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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Child Having Recurring Cough, Is Always Sick With Cold- Cough Symptoms, Conditions Resolve With Antibiotics. What Could Be The Cause?

Goodmorning ...I have been doctoring for my daughter for the last 4 years for a reoccuring cough . She also now sees and asthma/ allergy doc for the last year and a half. I am conviced that it is her adnoid causing this problem but the ENT we saw only looked at her tonsils and said she could go either way. She is sick all the time with cold like symptoms and cough til she puke when having these episodes last a couple weeks go on antibiotics and they resolve for awhile. Any advice you can give me as to this would be helpful cuz out of 3 doc they can t figure it out and I m tired of a sick kid on antibiotics all the time as is she sick and tired of being sick and tired
Sat, 30 Jun 2012
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Pediatrician 's  Response
Hello h.moline,
I just saw your question posted on may 14th 2012 just now ( Friday June 29th).
Though it is late, it is worthwhile to answer you, because several thousands through out the world have the same frustrations.
Let us analyse the problem from 7 angles.
1. What is the problem with your child
2. Why it has come
3. What diet
4. Drugs: the treating doctor is the best person to do this
5. Apart from diet and drugs what needs to be done to the child at home to prevent such attacks
6. What are investigations required
7. When to meet the doctor again?.
1. What is the problem:
Recurrent episodes of cold and cough can be due to disease or normal variation. children means they are prone for cold cough even, once in six to 8 weeks. Then how to differentiate normal variation with disease. In general if the child's weight, height, head circumference, chest circumference and mid arm circumference is appropriate for the child's age, birth weight then nothing need to be done, except closely monitoring the child.
If it is due to disease, we have to decide
where is the problem
nature of the problem
If the problem is in nose there will be symptoms related to nose like nose block or running nose for 10 consecutive days. This could be a early sign of sinusitis.( yes, it can occur in children)
If it is adenoids there should be snoring in the night, mouth breathing or noisy breathing, face dull and not attentive due to hearing problems.
If in the tonsils, then ENT doctor would have picked it up.
If it is in the voice box there would be hoarse voice
If in the bronchus there would be severe cough with sputum. When infected sputum would be yellow.
If small airways are affected there would be wheeze.
When alveoli, the part where oxygen from the air is transferred to the blood, is affected there will shortness of breath.
Nature of the illness we call it as pathology;
This could be inflammation ( then many of the above symptoms would have been present ) or others like allergy.
Features of respiratory allergy are
a. nose block
b. nose itch
c. nose leak
d. sneeze
e. wheeze
f. Cough in the night.
2. Why it would have come?
Allergy means dust allergy or rarely food allergy
Infection means from school or from family members
3. Indications for antibiotics
1. 10 days running nose or running nose is just like pus
2. Nose tip redness
3. Ear pain
4. Neck glands

4. Steps to be taken at home
a. invisible dust : fan ( clean it once a week ) pillow bed sheet, ( expose them to sun once a week )
old books and carpets
b. No unboiled items like bottled drinks
c. No artificially coloured or flavoured items
5. Diet: Highly individualised. Note down the foods associated with cold and cough ( this is extremely rare) Repeat it when the child is normal. If again it precipitates symptoms, then we can stop that diet alone
6. Tests requried.
Serum IgE levels will tell the child is atopic: Allergic tendancy is inborn, he will adjust with time
7. When to meet the doctor again?
When all precautions fail, the child growth is faltering and in one month twice he requires hospital visit then a second visit to the doctor is required.
with regards
arulalan
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Child Having Recurring Cough, Is Always Sick With Cold- Cough Symptoms, Conditions Resolve With Antibiotics. What Could Be The Cause?

Hello h.moline, I just saw your question posted on may 14th 2012 just now ( Friday June 29th). Though it is late, it is worthwhile to answer you, because several thousands through out the world have the same frustrations. Let us analyse the problem from 7 angles. 1. What is the problem with your child 2. Why it has come 3. What diet 4. Drugs: the treating doctor is the best person to do this 5. Apart from diet and drugs what needs to be done to the child at home to prevent such attacks 6. What are investigations required 7. When to meet the doctor again?. 1. What is the problem: Recurrent episodes of cold and cough can be due to disease or normal variation. children means they are prone for cold cough even, once in six to 8 weeks. Then how to differentiate normal variation with disease. In general if the child s weight, height, head circumference, chest circumference and mid arm circumference is appropriate for the child s age, birth weight then nothing need to be done, except closely monitoring the child. If it is due to disease, we have to decide where is the problem nature of the problem If the problem is in nose there will be symptoms related to nose like nose block or running nose for 10 consecutive days. This could be a early sign of sinusitis.( yes, it can occur in children) If it is adenoids there should be snoring in the night, mouth breathing or noisy breathing, face dull and not attentive due to hearing problems. If in the tonsils, then ENT doctor would have picked it up. If it is in the voice box there would be hoarse voice If in the bronchus there would be severe cough with sputum. When infected sputum would be yellow. If small airways are affected there would be wheeze. When alveoli, the part where oxygen from the air is transferred to the blood, is affected there will shortness of breath. Nature of the illness we call it as pathology; This could be inflammation ( then many of the above symptoms would have been present ) or others like allergy. Features of respiratory allergy are a. nose block b. nose itch c. nose leak d. sneeze e. wheeze f. Cough in the night. 2. Why it would have come? Allergy means dust allergy or rarely food allergy Infection means from school or from family members 3. Indications for antibiotics 1. 10 days running nose or running nose is just like pus 2. Nose tip redness 3. Ear pain 4. Neck glands 4. Steps to be taken at home a. invisible dust : fan ( clean it once a week ) pillow bed sheet, ( expose them to sun once a week ) old books and carpets b. No unboiled items like bottled drinks c. No artificially coloured or flavoured items 5. Diet: Highly individualised. Note down the foods associated with cold and cough ( this is extremely rare) Repeat it when the child is normal. If again it precipitates symptoms, then we can stop that diet alone 6. Tests requried. Serum IgE levels will tell the child is atopic: Allergic tendancy is inborn, he will adjust with time 7. When to meet the doctor again? When all precautions fail, the child growth is faltering and in one month twice he requires hospital visit then a second visit to the doctor is required. with regards arulalan