<s>[INST] Hello doctor,My son is 13 years old. We are based in Greater Noida which is in the outskirts of Delhi.Since he was five years old he as been suffering from asthma whenever there is season change during March/April and October during which he generally starts getting allergic cold. I used to earlier give him Asthalin inhaler but since last 4-5 years he is using Levolin inhaler to resolve the attack. Lately I have started nebulizing him at home using 0.63mg Levolin respule morning and evening and inhaler several times during the day. I have also started giving 0.5mg Budecort respule along with that recently, as his asthma is not coming under control for the last almost 1.5 weeks now. He wakes up in the middle of the night after 2 hours of nebulization and complains of feeling breathless and needs to take multiple puffs using the inhaler, sometimes much more than the prescibed dose as mentioned in the medicine leaflet. I have being trying to get him to inhale steam as well as that gives him temporary relief. He is really breathless when he wakes up at 6:00 in the morning and even had to miss school 2 days last week. I need your help to advice me on the right dosage of inhaler and nebulization to get the asthma attack under control. Do you suggest any other medicines? I definitely would want to avoid oral steroids or any strong medicines. [/INST] Hello. It seems your son is suffering from bronchial asthma. It is known to aggravate with seasonal changes. You need to understand that by nebulizing him regularly, he will get dependent on nebulizers.  In my opinion, he should be nebulized with the doses you are already doing only in case of acute attack. Once the acute attack settles, which usually takes 5-7 days, he should be weaned off nebulizers. Revert back to a pulmonologist online for further follow up --> </s>