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Child suffering from throat infection. Unable to sleep properly. No relief from medication. Safe remedy?

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ENT Specialist
Practicing since : 2001
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Hi, My son is 3.5 years old and suffers from throat infections every couple of months. We don't know what triggers it but it lasts for 2-3 weeks. He coughs continuously especially at night. He is unable to sleep and has been treated by many doctors including some renowned ENT specialists but he is still the same. Various medicines that he has been given over the years include Maxtra, Solvin Cold, Ascoril-C, Mucolite, Mucodyne, Ambrolite S, Ibugesic plus, Nebulisation with Budecort and Levolin, T-minic and many more such cough and cold medicines. Right now also he is suffering from the same problem and has been coughing for the last 3 hours continuously. The ENT specialist just today asked us to give him steam just before sleeping and as soon as he wakes us as these are two times when he cough is worst except for the 3 hr coughing today....but steam too hasn't helped and he is now settled because he has a Tus-Q Lozenges in his mouth........PLEASE HELP!
Posted Wed, 8 May 2013 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 22 minutes later

Thanks for posting the query

Recurrent throat pain and cough is the commonest ENT complaint among young children. This is due to enlarged adenoids and tonsils followed by reduction in the immunity of the child to fight the infections.

The cause of cough is due to either enlarged tonsils or post nasal drip. This happens commonly during sleep because the tonsils fall back and obstruct the throat making it difficult for the child to breath and the child aspirates the salivary secretions. Cough is a protective mechanism to prevent aspiration and any attempt to suppress the cough will lead to secondary infections.

Secondly, if the child is having enlarged adenoids, the child tends to breathe by keeping the mouth open. Breathing with the mouth open, will dry up the throat mucosa, thus, making it sore.

My suggestions to you are:
1. Give him plenty of warm water to drink.
2. Use saline nasal spray 3-4 times a day. This keeps the mucosa of the nose and throat moist, clears off the tenacious nasal secretions and also prevent cough.
3. Give an anti inflammatory medicine such as paracetamol or ibuprofen for the relief of pain.
4. Avoid milk products, this will reduce his cough to a certain extent by preventing accumulation of mucus at the back of the throat.
5. Do not give Tusq lozenges, this will worsen his problems.
6. Also, avoid making him sleep under the fan or in front of the blower of air conditioner.
7. Finally, make him sleep in the semi-prone position, this will prevent the nasal and throat obstruction as well as reduce cough.

Hope I have answered your queries; I will be available for the follow up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Child suffering from throat infection. Unable to sleep properly. No relief from medication. Safe remedy? 48 minutes later
Thank You Dr. for answering but I am still not satisfied and have a few queries as below:-

1) He has been coughing continuously for the last 4 hours and no Steam, medicines or warm liquids have helped. So is there any SOS solution to this problem. The only time he was not coughing was when he a Tus-Q in his mouth which you said is not recommended so what should be the solution to this problem. THIS IS REALLY IMPORTANT BECAUSE HIS COUGH IS LOUD and ROUGH, HE HAS THROWN UP AS WELL AFTER COUGHING FOR LONG LIKE THIS BUT THAT TOO HASNT STOPPED THE COUGH!!!

2) We have been giving him 5ml Meftal-P and 5ml Solvin cold twice a day for the last 10 days. You also suggest paracetamol or ibuprofen, which are the same, so how long should this combination be given and are there any side effects of these?

3) Another ENT we consulted today suggested that adnoids could be the problem but she also said that during an infection they are bound to be swollen so they should be investigated later after the infection has been treated. So while we understand that Adnoids need to be checked once he is better, our concern right now is to get rid of the infection and the phelgm that he has.

4) Focusing on my son's inability to sleep at night you have given suggestions but my concern is also how to get rid of this infection. Whatever needs to be done in terms of medicines or home remedies please give me the details. My son is having growth problems too because of these frequent infections.

Looking forward to a quick and helpful reply.
Answered by Dr. Naveen Kumar 40 minutes later

Welcome back

1. I am sorry, steam inhalation or warm liquids will not give instant relief from the cough. But, in the long run this is definitely going to help. The warm water and the steam lyses the thick tenacious post nasal discharge and reduces the throat irritation and the cough. Tusq is going to suppress the cough for a temporary period but will actually not cure the problem. He is throwing up because the secretions are stuck in the throat and the child will not be able to bring it out just like the adults do.

2. Meftal P can be continued and to be used only when there is pain. Secondly, avoid Solvin cold. This contains phenylephrine and chlorpheniramine maleate which will increase the consistently of the secretions thus worsening the cough. Instead, you can try giving plain mucolytic such as bromhexine or ambroxol, three times a day, this is much beneficial than the combination.

3. Your doctor is right, adenoids enlarge during an episode of symptoms reduce. Meanwhile, use saline nasal spray 3-4 times a day, this is a very good decongestant and a mucolytic. And also, it keeps the mucosa moist and reduces drying of the secretions.

4. I feel, at present your child does not have infection. Fever and lassitude are the typical symptoms of acute infection which your child doesn't have. The cough as I mentioned before is only due to the post nasal discharge and the dryness of the oral cavity. Occasionally, acid reflux from the stomach into the throat can also induce throat inflammation and cough.

Hope this clarifies your doubt. Revert back to me if you have any more queries. I wish your child good health and speedy recovery.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by
Follow-up: Child suffering from throat infection. Unable to sleep properly. No relief from medication. Safe remedy? 4 hours later
I think we are asking too many questions at the same time due to which we are not getting answer to the main question/problem at hand right now. Please answer just one point mentioned below:

1. What should we do or which medicine has to be given to him, when he starts coughing continuously/severely and it doesn't stop? We need an SOS solution for situations where he keeps coughing badly for hours.

Answered by Dr. Naveen Kumar 10 hours later

Thanks for writing back

I have already answered to this query in my previous responses. Cough is not a disease, it is a symptom of an underlying cause. We need to treat the cause rather than treating the symptom.

If the chest is clear with out any signs of chest infection, then the most probable cause of cough is the post nasal discharge. The secretions from behind the nose trickle down into the throat irritating the mucosa of the throat. This irritation induces cough in order to bring out the secretions. This increases on lying down because, the discharge starts flowing towards gravity and thus worsening of cough.

Our aim should be at treatment of this post nasal discharge. I can assure you, with medications such as a mucolytic (plain ambroxol or bromhexine) and saline nasal spray 3-4 times a day, the child will definitely become alright. Stop all the other medications and use only the above medicines. In spite of using the above medications if the child is not feeling better within 2-3 days, try giving a short course of oral steroids for a couple of days, this will relieve his symptoms.

Please go through this link for further reference:
WWW.WWWW.WW au/clinicalguide/guideline_index/Cough/

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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