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3 year old wheezing since 10 months old. How to build immunity against viruses and bacteria?

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hi Doctor, my 3 year old son has Wheezing since he was 10 months old. Over the past 2 years it has got worse to 2 or 3 attacks a month (and each lasting 7-10 days). We did some blood serum tests and found that he has no allergies and doctor said its mainly Virus induced Asthma. His chest x-ray was normal. He only gets sick when he is going to the nursery. i have tried giving him Flixotide for 6 months, then we tried Singulair for 6 months and finally Zaditen for 4 months, but the frequency of his attacks are still the same i.e 2-3 times a month. He always ends up taking antibiotics and Ventolin, Pulmicort & Atrovent nebulization. What can i do to make him feel better and reduce the number of attacks? He has dry 'barking' like cough at night and wet cough in the mornings when he wakes up. My doctor prescribed Mucosolvan for the cough, but he still wakes up at night coughing. Is there anything else we can do to make him feel better? How can i prevent or build his immunity against viruses&bacteria?
Posted Wed, 10 Oct 2012 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 1 hour later

Thanx for posting your query on XXXXXXX

From your description it is apparent that your son is suffering from childhood asthma and he is being treated with various drugs available for the treatment of asthma.

I suggest you give flixotide to him on regular basis instead of only during acute exacerbations as this is an anti inflmmatory drug and is used to control asthma symptoms. Otherwise you may try advair125 which has an added advantage of having a long term beta agonist though it is preferrably used in children 4 yrs and above. It can be used through a spacer device and child should be made to rinse his mouth with water after use to avoid any oral thrush.

You should continue using singulair(monteleukast). During acute attacks continue nebulization with ventolin, pulmicort and atrovent.

You have to have patience as large number of children with childhood asthma outgrow their symptoms with time. You should avoid any known allergens. You have mentioned that he only develops symptoms when he goes to the nursery. I hope there`s nothing there that`s aggravating his allergy. Why not try and change the nursery or discuss it with the management.

Avoid junk food like colas, wafers, french fries, extreme changes in temp and dusty and smoky atmosphere. His room and bed linen should be clean and frequently aired and sunned. I hope his immunization is complete as per his age and he has been vaccinated with pneumonia and influenza vaccine.

That`s all for now. Take care.
Above answer was peer-reviewed by
Follow-up: 3 year old wheezing since 10 months old. How to build immunity against viruses and bacteria? 40 minutes later
Dear Doctor,
Thanks for your reply.
I had given my son Flixotide 50mcg(with spacer) daily (2 puffs a day) for 6 months. There was no change in his asthma attacks and he lost a lot of weight during that time (I think mainly because Flixotide used to make him feel very thirsty and he did’nt seem to have appetite for food). Finally the doctor asked us to stop flixotide and start Monteleukast, which we also continued daily for 6 months. Both Flixotide & Monteleukast did not seem to be effective. Do you think we should try a different combination of medicines as a prophylactic?
We have already given him the Flu and pneumococcal vaccine . He does not have any allergies (allergy & IG-E blood reports attached for your reference in first mail). We even changed his nursery to a more hygienic play school. But my son seems to always get sick at the first sight of a sick child in the room. How long will it take for him to outgrow from childhood asthma?
Is there anything I can do to build his Immunity or resistance power?
Answered by Dr. Shashi Dangwal 4 hours later

As i have mentioned earlier also, you may try advair inhaler instead of flixotide as it has the added advantage of a long acting beta agonist also.

Some times a short course of oral steroids may also help.

Regarding his nursery, can you not totally avoid the nursery stay for him. From your description, some how i have a feeling that he may benefit if he does`nt go to the nursery because asthma has a psychosomatic element to it. You may try a baby sitter at home.

There is nothing much needs to be done to improve the immunity as he appears to be a normal healthy child. You may give him a vitamin supplement beside the normal balanced diet.

50% of children with childhood asthma outgrow their disease as they grow but no definite age can be assigned as to when that may happen. As he grows his symptoms may become milder and may totally disappear by say 8 to 10 years.

I hope i have been able to answer your query.
Above answer was peer-reviewed by
Follow-up: 3 year old wheezing since 10 months old. How to build immunity against viruses and bacteria? 15 hours later
Thanks a lot for your reply. It is really helpful. Since me and my husband are working, keeping my son full time at home is not an option for us.

Regarding the advair inhaler, does it have any side effects, like dry mouth, affecting growth rate etc.? how long should he take the course inorder to see the benefit?
Also, you mentioned some oral steroids. Can you please tell which ones are suitable for his age, so that i can check these with our son's pediatrician? How long should we take the course?

Thanks again for your help.
Answered by Dr. Shashi Dangwal 1 hour later

I`ve already mentioned that advair has the added advantage of having a long acting beta agonist beside fluticasone in it and is superior to flixotide alone but it is generally recommended for children of 4 yrs and above age. You may still try as you said that your son is not respondimg to most of the asthma drugs. There are minimal side effects as being an inhaler very little quantity actually enters the circulation. Make him rinse his mouth after inhalation.

Omnacortil is the oral steroid that may be used during acute attack and can be used for 5 to 7 days. You may also try giving him asthalin or terbutalin solution during an attack. You may consult his paediatrician and discuss these issues.

Take care.
Above answer was peer-reviewed by
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