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How Long Should Medication For Frequent Cold And Wheezing Be Continued In Children?
Question: Hello doctor,
My son XXXXXXX is 4.5 yrs old and usually has cough and cold regularly. He also has skin irritation sometimes. Also, Some times, like once in 3-4 months he gets wheezing as well.
We had got him checked by a Pediatrician when he was 1.5 yrs old who had prescribed him the medicines Montair LC kid tablet once every day before going to bed and 2 puffs of Flohale 50 inhaler. He also had recommended Asthalin inhaler if he had wheezing. Later after the condition of the child improved , he suggested to stop the medicines gradually and use them only if required.
We got him checked by an allergy specialist yesterday who got some tests done. The tests showed that the child was allergic to household dust mites. We were also told that the pft showed an improvement of 15% after medication. The result was 120% before medication.
The allergy specialist recommends using the same medications regularly now. The child looks fine now to us without any symptoms of wheezing. He has slight cough though. We are worried about giving the medication regularly to the child for long term. Please let us know if this problem of wheezing in the child will go away gradually as he grows and how to stop these medicines.
Thanks,
XXXX
My son XXXXXXX is 4.5 yrs old and usually has cough and cold regularly. He also has skin irritation sometimes. Also, Some times, like once in 3-4 months he gets wheezing as well.
We had got him checked by a Pediatrician when he was 1.5 yrs old who had prescribed him the medicines Montair LC kid tablet once every day before going to bed and 2 puffs of Flohale 50 inhaler. He also had recommended Asthalin inhaler if he had wheezing. Later after the condition of the child improved , he suggested to stop the medicines gradually and use them only if required.
We got him checked by an allergy specialist yesterday who got some tests done. The tests showed that the child was allergic to household dust mites. We were also told that the pft showed an improvement of 15% after medication. The result was 120% before medication.
The allergy specialist recommends using the same medications regularly now. The child looks fine now to us without any symptoms of wheezing. He has slight cough though. We are worried about giving the medication regularly to the child for long term. Please let us know if this problem of wheezing in the child will go away gradually as he grows and how to stop these medicines.
Thanks,
XXXX
Brief Answer:
It might be multi triggered wheeze or viral assoicated wheeze
Detailed Answer:
Hi...Thank you for consulting in Health Care magic. Greetings from XXXXXXX
By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -
Questions:
1. How many days per month does he cough or feel breathless?
2. How many nights per month does his sleep get disturbed due to above symptoms?
3. Does he feel breathless when he runs around or plays with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?
Please get back to me with answers to all the above questions and I will be glad to guide you further.
Regards - Dr. Sumanth
It might be multi triggered wheeze or viral assoicated wheeze
Detailed Answer:
Hi...Thank you for consulting in Health Care magic. Greetings from XXXXXXX
By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -
Questions:
1. How many days per month does he cough or feel breathless?
2. How many nights per month does his sleep get disturbed due to above symptoms?
3. Does he feel breathless when he runs around or plays with other kids?
4. Are the symptoms when there are seasonal changes?
5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
6. Is the cough always associated with fever?
Please get back to me with answers to all the above questions and I will be glad to guide you further.
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello doctor, following are my answers
1. He usually gets cough for about 5-6 days in a month on an average. This time it has exceeded 6 days. Breathlessness will not be there always. He gets it once in 3 months or so when he has wheezing.
2. Usually the cough will be more at night. So his sleep gets disturbed for about 2-3 days in a month.
3. He does not feel breathless while playing on normal days.
He feels tired when has wheezing like once in 3-4 months.
4. Symptoms are usually seen when there are seasonal changes. It is also seen when he takes some juice which is refrigerated.
5. His mother is allergic to dust, but does not have asthma or wheezing. She gets running nose if she is exposed to dust.
6. Cough is usually not associated with fever. Some times, rarely we have seen that after he gets wheezing, he gets fever for a day.
1. He usually gets cough for about 5-6 days in a month on an average. This time it has exceeded 6 days. Breathlessness will not be there always. He gets it once in 3 months or so when he has wheezing.
2. Usually the cough will be more at night. So his sleep gets disturbed for about 2-3 days in a month.
3. He does not feel breathless while playing on normal days.
He feels tired when has wheezing like once in 3-4 months.
4. Symptoms are usually seen when there are seasonal changes. It is also seen when he takes some juice which is refrigerated.
5. His mother is allergic to dust, but does not have asthma or wheezing. She gets running nose if she is exposed to dust.
6. Cough is usually not associated with fever. Some times, rarely we have seen that after he gets wheezing, he gets fever for a day.
Brief Answer:
Looks like multi triggered wheeze or moderate persistent asthma
Detailed Answer:
Hi...Greetings from XXXXXXX
Suggestions on wheezing -
1. There are certainly alternative management therapies in allopathy now-a-days. Medicine has advanced a lot and not asthma is 100% controllable.
2. Inhalers are the newest management strategies for this. If I were your paediatrician I would have suggested the use of Foracort metered dose inhaler (100mcg) 2 puffs twice a day through a spacer and this is for regular use for 8 weeks. Another metered dose inhaler is Levolin and this can used as rescue therapy whenever the kid is having severe cough in spite of regular usage of Budecort.
3. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your paediatrician for this.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we can specifically say this is the cause - unless we observe the kid closely - best person is the parent.
Coming to your queries -
1. Any wheezing kid can outgrow from the symptoms. But there is no way one can tell definitely when they outgrow it. So we need to follow up and see of the results.
2. Stopping these medicines should be done gradually - that too only after the kid has been symptom free for a period of 12 months. The trick of the management is coming down on the doses slowly in a step wise manner. This will and should be decided only by your paediatrician who is regularly following up the kid.
Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,
Looks like multi triggered wheeze or moderate persistent asthma
Detailed Answer:
Hi...Greetings from XXXXXXX
Suggestions on wheezing -
1. There are certainly alternative management therapies in allopathy now-a-days. Medicine has advanced a lot and not asthma is 100% controllable.
2. Inhalers are the newest management strategies for this. If I were your paediatrician I would have suggested the use of Foracort metered dose inhaler (100mcg) 2 puffs twice a day through a spacer and this is for regular use for 8 weeks. Another metered dose inhaler is Levolin and this can used as rescue therapy whenever the kid is having severe cough in spite of regular usage of Budecort.
3. The technique is very important and very crucial for the drug to be delivered correctly to the lungs. Regularity of medicine usage also matters a lot. So do not discontinue abruptly after you notice some improvement. The technique of administering an inhaler using a spacer has to be taught to you by your doctor and these are prescription medicines. So I suggest you consult your paediatrician for this.
4. Triggers can be environmental changes/ dust/ talcum powder/ seasonal changes/ un-cleaned a/c vents/ cold weather etc....we can specifically say this is the cause - unless we observe the kid closely - best person is the parent.
Coming to your queries -
1. Any wheezing kid can outgrow from the symptoms. But there is no way one can tell definitely when they outgrow it. So we need to follow up and see of the results.
2. Stopping these medicines should be done gradually - that too only after the kid has been symptom free for a period of 12 months. The trick of the management is coming down on the doses slowly in a step wise manner. This will and should be decided only by your paediatrician who is regularly following up the kid.
Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Our paediatrician had prescribed Flohale 50 inhaler 2 puffs only at night with a spacer and mask (huff puff kit). This was about 2 yrs back.
The same is prescribed by the allergy specialist recently but increased the dosage to 2 puffs thrice a day. Is it ok to take this medicine regularly for a child with these symptoms?
He has also prescribed Asthalin inhaler 2 puffs twice a day.
We have been using this from a long time and our doctor has shown how to use it again recently.
Thanks,
XXXXX
Our paediatrician had prescribed Flohale 50 inhaler 2 puffs only at night with a spacer and mask (huff puff kit). This was about 2 yrs back.
The same is prescribed by the allergy specialist recently but increased the dosage to 2 puffs thrice a day. Is it ok to take this medicine regularly for a child with these symptoms?
He has also prescribed Asthalin inhaler 2 puffs twice a day.
We have been using this from a long time and our doctor has shown how to use it again recently.
Thanks,
XXXXX
Brief Answer:
You can use it
Detailed Answer:
Hi...I medicine it is always a risk benefit ratio. As doctors we see this. If outweigh the risks of a drug we need to use it.
Another issue is that though the inhaled medications (Inhaled corticosteroids) are prescribed your son - they are in microgram doses and they should not pose any problems in the future. Please do not worry about it.
On very long and chronic use some of these medications have been shown to produce mild growth retardation, but the risk is very minimal. Please go ahead with the medications advised by your doctor.
One precaution which you can take is - ask your son to do gargling after each Flohale administration (after 2 puffs).
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
You can use it
Detailed Answer:
Hi...I medicine it is always a risk benefit ratio. As doctors we see this. If outweigh the risks of a drug we need to use it.
Another issue is that though the inhaled medications (Inhaled corticosteroids) are prescribed your son - they are in microgram doses and they should not pose any problems in the future. Please do not worry about it.
On very long and chronic use some of these medications have been shown to produce mild growth retardation, but the risk is very minimal. Please go ahead with the medications advised by your doctor.
One precaution which you can take is - ask your son to do gargling after each Flohale administration (after 2 puffs).
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok thank yyou
Brief Answer:
I am happy that my interaction helped you
Detailed Answer:
I am happy that my interaction helped you.
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
I am happy that my interaction helped you
Detailed Answer:
I am happy that my interaction helped you.
I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below -
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696
Regards - Dr. Sumanth
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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