Precautions to avoid illness such as yearly influenza immunization should be given to most of these youngsters. The most emotionally charged issues in the management of children with SMA concern whether or not to initiate aggressive mechanical support when the breathing muscles begin to fail. Less invasive means of dealing with respiratory problems include many options. Because of difficulty with coughing, even a simple cold may result in saliva and mucous obstructing a child's airway. Techniques of postural drainage and chest percussion may prevent this complication.
Some children benefit from supplemental oxygen usually delivered through a small nasal tube.
This is often helpful at night. Before initiating oxygen treatment, however, it must be determined that the brain is not using low concentrations of oxygen in the blood to determine how rapidly a child must breathe. Some of the normal regulation of breathing may be altered in children with chronic neuromuscular diseases. The decision to use supplemental oxygen should, therefore, be preceded by an evaluation by a pulmonary specialist. Instead of a tracheostomy, air is mechanically directed through the nostrils through a firmly, but gently fitted mask.