Asthma and Daycare

The school should be giving him his asthma treatments when he needs them. All you need is the doc to write orders and then you can show them how to do it.

I'd say his environment is not perfect but I also think that staying at home won't be perfect either.

He needs better care than he's getting by this doc if he's having problems this severe. I think that finding another doc specifically for his breathing and treatment would be so much better for him.

If you are home, why not keep him home until things are better controlled. If you have not, see a pediatric pulmonologist. There are plenty of ways to socialize while being home.

I actually liked having my kids "couped" up with me. They went to nursery school 1/2 days twice a week. These are years you cannot get back. His health comes first.

Is it asthma or RAD (reactive airway disease)? They're not the same.

Has he been to a pulmonologist for a pulmonary function test? What are his triggers? What percentage does his rescue inhaler help him? What preventative is he on?

Getting sick once a month is indicative of a preschool that isn't requiring enough handwashing. That's worth looking into.

The bottom line is, until you get him properly diagnosed and a real treatment plan, you cannot plan for things like preschool. I have no answer for you other than...get a referral to a specialist and get your son properly diagnosed and treated.

Can't you talk to the school and see if the nurse there can administer the treatment to him during the day? I know 3 different kids who do this, and they have absolutely no problem. Heck, one of them has to have some sort of treatment every 2 hours. She just has a little watch with a timer, and when it goes off the teacher's aid walks her to the nurse, she gets her treatment, then the nurse walks her back to class when it's finished.

RAD symptoms can be greatly reduced with a preventative medication. Have you tried that yet? My son used to use a medication called Pulmicort, administered through the nebulizer. We did it twice a day through the winter and heaviest cold seasons and once a day during the times he was less likely to catch a cold. Pulmicort helps keep their lungs open so that, when they do get sick, the RAD symptoms are less severe and so many treatments with a rescue medication aren't necessary.

Talk to your doc if you're not already doing a preventative treatment. It made a huge difference with my son.

Children are also very prone to illness the first year that they are in school, so I think if you pulled him now, you'd be facing the same issues whenever you decide to put him in again. However, if you're concerned about your daughter's health, pulling him may be good because at least she will be older whenever your son goes back to school.

There were several asthmatic kids in my son's daycare and later in his Montessori preschool. The teachers were 100% familiar with the use of nebulizers and inhalers and could administer treatments. Of course, parents did their best to schedule the kids so they did not fall within daycare hours if possible. But everyone did their best.

My son occasionally needed an inhaler for several days after he got a cold. Although the pediatrician said we could use the albuterol 4 times a day for several days, he seriously only needed in 2-3 times a day for 1-2 days, if that. You will get accustomed to your son's patterns and chances are he may only need the rare treatment at school.

Sadly, asthma is an epidemic in this country. If all asthmatic kids missed school whenever they were on albuterol, they would never get to school. Also - we switched to an inhaler with spacer when DS was probably 3.5-4 (I am not sure exactly when). This was FANTASTIC. The inhaler takes 10 seconds, not the prolonged period of time the nebulizer takes. It is also silent and my son liked it much better (no sitting still for 10 minutes). He is now in 2nd grade. He has an inhaler kept in the nurse's office at school and if he needs it (never has during school), he can tell his teacher and go down there.

ETA -there are standard guidelines now for what constitutes good control, when a child needs to have further evaluation, when a child should be on steroids, etc. Talk with your pediatrician about what you can expect. For us, the winter is worse because the kids are all inside together, spreading colds around. Viruses are his primary trigger (cats too but they don't have those in school). So if he needs his inhaler for a couple of days, a month apart for several winter months, we don't worry. He will then generally be med free from April or so until Nov/Dec.

If you son has gotten sick monthly for a few months before he was diagnosed, that does not mean that interval will continue. Also - now that you know what you are dealing with, you will likely intervene before the horrible coupy/coughing/wheezing happens. More like when you notice the first cough.

Is he on preventative medication? The inhailer treatments are for flair ups (which tend to be a huge problem in the winter with every cold going around). I'd suggest seeing a ped pulmonologist who will evaluate your son and set up a treatment plan to get him in good shape so every illness doing trigger a huge response in his lungs.

I've been down this road, it's not a fun one. 3 out of my 4 children have asthma. As far as school goes the teachers are usually willing to do the treatments as needed. If he seems to be getting sick on a monthly bases, first thing you should do is find the source. After doing a lot of research on asthmatic triggers. I removed all carpet, curtains from their rooms, also if possible purchase pillows made specifically for allergys, vacuum their mattresses monthly. Basic household cleaners can also be factors. Once I did all these changes my 2 older children improved greatly, and my youngest only has seasonally reactions now. They all carry inhalers with them at all times. But rarely need to use them. Also anyone who smokes should not be around your son as these are triggers as well. Even teachers who smoke outside of school or in their car before work carry these toxins in with them and your child is exposed.

Talk to the school.

Treatments and health come before the school, but they school might be able to work with you. Maybe they have a nurse on staff that would be willing and able to give him his mid-day treatment.

Also, you could try moving his treatments around. So if he is at school from 9a - 12p, then give him a treatment at 8:00a just before you head out, and then again at 2:00p when he is home, or get him out of school early. That way, his day stays somewhat normal.

i love montessori and think it's a great way, for the most part, to let kids learn and play.
but i'd never consider putting a child into a daycare JUST so they could play.
what's he going to miss at 3 and a half? especially if his health is fragile?
i'd keep my babies at home, and make sure that we had plenty of adventures every week in which they could play with other kids. and that way you're in charge of when he stays home because he doesn't feel well.
khairete
S.