Is a steroid necessary for asthma treatment for a toddler?

My twin sons are almost 20 months and this winter got beaten down by a lot of colds. One of the twins had to go to the ER for what turned out to be a very bad case of RSV. He in general wheezes a lot more than his brother when he's sick and wheezes quite a bit just when he gets all riled up with play. Anyway, our pediatrician advised albuterol neb treatments after the 3rd or 4th trip to her office and after treating him with that a couple of times and switching to xopenex (levalbuterol) it seemed to help symptomatically, but I'm still worried about the frequency of recurrence. SO this latest episode which kind of came out of nowhere and has led him to have the worst barky cough I've ever heard and makes him cry with the effort of trying to cough up whatever is irritating his poor lungs has really pushed me to push the pediatrician into looking deeper into the recurring RSV. So, I was told that it is a good possibility it is asthma and they recommend starting him on Pulmicort. I am not thrilled with the idea of putting him on a steroid. I will do it if it is necessary, but shouldn't there be more investigation before diagnosing a serious condition like asthma and prescribing a heavy-duty drug like a steroid?? I don't like giving either of my sons any kind of drug unless it is absolutely necessary. I'm just overwhelmed and confused by all the information out there and would like some advice from anyone who has already gone through this!!

steveangela1	It is immpossible to give a definitve diagnosis of asthma in a child of that age. However if your child has had in the past few months a rsv infection then your child has "reactive airway disease" which is just hypersensitive airways, this last up to 1 year after an rsv infection. your child should be old enough to perform a pumonary function study before they can diagnose him w/ asthma (usually 3-5 years of age)... What I would do is find an asthma clinic or a ped pulmonologist to treat your boys, Pulmicort is nessisary for this to control the attacks....

Claire A	Hi I know how you feel - my son is 32 months old and has been diagnosed with Asthma. I was initially worried about my son taking a corticosteroid every day - as I don't like giving him drugs either - but I have to say that my concerns over growth problems etc take a back seat when he has an Asthma attack and has to go into hospital (4 times in last 7 months). I've realised that the main thing we have to do is learn how to manage his Asthma well - so cut down on the inhalers when he's well but make sure we get them going quickly enough when he is poorly - if we can sucessfully achieve this then we should hopefully avoid hospital admisions and therefore stronger steroids and Corticosteroids. I found advice from Asthma Charities (in UK) was very good for general all round information. It was all quite clear and easy to understand - which was good for my sleep deprived brain. He too seems to be beset with viruses - another problem in that every different consultant that we see says something different - they still can't decide if he has Asthma or a virually induced wheeze - but the treatment seems to be the same. It seems that one of the main ways to diagnose Asthma is by using a peak/flow monitor and children don't tend to be able to do this until about 5. I know a long time for them to be on drugs they might not need!!! It's a difficult position to be in - you don't want to give any drugs that might not be needed but you also don't want them to be ill!!! I would advice that you look up Pulmicort on the internet to see how it works - what the side effects might be etc. Also ask about the interactions between all the drugs that your son may be on. I find that informaiton is power - I always go to see my doctor armed with questions and am going to start keeping an Asthma diary to see if we can find the triggers and to keep a log of all drugs administered/dr's appointments/hospital admissions etc. I go to the doctors regularly to ensure that my son's develpment (inc growth) is monitored closely and to ensure that he's not on medication that he doesn't need. I hope your little boy gets better soon and that you get some answers - I'm currently looking into different foods (trying to use foods with immune boosting properites) to help him cope with the viruses that seem to be lurking round every corner - and also looking into complementry treatment (not favoured by my doctor). Basically we're trying to enusre that he has the lowest dose of corticosteroid possible whilst keeping his Asthma under control. Good luck xx

GEE	Since the other medications aren't doing the trick I wouldn't rule out giving a steroid. Any inhaled steroids are very low dose. This is because, unlike a pill which has to travel all through the body, they go directly to where they are needed.

proud2btysmom	I completely know your concerns fist hand. My son who is now almost 4 is a Chronic Asthmatic. He has NEVER has RSV but has has pneumonia MANY times. Ty was diagnosed with asthma at about 11 months that was upgraded to chronic asthmatic at 17 months. While it seems confusing to have such a little guy with such a big condition it is more likely than not that they are right. Please email me if you would like to chat about this. My son has been hospitalized 29 times and three of them being in the Intensive Care Unit. He takes controller medications daily and sees a pulminologist every few months. I would be happy to chat with you on this subject. I know how scary it can be but having been through it for over three years maybe I can ease your anxiety.

tatal_nostru2006	I have noidea but read about clay and, maybe,you'll find the best medicine ever! http://www.botanical.com/products/learn/french-green-clay.html http://www.regenerativenutrition.com/content.asp?id=128 http://www.aboutclay.com/uses/detox.htm May God help you!

emmalous	my son had RSV when he was 6 weeks old can be real scary that's for sure, was your twins perm at all as its common in perm babies. and my daughter last week was taken in hospital because boom out of no where she couldn't breath (she did have pneumonia a couple of years ago) she had to have nebulizers every 2 hours and steroids for 3 days. she is now a lot better. an inhaler may help your son a lot. If you are worried about long term use only use it when he is bad with his chest. it maybe something that he grows out of as one of my other daughters now has no problems but when she was a toddler she always had a bad chest. it also maybe the teething that is causing your sons bad chest.