times a day right now. I, too, was very hesitant to use it. But even more scary is him getting worse and us going to the ER. So, we've been using it since Tuesday and I think he's getting better.

I'd use it. I don't mess around with lung stuff.
post #9 of 28
My babe was hospitalized at 3 months old with pneumonia last year. We had to nebulize him then, and also last month when he had RSV. Like PP's have said, you could use it sparingly if you're too worried about it, but I would definately use it some to ease her breathing.
post #10 of 28
Thread Starter 
It is probably worth mentioning that DD's bronchospasm is considered mild. Her oxygenation levels never dropped below 98 the whole time we were in the ER. Ped thinks it is mostly mucus stuck in her lungs that is causing the wheezies.

I decided to go ahead and try the albuterol about an hour ago. I did a full treatment, and didn't notice a difference one way or the other. Our ped told us to use it once a day, although the instructions on the prescription say "every six hours as needed". I don't know that it's ever "needed" because she doesn't have anything resembling an attack - it's just that she is ALWAYS wheezy sounding. I'm listening to her wheeze away right now as she takes a nap...

I was thinking of demanding that our ped refer us to an ENT specialist... we're on Healthy Families (medi-cal) so it may be difficult to get. But now you all have got me thinking that I need to be more proactive about finding something to clear this up!

By the way, I just found this article in Pediatrics that shows albuterol (both oral and nebulized) to be no more effective than placebo in treating infants with bronchiolitis:

post #11 of 28
I have, and did. But my ds's oxygenation level was low, and he was pretty sick with bronchialitis. (sp?) I did it every 4-6 hours until I couldn't hear the wheezing anymore. He did have some serious fussiness and agitation the first few days. But I was really worried. With a bigger kid, I have no problem with self treating. But it just felt off. Go with your gut, I say. (And ignore your pride, if need be.)
post #12 of 28
I would use it too. All my 3 older dc get asthma symptoms when they contact a flu. My dd2 was hospitalised more than once for respiratory tract infections which would not clear up except by iv antibiotics and ihalers (here they use ventolin as well). The problem with laboured breathing is that the oxygen blood saturation level becomes lower than normal, and it can become dangerous. I hate giving my children medications, but sometimes its necessary. If the wheezing is very bad, the dicomfort from not being able to breathe properly can be significantly higher than the side effects of the medications.
post #13 of 28
I didnt read other posts so sorry if I repeat. My dd was born with a lot of lung and liver problems. she was on oxygen for a few weeks after birth and later on, at about 9 mo, she had more problems. This time from phnemonia/rsv (not severe enough to hospitalize). We were given albuteral and a nebulizer. It was wonderful. we arent big on any type of drug but that is one that I would do again. She had none of the side effects but we got the results. We would only use if for 2 min, 3 times a day (we really only used it at bedtime) and almost instantly she would relax and start breathing better. For us it was totally worth it and helped to keep her out of the hospital.
IMO lung issues arent ones to wait around on, they are to scary.

good luck to you and your little one
post #14 of 28
I wouldn't. But then again, I am not in your shoes.

Do you BF? If so, cut out all mucus producing foods. YOu could also take some herbs yourself, under a naturapath or doctors guidance, and let them go through your breastmilk.

You have to go with what you are comfortable with and what your provider and you agree on treatment wise.
post #15 of 28
Originally Posted by darwinphish
It is probably worth mentioning that DD's bronchospasm is considered mild. Her oxygenation levels never dropped below 98 the whole time we were in the ER. Ped thinks it is mostly mucus stuck in her lungs that is causing the wheezies.

I decided to go ahead and try the albuterol about an hour ago. I did a full treatment, and didn't notice a difference one way or the other. Our ped told us to use it once a day, although the instructions on the prescription say "every six hours as needed". I don't know that it's ever "needed" because she doesn't have anything resembling an attack - it's just that she is ALWAYS wheezy sounding. I'm listening to her wheeze away right now as she takes a nap...
If she's wheezing when she inhales (as opposed to when she exhales) then you're probably not hearing asthma. She needs something to help her get the mucous out, not to relax the bronchi that aren't in spasm. I don't know of any expectorants that are safe for infants, though. Have you tried something like that kid's Vick's Vap-o-Rub plug-in thingy?
post #16 of 28
I would use the nebulizer and see if it helps. If she needs it, she probbly won't have the side effects. I only got jittery or racing heart if I used it when i didn't really need it. I would STAY AWAY from the liquid form if at all possible. I've had to use the oral albuterol (pills as I was old enough to swallow) and they gave me awful nightmares. It took me 3 days to figure out that's wht was causing them. I use the inhaler w/no probs.
post #17 of 28
If it were my child, I absolutely would not use the albuterol. I probably would refuse to see a doctor again who had tried that as a first thing, too. However, this is YOUR child. We're all just giving what we'd do in our shoes in a similar situation.

I assume you are exclusively breastfeeding. I didn't eat any of the standard-knowledge mucus producing foods (milk, wheat gluten, unfermented soy). If my child had been unusually stuffed up at that age (apparently, most newborn babies are a little mucusy, I've been told), I would have started drinking large amounts of elder (for the upper respiratory tract) and horehound (for the lungs) teas, along with plenty of galactogogues, like nettles, red clover, and oat tops. I would eat lots and lots of oatmeal -- without milk or cream.

If you are not exclusively breastfeeding, I would switch from a cow milk or soy formula to one made from goat's milk.

Our paediatrician recommended chiro body work at our pixie's first appointment (7 days after birth) just as a prophylactic for the birth trauma. He had a rough ride and too much poking and prodding right after birth and the paed. just thought it would be a good idea. Seemed to work well.
post #18 of 28
If is is just mucous, I wouldn't use it. But if your DC's airways are constricted, and you can hear a lot of wheezing and labored breathing (which sounds different from mucous rattling around), then I would use it.

My DS has had lots of colds, and during one, when he was about 4 mo, his breathing became wheezy and labored. The ped recommended humidifiers and sessions in a steamy bathroom at first. When that didn't help, DS had trouble sleeping and sometimes coughed until he vomited. So he was not well rested and not well nourished, thus would have trouble getting better. The ped then gave us (and we used) albuterol with a nebulizer, and after the first couple uses, DS went right to sleep (!). He needed sleep so much that it outweighed the stimulant effect. After that we just gave him a partial dose, and then later, used plain saline solution with the nebulizer to moisten up his lungs. It worked well, we had no problems, and we've never needed it again.

I read/heard the same thing that PPs have said - not dealing with lung infections in infants can lead to scarring and reduced lung function later. (I searched for read some original studies on this by doing a search on PubMed). To me, that concern was too serious to ignore.
post #19 of 28
A pediatric pulmonologist would be a good choice instead of an ENT...an ENT usually stops at about the level of the larynx...
post #20 of 28
Thread Starter 

rynna - now that I'm listening for it, it seems like she is wheezing only on the inhale, not the exhale. Jennifer - It sounds "junky" - like a bunch of stuff rattling around in there. but she only coughs/chokes when the nasal drip goes down her throat... she's not expectorating any if it. I put vicks babyrub on her everyday. We've also tried a 1/4 dose of children's benadryl - no effect.

hotmamacita & sohj - I cannot ebf. Thanks to a weeklong separation and severe illness at birth (her NICU w/anemia, me ICU) I never established a good supply. With the help of intensive pumping, herbs, domperidone, oats etc I am able to provide about 50% of her daily needs... the rest she gets a combo of donated breastmilk () and partially hydrolyzed cow's milk formula. I was planning to switch to horizon organic when she's 4 months... is there a reason that goat's would be better? I'm a little wary of adding more herbs to MY diet given what I'm already taking!

I am really worried about the future of her lungs but sort of stumped as to what to do. I feel that taking her back to the ped (or a pulmonologist -thanks for the clarification Janel!) will lead to more drastic interventions and I just feel like she's already had too much suffering from (albeit necessary) medical treatment.

I'm still just sort of stumped. I wish my gut had a clear answer for me!
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