Hello.
Thank you for asking at HCM.
I went through your nephew's history.
I would like to know more details for him like - Since what age is he having asthma? Does he have any other allergies like nose allergy,
skin allergy, any other? Does he have any other medical condition? Does he have any family member with allergies/asthma? Does he have any digestive problem? Is his growth (weight and height) normal compared to other children of his age?
However, from your given history, I would like to make suggestions to him:
1. One of the most important aspect of treating a young child with asthma is his technique of using inhaler.
First of all, I would suggest you to get his inhaler device and technique of using inhaler device reviewed by an experienced pediatrician/allergy specialist. This is most important as if the technique is improper, he may not be getting adequate amounts of drugs in his lungs and therefore the inhaler may not be that effective.
After varifying his technique and inhaler device only, I would think of increasing dose of his inhalers.
2. In my opinion, Metered Dose Inhaler with Spacer device with baby mask is the best inhaler device for him.
3. Were I treating him, I would add regular
montelukast which may improve asthma symptoms.
4. If he has frequent nose symptoms, I would also add daily levocetirizine/cetirizine to above treatment.
5. Personally I would suggest him allergy testing, which may reveal the substances he may be allergic to and also how to avoid them.
6. In general, please try to avoid exposure to dusts, smokes and air pollution as much as possible. Please make sure that no family member from home is
smoking inside the home (irrespective of your nephew's presence).
7. For diet, I would suggest him a healthy diet rich in
vitamins and minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) which will help him in a long run. If allergy testing suggests any
food allergy, he should avoid the food he is allergic to.
Hope above suggestions will be helpful to you.
Should you have any further query, please feel free to ask at HCM.
Wish you the best of the health.
Thank you & Regards.