Childhood asthma contributes to significant morbidity among patients and si
gnificantly impacts the quality of life and daily routines of their caregiv
ers. The parents or caregivers assume responsibility for tasks that childre
n are too young to perform; this often includes daily administration of con
troller medications and nightly administration of reliever medications. Mos
t young children do not have the coordination or understanding to effective
ly use pressurized metered-dose inhalers or inhalation-driven devices; thus
nebulizer therapy often is preferred for children younger than 4 years of
age. Budesonide inhalation suspension will be the first inhaled corticoster
oid available for children younger than 4 years of age and the first inhale
d corticosteroid for delivery by nebulization in the United States. This is
a case report of a 3-year-old boy who received budesonide inhalation suspe
nsion as part of several double-blind and open-label studies evaluating the
drug. Before study entry, the boy was experiencing more breakthrough wheez
ing episodes at night than the parents were used to, resulting in an increa
se in nighttime awakenings that required nebulizer therapy. These nighttime
awakenings had a substantial impact on the quality of life of the entire f
amily and interfered with the parents' ability to function at work Even tho
ugh they wanted to have more children, this situation discouraged them from
doing so. Budesonide inhalation suspension improved overall asthma control
and aas well tolerated. The boy had a decrease in nighttime symptoms and a
n increase in both height and weight percentiles for his age. Importantly,
use of budesonide inhalation suspension in this boy eased tbe management of
severe asthma and improved the quality of life of the entire family. The p
arents subsequently decided to have a second child. Budesonide inhalation s
uspension represents a major breakthrough for infants and young children by
providing a formulation that, on approval, can be delivered reliably by ne
bulizer for effective maintenance treatment of persistent asthma.