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Suggest Treatment For Coughing And Wheezing In Children

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Posted on Mon, 3 Oct 2016
Question: Hi
My 3.5 years old boy has been suffering from coughing and wheezing from past 2 weeks or so. He has this issue in weather conditions as in XXXXXXX This time however it's been prolonged too long and the coughing is just not going away.
In the past 1 month he has had antibiotic, then a week later omnacortil, relent and levolin inhaler. Right now as well he has been prescribed levolin inhaler, relent and maintain chewing tablets.
What's worrying is the duration this bout has been running for.
Please suggest.

- XXXXX
doctor
Answered by Dr. Archana Verma (34 minutes later)
Brief Answer:
No need to worry

Detailed Answer:
Hi XXXXXXX

I understand your concerns but don't worry. The most likely reason for such long lasting cough is inadequately controlled allergic bronchitis.

At present, I would recommend you to continue with levolin nebulization (0.63 every 8 hours) along with Syp. Montair LC kid (5 ml at 8 pm daily). In case you do not find relief in cough then start budecort nebulization twice daily. You may discuss this with a pediatrician after clinical evaluation of chest condition. These doses needs to be gradually caliberated as per your child's condition over a period of 2-3 months. Hopefully it will improve.

Hold all other treatment such as Relent and Maintain gum.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (39 minutes later)
Okay. Thanks for responding.
Also he has got sudden bouts of fever just touching 100 Fahrenheit in the past 2 days. Is that a worry? Generally we give Crocin DS and it subsides.
Montair right now he is having chewable tablets.
He was on Levolin and Budecort inhalers regularly last winter too. Currently he takes Levolin thrice daily and it's been for at least 2-3 weeks.
Budecort hasnt been restarted yet.
Also is Relent required in case we move to Budecort?
doctor
Answered by Dr. Archana Verma (2 hours later)
Brief Answer:
No need for Relent and chewable tablets

Detailed Answer:
Hi
You may give Crocin DS for fever if the spikes are more than 100 degrees Fahrenheit. Avoid giving any medications for lower temperatures. If coughing and fever both lasts for more than 5 days then an X Ray chest to rule out pneumonia will be useful.
At present, start with budecort along with levolin if the symptoms are insufficiently controlled on levolin and montair alone. Giving Syp. Montair LC kid will be better because it's more acceptable and has added advantage of antihistamines i.e. levocetirizine.

No need to use Relent at present. It's not recommended for treatment of allergic bronchitis.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (21 hours later)
Thanks again. Yesterday he was pretty fine post lunch. in fact was back to his playful self in the evening. issue is once he sleeps at night I see the coughing tendency to be reoccurring. that's been the case for past 2 nights. is that anything to do with how he sleeps or the room where he sleeps? generally the room does not have cross ventilation as such.
also right now he takes Levolin inhaler thrice a day, 2 puffs at a time. and Budecort he has taken earlier twice a day, 1 puff at a time. would the dosage remain the same?
doctor
Answered by Dr. Archana Verma (29 minutes later)
Brief Answer:
Start Montair LC kid

Detailed Answer:
Hi
The response seems to be fine. It take a few days for complete recovery. You may start Montair LC kid as suggested earlier if not yet started. This will help in better recovery. Continue with budecort and levolin in same dose.
The night coughs usually occurs due to troughs in body production of corticosteroids with associated bronchospasms. So, if they continue them starting him on regular metered dose inhaler ( Budesonide-formeterol) for at least 3 months will be useful. This needs proper clinical evaluation including pulmonary function test.

Hopefully it will be of help.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (30 hours later)
status: entire day he is more or less far better off in the last couple of days. however the coughing goes on through the night. also there may be a bit of. tough deposition on his chest. right now we have moved him to Montair LC syrup at night once and puffs of levolin and Budecort.
anything else to do?
thanks again for your help.
doctor
Answered by Dr. Archana Verma (5 minutes later)
Brief Answer:
Lets wait for 3 more days

Detailed Answer:
Hi
Good to hear about the improvement. I would recommend you to continue with same drugs and dosages for 3 more days. If the night cough do not show any improvement then we will step up the therapy.
Ensure plenty of water intake as it helps in the condition. Avoid dust and any known allergens.
Take care
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Archana Verma (31 hours later)
His coughing during nights is just not easing down. At night the coughing increases significantly and often makes him wake up from sleep. Can we treat that? Am afraid he is not getting proper sleep due to this.
doctor
Answered by Dr. Archana Verma (6 hours later)
Brief Answer:
Step up the dose of budecort

Detailed Answer:
Hi
If you are giving 1 puff of budecort twice daily then in view of persistent night coughs, I would recommend to give 2 puffs twice daily. This will improve his coughing at night. Continue levolin and Montair LC kid. Once the symptoms are well controlled then reduce the dose of levolin to one puff thrice daily followed by as and when required. Step down on budecort after 1 months of complete control and continue with 1 puff twice daily for at least 6 months thereafter.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (4 hours later)
Today morning am feeling the coughing has picked up much more than it normally is in the morning times. Almost every minute he is coughing which has not been the case for past 1 week or so. Generally at this time he does not cough this much.
doctor
Answered by Dr. Archana Verma (1 hour later)
Brief Answer:
Increase the budecort puffs as suggested

Detailed Answer:
Hi
Do not worry. Increase the dose as suggested earlier. The symptoms are suggestive of inadequate control. Hopefully it will improve.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (45 hours later)
update: daytime he is pretty OK. night remains a concern with the coughing.
the latest developments being I feel he has some cough in his chest coz the coughing sound seems to be coming from there, kind of a hollow one.
also he has started to form a lot of light yellow mucus on his eyes once he sleeps every night.

he is still being treated on montair of syrup, 5 ml once a day. And levolin and Budecort as suggested.
doctor
Answered by Dr. Archana Verma (6 minutes later)
Brief Answer:
Use normal saline nebulizations

Detailed Answer:
Hi
Thanks for your update. Since we have already increased the doses of budecort and levolin, so continue with same. If you feel secretory sounds still in chest with cough, you may give him normal saline (5 ml) nebulizations thrice daily. This is non medicated and will have added effect in clearing chest.
Hopefully it will be of help.
Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Archana Verma (7 minutes later)
thanks. and what about the light yellow mucus in his eyes when he sleeps? we now just clean it with cotton and warm water but this is something which has come up in past 2 days
doctor
Answered by Dr. Archana Verma (33 minutes later)
Brief Answer:
Continue cleaning with cotton

Detailed Answer:
You may use cotton and normal saline to clean the eyes. Normal saline nasal drops will help because these symptoms occur due to blocked nose and nasolacrimal duct leading to poor drainage of eye secretions. Normal saline nebulizations will have added advantage.
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. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Archana Verma

Pediatrician

Practicing since :2006

Answered : 1129 Questions

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Suggest Treatment For Coughing And Wheezing In Children

Brief Answer: No need to worry Detailed Answer: Hi XXXXXXX I understand your concerns but don't worry. The most likely reason for such long lasting cough is inadequately controlled allergic bronchitis. At present, I would recommend you to continue with levolin nebulization (0.63 every 8 hours) along with Syp. Montair LC kid (5 ml at 8 pm daily). In case you do not find relief in cough then start budecort nebulization twice daily. You may discuss this with a pediatrician after clinical evaluation of chest condition. These doses needs to be gradually caliberated as per your child's condition over a period of 2-3 months. Hopefully it will improve. Hold all other treatment such as Relent and Maintain gum. Take care