Expert: Marc Rubin, RPh Asthma Educator - 5/4/2010

Question
Our two children (age 2 and 7) both experience sudden and unexplained nighttime episodes that mimic asthma. They will wake up with a barking, croupy cough and wheeze with every breath. The next night there might be another less severe episode. After 1 or 2 days they are 100% better and might not have another attack for a month or more. The doctor described this as Intermittent Asthma and gave us albuterol treatments to administer at home. However they struggle so much not much medication gets to them. Would they benefit from having an inhaler to use during these attacks? Also, what might be the cause of these unpredictable attacks? They seem to come out of nowhere. We thought maybe an allgery triggered them, but then shouldn't they be having attacks all throughout "allergy season?"

Answer
Hi Anne,
You stated that the doctor gave you albuterol treatments to administer at home. What were his instructions for use? Was it with a nebulizer machine, or a metered dose inhaler?
You also stated that they struggle with the treatment. It is very important to bring on a sense of calm during an attack. Anxiety can worsen an attack. When it occurs, you need to communicate to the kids that they must calm down, and focus on breathing slowly, in and out. This will improve the treatment administration. You must also display that you are calm, or they will feed of your anxiety.

Pollen levels vary on a daily basis, which can affect the allergy response. If you go to http://www.pollen.com you can enter your email address & zip code and get daily pollen reports specifically for where you live. This may help in identifying the pollen(s) that are causing the problem. Keep in mind that it may also be due to dust, pets, cleaning agents, viruses, etc. An allergist can do testing to determine exactly the problem source. Asthma is a variable illness, and fortunately, not all patients have the same level of difficulty.

There is a great website for parents: http://www.aanma.org/  to help you understand asthma and guide your children. Also another site to use: http://www.aaaai.org

To find a local asthma specialist in your area, go to : http://www.aaaai.org/physref/

Hope this helps you.

Sincerely,

Marc