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Sunday, February 26, 2012

Albuterol is not a Steriod; it is not an antibiotic.

Wheezing and chest congestion is one of the most common illness that I see in babies. If your breastfed baby is wheezing, IT IS NOT A SIGN OF ASTHMA. It is a virus. Likely RSV. Adults get a cold. Babies manifest the same virus in their airways.  Babies who get bronchiolitis (wheezing) are not necessarily prone to asthma, at least I don't see it that way. I don't diagnose asthma based on one episode. Continue breastfeeding. Usually it is worse at night. In my experience, breastfed babies run the course without complication. That said, Albuterol via nebulizer is my preferred medical treatment for wheezing and cough due to inflammation in the airways.

Albuterol is NOT a steroid.

Albuterol is NOT an antibiotic.

Albuterol via nebulizer reduces airway inflammation immediately by acting on airway receptors, and REDUCES the need for antibiotics, steroids and hospitalization. It tends to be much quicker acting then inhalers or the pill or syrup. Proventil 2/5 liquid is another option, but it is more systemic (you are swallowing it rather than breathing it).If your household members are prone to wheezing, it's worth keeping a nebulizer handy in the house. I say if you suspect wheezing, use the nebulizer early on and follow up with the doctor. There really isn't a reason to hold off on treatment until seen.

I also get questions, "If my baby is coughing, and I don't want antibiotics, is there any reason to bring baby in." Yes, I would like to know if they are wheezing.

Other names for Albuterol are Ventolin and Proventil. Xopenex is similar. (I don't buy into the fact that it has less side-effects. it just has a stronger sales pitch as it is a newer medication.)

How often should you use the nebulizer? Initially you may need back-to-back treatments or more frequent. Maybe one treatment is enough to get you over the hump. As the symptoms reduce, you can back off on frequency. With a baby they can breastfeed and you can hold the mask or tubing close to their nose and mouth. (I don't like the pacifier version of delivery, especially in a baby that doesn't use the pacifier). If you need an initial treatment, you can expect that the coughing to run a course of up to 3 weeks. Thus you may need a nightly treatment for a few weeks.

I learned to use the nebulizer when I worked in urgent care. It brought immediate results most of the time. Of course if it doesn't you may need further evaluation. This post refers mostly to the exclusively breastfed baby.

I know many pediatricians reach for antibiotics and steroids in the same situation along with or in place of albuterol. Perhaps that has to do with many of their patients being formula fed and different lifestyle factors, running a more complicated course than what I see. If you have a baby prone to wheezing, you may want to consider allowing no one to smoke around your baby. If you're in a daycare setting, reconsider that situation. Probiotics is beneficial to immunity. If your baby is taking solids, you may want to make sure that the food does not contain dyes and processed ingredients. Chronic wheezing, asthma can be modified. That means you do have some influence.

On a slightly different note, but related observations about ill EBF babies, you do not have to give a sick baby Pedialyte. Breastmilk has everything they need. But if for some reason you need to supplement a sick baby over 6 months (even a formula dependent baby), coconut water is a great choice for hydration. Fever-all is a dye-free acetominophen supp used for fever and crankiness. Even in the breastfed, unvaccinated population, I do see wheezing. But mild usually.  Vaccine status (lack-of) did not cause this illness.

When you use the nebulized version don't take deep breaths and you may not have to use a long treatment. You only need a treatment to last as long as it takes to get relief.

For whatever reason, wheezing in babies is common. Breastfeeding is the best way to prevent or reduce the frequency.

I am not a rep for the medication or the machinery.


Hannah Banana said...

This makes me feel a lot better. I have an adopted child who was born at 27 weeks. (She's 2 now, but has special needs... so she's still considered about 1.) She has been diagnosed with BPD and Reactive Airway Disorder.

I feel she catches every tiny little throat tickle. And I'm constantly giving her breathing treatments.

I wasn't sure about the effect on her... or exactly what Albuterol was. I was just doing it because the doctors felt that was best. And I wasn't willing to take the chance of her catching more serious.

And well, usually we're at the doctor's office once a month making sure that little cough hasn't turned into pneumonia.

Thanks for the info. I will be bookmarking this post for future reference!

Casey Kettle said...

Thanks for this post! Good info.

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