My 2year old has asthma and it gets worse when he runs and plays hard..the inhaler doesn't seem to work, what should i do?

See his doctor.: First, make sure he's using a spacer device (like an aerochamber) with the inhaler, since that helps get the medicine down into the lungs. If he's using an albuterol or xopenex (levalbuterol) inhaler before exercise and it doesn't help enough, next step is to see his doctor and add an inhaled corticosteroid twice daily. If you're already doing that, i'd add singulair next. Beyond that, see a peds pulmonologist.

See an allergist: If this is asthma, he probably needs to start an inhaled steroid to decrease the inflammation and allow his lungs to grow and develop normally. Many 2yo wheezers don't go on to develop asthma, but it's important to find out if he has a dust mite allergy - if so, reducing his exposure to dust mites can decrease his risk of developing asthma. Your allergist can help sort this out.

Be sure it's Asthma.: You mentioned that your child has asthma and that it is getting worse with activity. He needs stronger preventive/controller treatments. He may benefit from daily nebulized Budesonide (pulmicort) treatments. This is much better for him than frequent bursts of oral prednisone. Besides dust mites, he could be sensitive to indoor pets or mold spores. Take him to a pediatric allergist.

Lots of good advice: From everyone else but you want to know why meds aren't working. Inhaled drug delivery can be tough for a 2 year-old. I recommend a nebulizer with mask over an inhaler with spacer. An asthma educator can help teach you & your child how to use inhaled medication effectively. See if your allergist or pulmonologist has one on staff. For asthma restricted to exercise singulair (montelukast) may be best controller.