QuestionI have a ten-moth old who was diagnosed with a cold and mild bronchiolitis on Friday. I was given an albuterol inhaler for him with instructions to give him two puffs (5 min apart) every 4-6 hours. Tonight he has been up off and on since going to bed. He has a pretty stuffy and runny nose and he has been trying to suck on his pacifier. He keeps crying and nothing really seems to comfort him as he is very tired. What should I do? Thank you for your advice.
AnswerHello,
Thank you for question. I apologize for the delay.
I certainly don't blame you for being tired at sound like a challenging situation. The baby is likely as tired as you are, but can't sleep because he is either uncomfortable or because of the side effects of his medication. Albuterol, as you know, is a bronchodilator and is very helpful with bronchiolitis. Side effects of albuterol, however can be nervousness and agitation. Albuterol is similar to adrenaline in that it opens airways and increase his heart rate. In the same fashion it can also create insomnia.
Your question as to "what to do" is relevant, but I'm not sure what the answer is. It's often necessary for these children to be on albuterol, or similar medications for several days before the bronchiolitis has resolved significantly. I recall when my oldest daughter had bronchiolitis, from RSV and was on albuterol, that she was awake for about three days.
Having said that, what you can offer your son is supportive care. If you can identify other potential causes, try to remove them. Trying to make him as comfortable as possible given the situation, will be your best approach until the bronchiolitis is resolved.
Thank you the question.
Dr.T
