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Blood transfusions done for premature baby. Now suffering from cold, cough, wheezing. Worrisome

Feb 2013
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Practicing since : 2002
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Hi Doctor, My son has been a premature - 33 weeks and had a blood transfusion. He is 3.5 years old now. he has been suffering from cold cough , wheezing since his birth. We were in Delhi, for last 2 years have moved to Bangalore. He has not improved. Doctors say its quite common for wheezing, cold cough. I have a admitted him to hospital 4 times in last 1 year for the same problem. The doctors have prescribed him for Asthalin (2 puffs - 3 times a day) and Budecort (2 puffs - morning and evening). We have heard a lot for the side effects and are worried. My son name is XXXXXX Since childhood my son is facing a problem of cold and cough. He was born as a premature baby in Delhi.
Now it’s been 2 yrs, we’ve moved to Bangalore. After coming to Bangalore, he is having wheezing problem also (which he never had in Delhi). He was admitted thrice to ICU in 2yrs time.
• 1st admission- when he took fruit juice and ice cream - so first it started from cold and cough then after 5 days he got wheeze and short of breath.(no fever)
• 2nd admission - He had strawberries and he got cough then after 5 days he got wheeze and short of breath.(no fever)
• 3rd admission - He went out on Scooter with me and by evening he started coughing and again after 3-4 days we admitted him for wheeze and short of breath in ICU (no fever).
During each of his admission in the ICU, they gave him Levolin, Budecort, Duolin (Nebulizers).
Food Habits -He eats everything, however we don’t give him fruits, fruits juices, Curd, Ice creams at all (not even XXXXXXX /banana)as we’ve observed that after coming to Bangalore he gets cough and running nose with fruits also.
Present Medications – He is on Inhalers now –
• Asthelin 2 puffs thrice a day
• Budocord 2 puffs twice a day
• Metatop (Nasal spray) 1-1 in both nostrils - twice a day.
One of the ENT specialists told us not to keep furry toys around him and not to make him wear woolen sweaters – as this creates irritation and in term causes the problem.
I have tried giving him XXXXXXX Junior, Honitus (Dabur), even Ayurvedic medicine (Ram XXXXXXX Baba) too but nothing worked with him.
Kindly help us.
1. We have been told that Asthalin and Budecort are steroids so has a side effect on Long term usage – as my son is 3.5 years old now.
2. His pediatrics has prescribed a course of Asthalin and Budecort for 3 months without any gap – we have been giving him for last 1.5 months now. Looking at the young age and medicines being given. We don’t want to give any steroids or would like to shift to something which could cure the problem rather he take the inhalers for life long. Even if it’s a having a long term medication moving out of inhalers is what we would request you to prescribe.
3. And also do you think moving back to Delhi would be a solution.
4. Doctors also mentioned that when he attains 5 years the immunity will increase and will not have similar problems.
I have attached 9 files – hope that helps
Posted Sun, 5 May 2013 in Child Health
Answered by Dr. E Venkata Ramana 4 hours later

Thank you for your query on Healthcare Magic.

I can understand your concern regarding your child health problems and side effects of the drugs.

I went through his discharge summaries and prescriptions.

My answers to your questions are :

1. Asthalin is not a steroid. It is a drug which acts on small airways and relives
narrowing of airways.

Budecort is a steroid and it is given to control the airway inflammation. As it is given in inhaler form the dose is very less which will be in micrograms and the dose will go to the target organs (lungs) directly so it is not absorbed into blood significantly so the side effects are negligible in comparison to its benefits of controlling the symptoms of disease.

2. As your child is getting the wheezing frequently the long term use of these
inhalers are required and as I told the benefit of use is more in comparison to
its side effects.

If the child disease is not controlled with appropriate inhalers, this will lead to growth retardation, poor effort, and decreased quality of his life.

3. If you consistently find that your child is not accustomed to Bangalore weather
and if the environment is not suitable for your child you can think of moving
back to Delhi but the decision depends on many factors.

4. Yes usually after 6 years of age the frequency of infections will decrease due to
development of immunity and resistance to common infecting organisms and
school going period is relatively healthier period in comparison to preschool

And as the airways size also grows with the age, the frequency of wheezing episodes will decrease with the age.

My advise is to follow your doctors advise and be in regular follow up with them.

Hope I have answered your query, if you have any clarification please let me know.

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