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Suggest Treatment For Cough And Chest Congestion In A Child
Question: My daughter is 11weeks old weight is 5.4 kgs and is on formula. Since yesterday she is having cough and congestion in the chest. She is getting very restless while sleeping and drinking milk . No running nose and she not coughing continously but it seems she is getting very uncomfortable with cough coming in her mouth as she is not able to spit it out. She also vomitted cough after drinking milk in the morning. My paedratician prescribed phenergan (2.5ml) 3 times a day. However i read on internet that phenergan should not be given to children under two years of age. Kindly help.
Brief Answer:
Please don't use Phenergan - use only saline
Detailed Answer:
Hi...Thank you for consulting in Health Care magic.
Please do not use Phenergan itbis not licensed at this age group. The safety standards are not established.
Cough and cold are viral 95% of the times in children.
Cough should not be treated at this age. Occasional cough is a protective reflex at this age.
For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Even a mild antiallergic medication like Cetrizine is not indicated at this age.
Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F.
I suggest not using combination medicines for fever, especially with Paracetamol.
For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.
Regards - Dr. Sumanth
Please don't use Phenergan - use only saline
Detailed Answer:
Hi...Thank you for consulting in Health Care magic.
Please do not use Phenergan itbis not licensed at this age group. The safety standards are not established.
Cough and cold are viral 95% of the times in children.
Cough should not be treated at this age. Occasional cough is a protective reflex at this age.
For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Even a mild antiallergic medication like Cetrizine is not indicated at this age.
Paracetamol can be given in the dose of 15mg/kg/dose (max ceiling dose 500mg) every 4-6th hourly, that too only if fever is more than 100F.
I suggest not using combination medicines for fever, especially with Paracetamol.
For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
She doesnt have blocked nose but she is having congestion in the chest . So please advice what is to be done for CHEST CONGESTION. Because she is being uncomfortable because of cough coming in her mouth.
Brief Answer:
Please answer the questions
Detailed Answer:
Hi....I understand your concern. By what you quote I feel that the baby might be having a lower respiratory infection due to viral illness or acute bronchiolitis. This is what you are feeling as chest congestion. There might be mild wheeze too. The most common cause for this is again viral infection or Respirator Syncitial Virus (RSV).
I have a few questions for you -
1. Is there fast breathing / please count the respiratory rate per minute and get back to me. Count when baby is not crying.
2. Is there chest in drawing - you need to see if the kid's chest wall is being sucked in while inspiration.
3. Is there any difficulty in feeding?
4. Is there any fever?
If it's bronchiolitis or lower respiratory illness as I had suggested - these would be my suggestions -
1. She might require 3% Sodium Chloride nebulization.
2. Need to check her oxygen saturation in the blood by a simple device called pulse oximeter and if it's less than 92% she might require oxygen supplementation.
3. If this doesn't work she might need adrenaline nebulization.
4. I would also like to have a chest X-ray done along with nasopharyngeal aspirate for RSV.
All this needs to be done in a hospital based setup.
Please get back to me with answers to above questions and I will guide you further.
Regards - Dr. Sumanth
Please answer the questions
Detailed Answer:
Hi....I understand your concern. By what you quote I feel that the baby might be having a lower respiratory infection due to viral illness or acute bronchiolitis. This is what you are feeling as chest congestion. There might be mild wheeze too. The most common cause for this is again viral infection or Respirator Syncitial Virus (RSV).
I have a few questions for you -
1. Is there fast breathing / please count the respiratory rate per minute and get back to me. Count when baby is not crying.
2. Is there chest in drawing - you need to see if the kid's chest wall is being sucked in while inspiration.
3. Is there any difficulty in feeding?
4. Is there any fever?
If it's bronchiolitis or lower respiratory illness as I had suggested - these would be my suggestions -
1. She might require 3% Sodium Chloride nebulization.
2. Need to check her oxygen saturation in the blood by a simple device called pulse oximeter and if it's less than 92% she might require oxygen supplementation.
3. If this doesn't work she might need adrenaline nebulization.
4. I would also like to have a chest X-ray done along with nasopharyngeal aspirate for RSV.
All this needs to be done in a hospital based setup.
Please get back to me with answers to above questions and I will guide you further.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor. One more query as my baby's cough and cold still persists. On 9/11/2015 the paediatricians prescribed Otrinoz (Saline) nasal drops and told us that we can use as much as we wish to as baby was not having milk cos of blocked nose. Now we have realised that instead of Saline drops the chemist has given us Otrinoz 0.025% nasal drops for babies which I have recently read that should not be given for more than 3 days. I hope the present condition of my baby is not because of this wrong medication as we have been using the drop since last one month. pls advise if this is true and also the remedy. attaching the snaps of prescription and the wrong drops given by chemist
Brief Answer:
Please stop medicated nasal drops
Detailed Answer:
Hi....I have seen the images. The chemist has given a wrong drug which is not mentioned in the prescription.
When medicated nasal drops like this are used for more than 3-5 days continuously, then definitely rebound nasal congestion can occur.
I appreciate your coming out with the fact that medicated nasal drops have been used for the past 1 month.
This noisy breathing could be due to rebound nasal congestion due to prolonged usage of medicated drops.
My suggestions regarding this -
1. Please stop Otrinoz medicated drops immediately.
2. Use only saline nasal drops to relieve congestion.
3. It might take 2-4 weeks for this rebound nasal congestion to get better.
4. Do not worry about noisy breathing.
5. The danger signs or red flag signs when you need to worry are - fast breathing, chest in drawing, inability to feed, extreme cough up to the level of disturbing sleep or causing breathlessness.
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. In this way even in health care magic you can follow up always with a single doctor who knows the history of your kid completely. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
Please stop medicated nasal drops
Detailed Answer:
Hi....I have seen the images. The chemist has given a wrong drug which is not mentioned in the prescription.
When medicated nasal drops like this are used for more than 3-5 days continuously, then definitely rebound nasal congestion can occur.
I appreciate your coming out with the fact that medicated nasal drops have been used for the past 1 month.
This noisy breathing could be due to rebound nasal congestion due to prolonged usage of medicated drops.
My suggestions regarding this -
1. Please stop Otrinoz medicated drops immediately.
2. Use only saline nasal drops to relieve congestion.
3. It might take 2-4 weeks for this rebound nasal congestion to get better.
4. Do not worry about noisy breathing.
5. The danger signs or red flag signs when you need to worry are - fast breathing, chest in drawing, inability to feed, extreme cough up to the level of disturbing sleep or causing breathlessness.
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. In this way even in health care magic you can follow up always with a single doctor who knows the history of your kid completely. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor
1. Should we give any medication for treating rebound nasal congestion
2. We are applying home remedies as of now
3. Danger signs are not there
4. She is taking feeds but is fussy and takes small feeds at short interval
5. She is irritable most of the times
6. She is a bit disturbed while sleeps but no extreme coughing
Hence pls suggest if some medicine is to be used
1. Should we give any medication for treating rebound nasal congestion
2. We are applying home remedies as of now
3. Danger signs are not there
4. She is taking feeds but is fussy and takes small feeds at short interval
5. She is irritable most of the times
6. She is a bit disturbed while sleeps but no extreme coughing
Hence pls suggest if some medicine is to be used
Brief Answer:
No medicine needs to be used - just stop medicated drops and wait
Detailed Answer:
Hi XXXXXXX ... Ni medication needs to be used. Just stop administering medicated nasal drops. That is enough. Only thing is you need to wait as I mentioned for few weeks for the rebound nasal congestion to get better.
Instead of home remedies for nasal congestion, you can use saline nasal drops. No harm.
Her irritability could be due to the nasal congestion. Use saline nasal drops.
Regards - Dr. Sumanth
No medicine needs to be used - just stop medicated drops and wait
Detailed Answer:
Hi XXXXXXX ... Ni medication needs to be used. Just stop administering medicated nasal drops. That is enough. Only thing is you need to wait as I mentioned for few weeks for the rebound nasal congestion to get better.
Instead of home remedies for nasal congestion, you can use saline nasal drops. No harm.
Her irritability could be due to the nasal congestion. Use saline nasal drops.
Regards - Dr. Sumanth
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. Yogesh D
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