What I Wish I knew After My Son's 1st "Asthma" Attack

I was brushing my teeth getting ready to go to bed when I heard a strange coughing / gasping sound coming from the Nanit. I ran into my son's room and it felt like he was struggling to breathe. My husband felt it, too. We immediately got into the car and went to the Emergency Room 5 minutes from our house.

It was the first snowfall of the season, so the roads we're icy, and the ER was packed. We were triaged with moderate croup and it took 4 hours to be seen. We felt like our son's cough sounded bad, but we kept thinking, well we're here in the ER in case something happens, right?

Once we finally had a room, a nurse ran in and said I'm going to go get the doctor now. The doctor came in and did order an immediate nebulizer and round of steroids. She said something that has always stuck with me, "it's too early to know for sure, and I don't want to make you nervous, but your son may have asthma. He has wheezing plus eczema".

They told us to be prepared to stay the night. Yet, my son responded extremely well to the treatment and the doctor even said, she was surprised to see it, but we could go home. My son was diagnosed with bronchiolitis, they "trained" us how to use the inhaler and spacer, and we were sent home.

Two days later, we followed-up and were seen by our pediatrician's office. The pediatrician asked us to show her how we had been using the inhaler and immediately started shaking her head. We were a little confused - we did what they told us: shake, put in the spacer, put in my son's mouth, press, and count to 10.

"There's supposed to be a mask, since he's a baby - you don't put the end into his mouth!" We pulled out the box in my purse, and sure enough, the little baby mask was in there, still in its wrapping.

3 ER visits later, over 10 pediatric clinicians interviewed, multiple conversations with adult advocacy groups, and review of GINA guidelines: Here are my top 5 things I wish I knew after that first ER visit (mainly so that I could have better advocated for my son, instead of being told after multiple ER visits it was just "bad luck"):

• The fact that my son responded well to albuterol: likely asthma

• Wheezing + eczema: likely asthma

• Multiple wheezing events: likely asthma (this would come in handy at ER visit #2)

• Diagnosis of "bronchiolitis" as a 6 month old: likely asthma*

• Proper use of the spacer: Link to education here (Note: it is important to prime your inhaler per its instructions, if required! And based on our lived experience, when my son was under 16 months, we laid him on his back as he wouldn't sit still sitting up right).

*Important note: I'm not a medical professional. Based on interviews with top asthma experts, this is what ONE of them told me. Please consult your clinician and care team.

References:

2025 GINA Guidelines