Babies and Breathing Treatments: Do's and Don'ts
by Lisa C. Greene
Starting to do breathing treatments with your new baby can be a little stressful. Don't worry, before you know it, you'll be a pro. Lots of babies need to have nebulized medications for many different reasons. Your CF Team will have ideas for you about how to make this as easy a process as possible. Here are a few of my own:
1. Timing is important: Try to stay away from the danger zones: right before feeding time, nap time, or during times of high family energy. Setting a consistent schedule can be helpful.
2. Set the ambience: A cool room, low lights, soothing music, soft clothing, a rocking chair, perhaps a bath before hand to relax your baby. Avoid high energy and over-stimulation.
3. Relax yourself: A baby picks up very quickly on a parent's vibes. Make sure you are calm and relaxed. If you are feeling anxious, stressed or frustrated, your baby will pick up on this and likely reflect your emotions (due to mirror neurons). If you are feeling anxious, take a few moments to breath deeply and drink a glass of cool water. This will help relax you. The smell of lavender is also good- it promotes relaxation and reduces anxiety. I keep a sachet of dried lavender close by.
4. Take your time: Start the process with snuggles and hugs, gentle toe tickles, singing, reading a book, playing with a baby toy. Create a calm, pleasant routine- just like you do at bedtime. Ease into the treatment gently. Put the mask on your baby for a few minutes each day without the nebulizer running to get him or her used to it. If it's okay with your doctor, start with short treatments and then build up to the full time slowly.
5. Make the time fun: Eye contact, big smiles, singing, playing with a baby rattle or a mobile, and having fun with your baby during the treatment will help distract her and keep her attention on you- not the medication. Try putting a mask on yourself or have a sibling wear one and act silly. Or put a mask on your baby's favorite stuffed animal and have a "puppet" show.
6. The medical equipment can make a difference: Is your compressor loud and scary to your baby? Some models are quieter than others. Your respiratory therapist can help you with this. Make sure that whatever compressor you use is approved for your particular medications. You can try using towels to muffle the sound but be careful not to block the airflow or cause it to overheat. The type of nebulizer cup you use can also make a difference. Here are some options for babies to discuss with your CF Team:
- Pedi Neb Pacifier: A pacifier with a built in nasal nebulizer
- Mask: Covers the mouth and nose
- Nasal Nebulizer
- Blow-by nebulizing with a corrigated extension tube
7. Dealing with resistance: It's likely that your baby will show some resistance to breathing treatments at some point. How do you handle it? In the same way as when your child shows resistance to a diaper change or getting a bath. Don't yell or get angry. Stay calm, use a sing-song voice and say, "I know you don't like it but this isn't a choice. Hang in there." And gently but firmly hold the mask over your child's face.
The goal is to show your baby that you are more powerful than he or she is and also very loving at the same time. You can then try using distraction or changing your baby's position. If your baby is on your lap, put her on the floor under a mobile. Or put him in an Exersaucer. Pull out a favorite toy, rattle, or music maker; sing a favorite song. Above all, stay calm, loving, matter-of-fact and firm. Remember that this phase will soon pass. You'll have good days and bad days. Just be consistent, calm, firm, and don't give up.
Chest Physical Therapy (CPT):
Many of the above tips apply to CPT as well. Most babies seem to like manual CPT- both of our kids did. We'd sing or play songs and keep the rhythm to the music. They'd often end up falling asleep. Then you can put on the mask or do a blow-by nebulizer treatment. Or take a nap yourself!
Some companies make a mechanical vest system that is small enough for babies but there are conflicting opinions in the medical community as to whether or not they should be used with infants. Your CF Team will guide you in making the best decisions for you and your baby.
You might be feeling a little overwhelmed by everything your infant needs to stay healthy. Or you might be wondering if it's even really necessary in the first place. There is growing evidence that with good, early intervention and care, your child with CF is likely to live many healthy, happy years. There is so much promise on the horizon in CF research and drug development. Even though it's hard at times, all of these medical treatments give me hope. To me, CF is not a death sentence as it was in past generations; it’s something that our family simply lives with in order to live life well.
Lisa C. Greene, MA CFLE is the mother of two children with cystic fibrosis, a certified family life educator and public speaker. She is also the co-author with Foster Cline MD of the award-winning Love and Logic book “Parenting Children with Health Issues.” For more information, see www.ParentingChildrenWithHealthIssues.com.
For more Tips for CF Parents, visit Lisa’s website at www.TipsForCFParents.com.