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Having greenish/yellowish nasal discharge. Tried saline nasal sprays. Having GERD, PFO/ASD. Having running stools. Remedy?

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My 5 1/2 month old has had greenish/yellowish nasal discharge, off/on low grade fevers (highest 101), cough, chest congestion and tugging at ears at times since May 8th. I tried saline nasal sprays with bulb suctioning, cool mist, steam in bathroom, and tylenol every now and then. I then took him in to his DR office May 28th. They said it is most likely viral. Well, that was 3 weeks ago and he still has the same symptoms. On top of all that, the poor little guy is always pale looking, even lips are pale at times. The other night, he had a few minutes of grunting while breathing and seemed like he could not catch his breath d/t nasal drainage. I was going to take him to ER but then few minutes later started breathing normal and smiling. Scary though!!! His medical history includes GERD, PFO/ASD (echo follow-up July 1st, has been asymptomatic so far) and baby is on hypo-allergenic forumla. He has his normal spit up but last week was throwing up hours after bottles. He is still having 5-6 wet diapers and runny stools (has always had runny stools d/t nutramigen formula). Do I keep doing the wait and see approach or go to walk in clinic? Please help this first time mommy!! I am a nurse so I am trying not to take him unless its a true emergency but I just would hate myself if he started to get pneumonia, or something worse like meningitis from an ear/sinus infection gone too long.
Posted Sat, 13 Jul 2013 in General Health
Answered by Dr. Grzegorz Stanko 21 minutes later

Thank you for the query.

GERD is a condition which can cause all mentioned by you symptoms. Moreover, this condition is very often associated with asthma and sinus inflammation due to allergy.

Grunting and shortness of breath episodes can be caused by asthma.
Throwing up after meal can be a symptom of acid reflux disease. Moreover it can irritate throat and sinuses and cause an inflammation in this areas.
Runny stools seem to be caused by food intolerance or allergy. Allergy can also cause sinuses swelling and nose blockage.

As you can see, the symptoms do not point to one condition. That is why your son needs proper diagnostics and treatment.

You should take him to a good pediatrist who will take care of him. He needs allergy tests, eliminating diet, stool tests, asthma diagnostics (spirometry if possible), acid reflux disease treatment (gastroenterologist should be consulted) and sinus inflammation treatment (laryngologist should be visited). It is nothing emergent, but you should not wait with it for a long time.

Hope this will help. Feel free to ask further questions.
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Follow-up: Having greenish/yellowish nasal discharge. Tried saline nasal sprays. Having GERD, PFO/ASD. Having running stools. Remedy? 36 minutes later
What do you mean by eliminating diet? What would stool sample be for? He is already on a hypo-allergenic formula and that is it. I do add 1/2 teaspoon baby oatmeal to thicken for the GERD (recommended by dr) His doctor did say next step would be GI consult. As for the asthma, doctors have never mentioned that as a possible problem but I have researched it and wondered if he may have that as well. Thank you.
Answered by Dr. Grzegorz Stanko 8 minutes later
Well than if he is no hypo-allergenic formula than no eliminating diet is needed.

With stool sample we can diagnose lactose intolerance, coeliac disease, parasites, bacterial infection. Every diarrhea which lasts longer than 48 hours should be checked with stool tests.

GI consult as a next step is a very good idea.

Hope this will help.
Above answer was peer-reviewed by
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