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Hi, My Son Is 3.5 Years Old. He Is Having

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Posted on Sat, 22 Feb 2020
Question: Hi,
My son is 3.5 years old. He is having allergy attacks since 1 year. Earlier he was only having urticaria , but now he is getting wheezing in night. He is coughing and has runny nose .
He is on allergy medication for last 3 months ( montak, Allegra) now Ab phylline and seroflo 250 is also added, montak is stopped.
We are very much worried . Plz help.
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Follow up: Dr. Sumanth Amperayani (0 minute later)
Hi,
My son is 3.5 years old. He is having allergy attacks since 1 year. Earlier he was only having urticaria , but now he is getting wheezing in night. He is coughing and has runny nose .
He is on allergy medication for last 3 months ( montak, Allegra) now Ab phylline and seroflo 250 is also added, montak is stopped.
We are very much worried . Plz help.
doctor
Answered by Dr. Sumanth Amperayani (46 minutes later)
Brief Answer:
I need some more information please

Detailed Answer:
Hi...Thank you for consulting here. Greetings from XXXXXXX
By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -
Questions:
1. How many days per month does your kid cough or feel breathless?
2. How many nights per month does your kid's sleep get disturbed due to above symptoms?
3. Does your kid feel breathless when running around or playing with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?
Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sumanth Amperayani (0 minute later)
Brief Answer:
I need some more information please

Detailed Answer:
Hi...Thank you for consulting here. Greetings from XXXXXXX
By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -
Questions:
1. How many days per month does your kid cough or feel breathless?
2. How many nights per month does your kid's sleep get disturbed due to above symptoms?
3. Does your kid feel breathless when running around or playing with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?
Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (3 days later)
Questions:
1. How many days per month does your kid cough or feel breathless?
--its almost 15 days every month since October

2. How many nights per month does your kid's sleep get disturbed due to above symptoms?
-- his sleeps is getting disturbed since 10-15 days only.
3. Does your kid feel breathless when running around or playing with other kids?
-- such a thing is not noticed, however his physical activities are limited to swings and play less frequently with other kids.
4. Are the symptoms when there are seasonal changes?
-- since September 2018 he has suffered many times with urticaria. But march to August 2019 were relatively better as it happened 2 times. However since October 2019 he is continuously getting sick and Very frequently visited clinic cause by coughing and running nose. From November to December he was on montekulast still he got sick with cough, running nose and was given duolin and budacort nebuliser.
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
--yes, I am his father and I suffer from allergies.
6. Is the cough always associated with fever?
No
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Follow up: Dr. Sumanth Amperayani (0 minute later)
Questions:
1. How many days per month does your kid cough or feel breathless?
--its almost 15 days every month since October

2. How many nights per month does your kid's sleep get disturbed due to above symptoms?
-- his sleeps is getting disturbed since 10-15 days only.
3. Does your kid feel breathless when running around or playing with other kids?
-- such a thing is not noticed, however his physical activities are limited to swings and play less frequently with other kids.
4. Are the symptoms when there are seasonal changes?
-- since September 2018 he has suffered many times with urticaria. But march to August 2019 were relatively better as it happened 2 times. However since October 2019 he is continuously getting sick and Very frequently visited clinic cause by coughing and running nose. From November to December he was on montekulast still he got sick with cough, running nose and was given duolin and budacort nebuliser.
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
--yes, I am his father and I suffer from allergies.
6. Is the cough always associated with fever?
No
doctor
Answered by Dr. Sumanth Amperayani (12 minutes later)
Brief Answer:
Looks like multi tirggered wheeze

Detailed Answer:
My suggestions for you -
1. Oral Prednisolone for 2 - 3 days.
2. Inhalers are the newest management strategies for this. I suggest the use of Budesonide metered dose inhaler (100mcg) 2 puffs twice a day through a spacer and this is for regular use for 2 weeks and then you can taper down to 1 puff twice a day for another 2 weeks and then stabilize at 1 puff twice a day to continue. Another metered dose inhaler is Levosalbutamol and this can used as rescue therapy whenever you are having severe cough in spite of regular usage of Budesonide. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your physician for this.
3. Tablet Monteleukast 4mg once a day in the evening at 6pm daily for 3 months.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we cannot specifically say this is the cause - unless we observe closely - best person is yourself.

Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sumanth Amperayani (0 minute later)
Brief Answer:
Looks like multi tirggered wheeze

Detailed Answer:
My suggestions for you -
1. Oral Prednisolone for 2 - 3 days.
2. Inhalers are the newest management strategies for this. I suggest the use of Budesonide metered dose inhaler (100mcg) 2 puffs twice a day through a spacer and this is for regular use for 2 weeks and then you can taper down to 1 puff twice a day for another 2 weeks and then stabilize at 1 puff twice a day to continue. Another metered dose inhaler is Levosalbutamol and this can used as rescue therapy whenever you are having severe cough in spite of regular usage of Budesonide. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your physician for this.
3. Tablet Monteleukast 4mg once a day in the evening at 6pm daily for 3 months.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we cannot specifically say this is the cause - unless we observe closely - best person is yourself.

Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (43 hours later)
Dear Sir,
I need to ask if nebuliser can be used.
Also can we do an allergy test to find the exact reason.
In addition I need to know after completing this 3 months course do we stop all medicine.
Will these medicines have any side effects that will affect my son's growth
default
Follow up: Dr. Sumanth Amperayani (0 minute later)
Dear Sir,
I need to ask if nebuliser can be used.
Also can we do an allergy test to find the exact reason.
In addition I need to know after completing this 3 months course do we stop all medicine.
Will these medicines have any side effects that will affect my son's growth
doctor
Answered by Dr. Sumanth Amperayani (1 hour later)
Brief Answer:
Metered dose inhaler is better than nebulization

Detailed Answer:
I. You cannot be using nebulizer without Oxygen. This cannot be done on a regular basis at home without medical rated oxygen supply.

2. When used at the appropriate dose and for appropriate duration metered dose inhalers will not cause any growth hampering.

3. You cannot stop the metered-dose inhaler like that and you should be gradually tampering down in consultation with your pediatrician.

Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Sumanth Amperayani (0 minute later)
Brief Answer:
Metered dose inhaler is better than nebulization

Detailed Answer:
I. You cannot be using nebulizer without Oxygen. This cannot be done on a regular basis at home without medical rated oxygen supply.

2. When used at the appropriate dose and for appropriate duration metered dose inhalers will not cause any growth hampering.

3. You cannot stop the metered-dose inhaler like that and you should be gradually tampering down in consultation with your pediatrician.

Best regards - Dr Sumanth Amperayani
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8339 Questions

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Hi, My Son Is 3.5 Years Old. He Is Having

Hi, My son is 3.5 years old. He is having allergy attacks since 1 year. Earlier he was only having urticaria , but now he is getting wheezing in night. He is coughing and has runny nose . He is on allergy medication for last 3 months ( montak, Allegra) now Ab phylline and seroflo 250 is also added, montak is stopped. We are very much worried . Plz help.