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5 month old prescribed with prednisone for wheezing and cough. Safe for the baby? History of bronchitis

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General & Family Physician
Practicing since : 2000
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Hi I have a 5 month old baby, when he was 3 months old we were admitted to hospital for 6 days with bronchilitus (rsv virus), since then he has had a constant wheeze and every time he gets another cough and cold the wheeze gets worse. Yesterday I took him to the dctor and he gave us antibiotics and steroid tablets - Prednisolone. I am hesitant about the antibiotics because I am so frequently told atibiotics will not cure viruses and very unsure about steroids for a baby so young, what do you think?
Thank you XXXXXXX
Posted Mon, 30 Apr 2012 in Child Health
Answered by Dr. Jagdish 1 hour later

One of the most common air way problems in the infancy is RSV bronchiolitis. This is generally very well tolerated by infants but needs monitoring by the parent / doctor.

There is no hard evidence but hypothetical belief amongst Pediatricians is that RSV bronchiolitis may lead to reactive air way disease and frequent wheezing. This is no big secret. You may talk to the Pediatrician about this.

Infants (post RSV) with Reactive Airway Disease get frequent wheezing, cough, difficulty breathing. Usually they grow out of this problem as they grow older (< or = 5yrs of age).

Reactive Airway Disease is frequently get aggravated by viral and bacterial infections. Even though most of the infections are viral, there is high chance of secondary infection by bacteria, as because the viral infections decrease immunity. They affect the bronchioles and predispose children for bacterial infections. That is why your doctor prescribed antibiotics to prevent bacterial infections. Frequent use of antibiotics leads to resistance to that antibiotic but rotating different antibiotics will still benefit when the child has infection.

Even though steroids on daily basis for long term will cause complications, they do not cause harm for short term use. And reactive Airway Disease (Wheezing) best responds with steroids. Some doctors let the infants be 'Happy wheezers' (without drop in Oxygen saturation) and not prescribe steroids, but your baby's doctor is not one amongst them. I believe he is going in the right direction.

Please post me if you have follow up questions.

Dr. Jagdish
Above answer was peer-reviewed by
Follow-up: 5 month old prescribed with prednisone for wheezing and cough. Safe for the baby? History of bronchitis 2 hours later
Thank you Doctor for your thorough response, one final question though; I notice that after a bottle of formula (cows milk) my sons wheezing/coughing sounds much worse, and he seems quite uncomfortable swallowing it. Could this be just because he has a cold anyway or is the lactose aggrivating the virus? Would it be worth trying goats or soya formula, or would you think unnecessary?
Thank you XXXXXXX
Answered by Dr. Jagdish 3 hours later

the current episode of wheezing could be from viral or bacterial infection or exposure to cold. Reactive Air way disease is basically allergic response. So if your observation is very confident, avoid cow milk and go for soy based formulas.

Above answer was peer-reviewed by
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