Constipation means painful hard bowel actions. This is common and the right advice will avoid long term problems. Understanding constipation is essential to ensure an appropriate treatment plan is developed to help fix this. There is lots of inappropriate advice and suggestions surrounding childhood constipation which can delay proper management
Between the ages of 12 months and 5 years many toddlers and young children will experience ‘wheeze’ associated with a cough and runny nose. This is similar to asthma and responds to asthma treatment which involves giving ventolin given via a spacer device and mask. Occasionally some toddlers will require preventative medication. Hospitalisation is sometimes needed if oxygen is required.
What causes the wheeze ?
A simple cold virus, will interact with the smaller airways of toddlers, resulting in inflammation. This leads to the formation of tiny bubbles. When breathing air in and out, these bubbles burst and reform, much like the squeezing of a wet sponge. This is wheezing. If there is a large amount of inflammation (similar to a wet sponge), there will be increased work of breathing. This condition can occurs in up to 30% of children.’
Is this asthma ?
This condition is called preschool asthma. However many children will grow out of this by the time they are 5-6 years of age. Asthma continuing into primary school will usually occur in children who have other asthma triggers. These include allergies, exercise, changes in weather and even emotion. For daycare’s and early childhood, calling it asthma is acceptable and using an ‘asthma management plan’ is appropriate.
How to treat wheeze in toddlers
Treatment involves opening the airways with ventolin which is given by a mask and spacer device (see pic). The technique is important to ensure a tight seal around the face. This sometimes requires a firm hold which can be frustrating for parents when dealing with a fractious toddler. See Royal Childrens Asthma Videos for some tips on how to correctly use the mask and spacer. Make sure the mask is of good quality (silicon) and the spacer is the small type. The dose of ventolin tends to be between 3 – 6 puffs. Each puff delivered separately with 3-5 breaths between each puff. Frequency and amount of ventolin given depends on the severity and is indicated in the table below.
Assessing wheeze and cough
The toddler or child will start coughing when suffering from a cold. The cough will sound slightly moist and initially breathing will be unaffected. However in some instances there will be shortness of breath. This is assessed by carefully watching the breathing. Assess the effort involved in breathing and use exercise as an analogy. So a mild increase in chest movement is similar to someone walking, moderate is how someone’s breathing looks when jogging and severe is what someone looks like who has just been sprinting. The table below summarises this.
How to assess and manage wheeze
Severity
Assessment of wheeze
Treatment – using ventolin administered by mask
Ongoing treatment
Mild
The breathing appears similar to walking – your child will be comfortable, but there maybe a slight increase in rate of breathing and effort. Talking is still easy without pauses for breaths.
Give ventolin, 4 puffs, every 3-5 hours depending on response and whether there is improvement or deterioation
As the wheeze and cough disappears the ventolin use can be weaned. If still slight cough, then continue two puffs of ventolin twice per day
Moderate
Breathing appears similar to Jogging – your child will still be comfortable, but the chest is moving more than usual and talking requires pauses for breaths.
Give ventolin 6 puffs initially every 1-2 hours. If improvement noted move to mild treatment. If deterioation then move to severe treatment and seek urgent medical help
Contine to use ventolin frequently. If there is limited response sometimes prednisolone is required to help with the inflammation. Seek medical advice if treatment appears to be not working.
Severe
Breathing appears similar to Running – your child is clearly short of breath, talking is difficult and there is considerable effort with each breath.
Give 6 puffs of ventolin. This can be given quite frequently (every 20 minutes) and urgently seek medical help. Do not hesitate to call an ambulance.
Severe attacks that result in hospitalisation often require preventative treatments. These are safe and effective and lessen the severity and amount of medication required.
What preventatives are useful ?
Flixotide – This is an inhaler to be used with a spacer and contains a low strength inhaled steroid. This is extremely safe and effective when used as directed. It can take a 2-3 weeks to work. The usual dose is one puff twice per day but sometimes two puffs twice per day are needed.
Singulair – This chewable tablet can be given to toddlers over the age of two years. Unfortunately there is a rare but definite association with behaviour problems in some children and currently has a warning attached. It works to block some of the inflammatory chemicals released by the airways in response to the virus. It is not a steroid. It is generally used as an additional treatment to flixotide in those who have quite severe or persistent asthma.
Some Facts about wheezy toddlers.
If your child has wheezing in response to exercise, changes in temperature, allergens such as dust mite, it is more likely to result in longer term asthma.
Sometimes recurrent episodes need to be prevented. The primary preventer recommended is an inhaler called flixotide.
Influenza A is a common trigger for particularly severe episodes, so annual vaccination is strongly recommended.
Passive smoking will certainly contribute to this condition.
Ventolin syrup has no effect on wheezy toddlers.
Beware of alternative treatments and their claims. There is no evidence that wheat and dairy have any role in viral induced wheeze.
https://childhealth.com.au/wp-content/uploads/2015/03/shutterstock_219961792.jpg7141000scotthttp://childhealth.com.au/wp-content/uploads/2013/11/childhealthlogo.pngscott2018-12-12 04:25:512024-04-14 21:40:30Wheeze in 1-5 year olds – Preschool Asthma
How Do You Catch It? The virus is spread when infected mucous is sneezed or coughed into another child’s face or onto table tops or objects such as toys. Infection occurs when the child touches these surfaces and then his/her eyes or nose. Illness begins about 3 to 7 days later. The illness Bronchiolitis […]
Gastroenteritis refers to vomiting and diarrhoea. The cause is usually viral and it represents one of the most common reasons for seeing a doctor. The treatment involves oral rehydration therapy to avoid dehydration.
Cough is an essential way in which the lungs expel unwanted material. It is a protection for the more fragile areas of the lungs. Unfortunately cough can be distressing particularly during the night. There is little role for cough medicines in children though they are marketed very well. The most common cause of cough is a simple viral bronchitis after an upper respiratory tract infection.
Pneumonia implies an infection that has infiltrated the tissues of the lungs. In children the most common cause is viral, but often it is difficult to determine whether bacterial or viral. In more serious cases the child will need hospitalisation for oxygen and intravenous medication. The vaccine prevenar has dramatically reduced the incidence of pneumococcal pneumonia, which was the most common cause of life threatening pneumonia in children. Hib vaccine is also effective against a bacteria called haemophilus.
Croup is a barking cough caused by a virus that infects the larynx. Sometimes the larynx is so inflamed a noise called a stridor occurs, which can be quite distressing and if severe will require treatment in hospital.
Colds, also known as upper respiratory tract infections affect everyone, particularly during the winter months. Some children suffer middle ear infections, wheezy respiratory illnesses and other complications. This article aims to educate parents on managing these frequent viral illnesses.
Constipation The definition is pain and discomfort when passing a bowel action. Young children for a variety of reasons can have a period of constipation, and they will suffer intermittent abdominal pains. This often occurs at the start of prep or grade one, where ‘bowel routines’ are put aside, due to being too busy, having […]
https://childhealth.com.au/wp-content/uploads/2014/01/shutterstock_125563262.jpg1000814scotthttp://childhealth.com.au/wp-content/uploads/2013/11/childhealthlogo.pngscott2014-01-10 04:35:032024-02-16 14:41:34Recurrent Abdominal Pain In Children
Children often complain of abdominal pains and ascertaining whether the cause is serious can be difficult. This is a common reason to seek medical advice. This article helps to decide whether the problem is severe enough to warrant a trip to the doctor. Click here to see the article on recurrent abdominal pain. How does […]
Constipation
Constipation means painful hard bowel actions. This is common and the right advice will avoid long term problems. Understanding constipation is essential to ensure an appropriate treatment plan is developed to help fix this. There is lots of inappropriate advice and suggestions surrounding childhood constipation which can delay proper management
Wheeze in 1-5 year olds – Preschool Asthma
Between the ages of 12 months and 5 years many toddlers and young children will experience ‘wheeze’ associated with a cough and runny nose. This is similar to asthma and responds to asthma treatment which involves giving ventolin given via a spacer device and mask. Occasionally some toddlers will require preventative medication. Hospitalisation is sometimes needed if oxygen is required.
What causes the wheeze ?
A simple cold virus, will interact with the smaller airways of toddlers, resulting in inflammation. This leads to the formation of tiny bubbles. When breathing air in and out, these bubbles burst and reform, much like the squeezing of a wet sponge. This is wheezing. If there is a large amount of inflammation (similar to a wet sponge), there will be increased work of breathing. This condition can occurs in up to 30% of children.’
Is this asthma ?
This condition is called preschool asthma. However many children will grow out of this by the time they are 5-6 years of age. Asthma continuing into primary school will usually occur in children who have other asthma triggers. These include allergies, exercise, changes in weather and even emotion. For daycare’s and early childhood, calling it asthma is acceptable and using an ‘asthma management plan’ is appropriate.
How to treat wheeze in toddlers
Treatment involves opening the airways with ventolin which is given by a mask and spacer device (see pic). The technique is important to ensure a tight seal around the face. This sometimes requires a firm hold which can be frustrating for parents when dealing with a fractious toddler. See Royal Childrens Asthma Videos for some tips on how to correctly use the mask and spacer. Make sure the mask is of good quality (silicon) and the spacer is the small type. The dose of ventolin tends to be between 3 – 6 puffs. Each puff delivered separately with 3-5 breaths between each puff. Frequency and amount of ventolin given depends on the severity and is indicated in the table below.
Assessing wheeze and cough
The toddler or child will start coughing when suffering from a cold. The cough will sound slightly moist and initially breathing will be unaffected. However in some instances there will be shortness of breath. This is assessed by carefully watching the breathing. Assess the effort involved in breathing and use exercise as an analogy. So a mild increase in chest movement is similar to someone walking, moderate is how someone’s breathing looks when jogging and severe is what someone looks like who has just been sprinting. The table below summarises this.
What preventatives are useful ?
Some Facts about wheezy toddlers.
Asthma
This article discusses asthma, background, different types and the current available medications.
Bronchiolitis
How Do You Catch It? The virus is spread when infected mucous is sneezed or coughed into another child’s face or onto table tops or objects such as toys. Infection occurs when the child touches these surfaces and then his/her eyes or nose. Illness begins about 3 to 7 days later. The illness Bronchiolitis […]
Gastroenteritis
Gastroenteritis refers to vomiting and diarrhoea. The cause is usually viral and it represents one of the most common reasons for seeing a doctor. The treatment involves oral rehydration therapy to avoid dehydration.
Cough
Cough is an essential way in which the lungs expel unwanted material. It is a protection for the more fragile areas of the lungs. Unfortunately cough can be distressing particularly during the night. There is little role for cough medicines in children though they are marketed very well. The most common cause of cough is a simple viral bronchitis after an upper respiratory tract infection.
Pneumonia (Chest Infection)
Pneumonia implies an infection that has infiltrated the tissues of the lungs. In children the most common cause is viral, but often it is difficult to determine whether bacterial or viral. In more serious cases the child will need hospitalisation for oxygen and intravenous medication. The vaccine prevenar has dramatically reduced the incidence of pneumococcal pneumonia, which was the most common cause of life threatening pneumonia in children. Hib vaccine is also effective against a bacteria called haemophilus.
Croup
Croup is a barking cough caused by a virus that infects the larynx. Sometimes the larynx is so inflamed a noise called a stridor occurs, which can be quite distressing and if severe will require treatment in hospital.
Colds & Upper Respiratory Tract Infections
Colds, also known as upper respiratory tract infections affect everyone, particularly during the winter months. Some children suffer middle ear infections, wheezy respiratory illnesses and other complications. This article aims to educate parents on managing these frequent viral illnesses.
Recurrent Abdominal Pain In Children
Constipation The definition is pain and discomfort when passing a bowel action. Young children for a variety of reasons can have a period of constipation, and they will suffer intermittent abdominal pains. This often occurs at the start of prep or grade one, where ‘bowel routines’ are put aside, due to being too busy, having […]
Coeliac Disease
This post discusses coeliac disease and also touches on the background to gluten intolerance
Acute Abdominal Pain
Children often complain of abdominal pains and ascertaining whether the cause is serious can be difficult. This is a common reason to seek medical advice. This article helps to decide whether the problem is severe enough to warrant a trip to the doctor. Click here to see the article on recurrent abdominal pain. How does […]