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Child gets cold frequently. Had pneumonia and elevated IGE levels. Advised Montair. What is the reason?

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Pediatrician, Pulmonology
Practicing since : 2003
Answered : 1793 Questions
I have two questions related to my kid. I am hoping that I get some information and help regarding it. 1) He contracts cold very often and it remains for about 8-10 days. He had been diagonised with Pneumonia about four times between 2yrs and 7 yrs of age. A recent diagnosis revealed that he has very high levels of IGE. The levels are more than 3000. On Contacting a doctor, he is advised to be given Montair LC Kid twice a day and for one year. The following food items are advised to be not given to the kid. a) chocolates b) Any types of Fruits c) Dry Fruits - any type d) Ice cream e) Cream biscuits and bakery products. We have been religiously following the entire course but I see no improvement in the kid. He is still prone to cold. He is super active and is very very thin. He weighs only 18 Kgs at 9 years. Please guide in the right direction. 2) My kid grinds his teeth in sleep. He does it so loud that I wake up from sleep many times due to the sound and even he does get up.I contacted various doctors who advised that he might have intestinal worms and have been medicated accordingly. But that doesn't help. Could you please help me in this as well?
Posted Wed, 11 Dec 2013 in Child Health
Answered by Dr. Arun 1 hour later
Brief Answer: Allergic cough needs inhalers Detailed Answer: Hi Thanks fir writing to XXXXXXX 1) From what you describe your kid has allergic cough which is indicated by high IgE levels. With such repeated pneumonias I would definitely propose that many would have been actually wheeze associated with lower respiratory tract infection. Your kid is not improving on montair which is rightly the first step. You need to start him on inhaled corticosteroids which are absolutely safe even if taken for long time. Believe me you need to put him on this inhaler like budesonide 100 mcg twice daily . It should be taken daily without fail to control his symptoms which may take few months. Do consult allergy specialist for allergen testing on skin which if identified and avoided ( not the list you mentioned ) could help tremendously . 2) Teeth grinding could be due to anemia too . Check his hemoglobin and give him iron supplements too. It's sometimes a sleep habit which will settle spontaneously. Wishing your kid good health Regards Dr Arun
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Follow-up: Child gets cold frequently. Had pneumonia and elevated IGE levels. Advised Montair. What is the reason? 1 hour later
Hello Doctor, Thank you for the response. I have a few follow up questions on both my queries. 1) I understand that I need to use pump for my kid to get better and you have mentioned that it needs to be administered for a few months. What duration should I begin the medicine "BUDESONIDE 100MCG" twice daily? Should I revisit you after 3 months for the progress? Will this medicine help contain the allergy? Can you recommend any good doctor for allergy testing where I can get this done? Do I need a written prescription for the test to be conducted? 2) My Son is not anemic. His haemoglobin is 12.5% which falls within the normal range (I guess). I am very concerned with the teeth grinding because this act disturbs his sleep and I don't find him sleeping sound. I guess his permanent teeth are also not in shape because of this. They are very hapazard. If this is a sleep disorder, do we have any treatment or do we need to wait for him to overcome naturally, after a specific time period? Thank you for your time and patience to respond to my questions. XXXXX XXXXXXX
Answered by Dr. Arun 3 hours later
Brief Answer: See below Detailed Answer: 1) yes skin testing has to be done by a trained allergy specialist. As you are from hyderabad you can visit rainbow childrens hospital ( I think Dr XXXXXXX does it there ) . Budesonide atleast 3 months before reviewing again. 2) Teeth grinding needs to investigated further. Making him stress free in the day with inhalers might actually benefit him. I would suggest dental examination to rule out malocclusion. Dental guards might help but you need to confirm with your dentist. Medications arent still approved for pediatric use. Wishing your kid good health Dr Arun
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Follow-up: Child gets cold frequently. Had pneumonia and elevated IGE levels. Advised Montair. What is the reason? 14 hours later
Hello Doctor XXXXXXX Thank you so much for your help. I am going to start "Budesonide 100 mcg" with immediate effect. I will get in touch with you after three months. I just need your guidance on how to administer this drug as I have never used it. Any suggestion would benefit me. I will consult a dentist to check on the teeth grinding. Once again, Thank you for your help. Kind regards, XXXXX XXXXXXX
Answered by Dr. Arun 11 minutes later
Brief Answer: Use with spacer like transpacer Detailed Answer: You need a spacer device between the inhaler and mouth. The exact way to take it will be shown in the package inset with spacer Regards
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