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Dr. Andrew Rynne

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Suggest treatment for persistent cough during sleep

Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 5503 Questions

Question
Hi
have a 6 month old baby, constant cough mostly during sleep time during day and night. Given the nebulaizatoin for constant 4-5 times for last 3 days with .31 mg levolin and 2 dose of budesol , but when she is awake, cough is very less but during sleep , its more and baby is not able to sleep properly. beside nebulization, given Augmentin syrup and betensol oral drops.. at times trying with tedykoff syrup as well but still not much relief. please suggest...
Wed, 13 Aug 2014 in Child Health
 
 
Answered by Dr. Sumanth Amperayani 11 minutes later
Brief Answer:
Multi triggered wheeze or Viral 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 she cough or feel breathless?
2. How many nights per month does her sleep get disturbed due to above symptoms?
3. Does she feel breathless when she plays a lot?
4. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
5. Is the cough always associated with fever?

If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing. No point in using antibiotics or cough syrups like Tedykoff every time. It will do more harm than good.

As you wanted, there are now very good medicines through inhaler devices through which the medications can be delivered to the lungs directly and which are capable of preventing these exacerabations of symptoms either seasonal or due to exertion. I suggest you meet a paediatric pulmonologist who is near your place. Betnesol is a steroid and I suggest you not to use it by yourself without a doctor's advice.

Get back to me with the answers to above questions and I will guide you better.

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
 
Follow-up: Suggest treatment for persistent cough during sleep 29 minutes later
Hello Doctor
we have been visiting child specialist frequently and he always suggests of doing nebulization . Is that safe ?

As we have been regularly visiting , my purpose to ask online is to get more aware with the treatments . hence I am looking for more details understanding of treatment and your suggestions . Answers to your questions are below :-



1. How many days per month does she cough or feel breathless?
XXXXX :- She gets cough frequently, it was 2 weeks before when she was severe congestions, on doctor's suggestion, we gave nebulization using levolin .31mg and budesol, and next day we found the baby to be recovered . But now she has got again, but as I said during her awake , it is not there and she looks to be playing without much problem.
2. How many nights per month does her sleep get disturbed due to above symptoms?
XXXXXX :- its for last 1 week, we are finding this issue .

3. Does she feel breathless when she plays a lot?
XXXXX - NO
4. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?
XXXXXX - NO
5. Is the cough always associated with fever?
XXXXXX - Yes
 
 
Answered by Dr. Sumanth Amperayani 16 minutes later
Brief Answer:
Episodic viral wheeze

Detailed Answer:
HI...thanks for the trust in me.

After going through your history and after seeing your answers to my questions, I conclude that, what your kid is having is episodic viral wheeze. She will require regular inhalers (metered dose inhalers) and these are of 2 types -
1. Preventers - to be used regularly whether he has symptoms or not
2. Rescuers - inhalers which are used only when an attack comes.

For her age and severity assessment based on what you have quoted, I suggest using Budecort 100 2 puffs morning and night regularly and Levolin inhaler whenever there is an attack. These have to be used along with a spacer device and this is the best we can do for her now. But these inhalers and spacer device need to be taught how to use them and you should be in regular follow up with your paediatrician or pulmonologist. I suggest you seek professional help directly regarding the technique of delivering medicine by spacer device and inhaler. Apart from these, using oral Monteleukast daily at 6PM at appropriate dose should be very effective as it is viral associated wheeze.

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
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for persistent cough during sleep 27 hours later
Hello Doctor
Thanx For detailed answer.

oral Monteleukast = Montair LC Kid syrup which I had taken from nearby shop. Also we have Omron nebulizer using which we has been giving her levolin and Budesol as earlier mentioned .

I think, ur mentioning of using spacer would not appropriate for my 6 month old baby , hence could you please suggest usage of Budecort (one Respule is .5 mg)
on a daily basis and how long we have to keep this dosage for her ?

As Currently we are giving levolin and Budesol due to recent attack of cough , hence what dosage we need to follow for levolin ?

It would be great , if you could explain the difference between budesol and budecort ? are they same or different and which one would be more effective ?

To strengthen the immune system for her , please suggest ways, we can adopt for her during her diet and daily living style .

Once again , thanx for your kind support.

regards
XXXXXXX
 
 
Answered by Dr. Sumanth Amperayani 11 hours later
Brief Answer:
Dont use nebulizer without oxygen

Detailed Answer:
Hi... I suggest you not to use nebulizer if you are using it without oxygen as sudden deaths are reported by using nebulizer without oxygen.

Coming to your queries -

1. Budesol is the same as Budecort medicine wise. Only difference is that Budesol is a nebulizer variant of Budecort. Both contain Budesonide.

2. Spacers are the latest and THE BEST form of delivery devices. Even of 6 months age they can be used with a mask.

3. You can use Montiar LC kid for 8 weeks at 6pm 5 ml orally.

I insist that you change over to spacer device at the earliest please. But if you do not want to - You can continue whatever you are using now, but it is not my advice. But these inhalers and spacer device need to be taught how to use them and you should be in regular follow up with your pediatrician or pulmonologist. I suggest you seek professional help directly regarding the technique of delivering medicine by spacer device and inhaler.

Diet is not related to her allergy problem, so do not worry. Her immunity is perfect.

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

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