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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes persistent cough and runny nose in an infant?

Answered by
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8092 Questions

Posted on Wed, 27 Apr 2016 in Child Health
Question: Hi, my one year old son has a few symptoms that have me concerned 1. 3rd percentile for height, 20th percentile for weightbut was born in the 100th percentile overall,2. always has a cough and runny nose but never appears to be overly sick 3.) when he cries or laughs he has extremely distended neck veins on both sides-they are very prominent. Wondering if I should be concerned A) Cystic Fibrosis B) some type of heart issue. His newborn CF screen was negative and I am in WI. Thank you
Answered by Dr. Sumanth Amperayani 26 minutes later
Brief Answer:
I need more information.. Please answer the questions

Detailed Answer:
Hi and welcome to HCM,.I need more information before I guide you further. I don't think this is cystic fibrosis, So

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 plays around?
4. Are the symptoms there 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?
7. The distended veins which you quote - are they visible even when the kid is calm or only during laughing and exertion?
8. Is there any family history of congenital heart disease?
9. Does he feel breathless even at rest?

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Naveen Kumar
Follow up: Dr. Sumanth Amperayani 24 minutes later
Hi: Here are the answers to your questions
1. He has a cough every day-I noticed this start at about 6-7 mos of age
2. He is a good sleeper, but I hear him coughing often during the night-the cough does not wake him while he sleeps
3. He does not appear breathless while playing, however I do notice a exp wheeze when is exterts himself
4. I have not noticed symptoms changing with the seasons at this point
5. We do not have a family history of asthma-one paternal aunt has severe allergies/asthma but that is it
6. The cough is almost never associated with a fever
7. The veins are slightly visible all the time, but become very prominent with exertion ie: crying and laughing-they become so distended it almost appears that there is an aneurysm in the vein on the right side
8. No family history of Congenital heart disease maternal grandfather died at age 49 of what was presumed as a massive heart attack, however no autopsy was performed to confirm exact cause of death
9. He does not appear breathless at rest
Thank you
Answered by Dr. Sumanth Amperayani 8 hours later
Brief Answer:
Looks like multi triggered wheeze - need image of neck veins

Detailed Answer:
Hi....this looks like multi triggered wheeze...I fel he needs metered dose inhalers.

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 Budecort 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. 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.
3. 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.


4. Unlikely to be heart disease as the history you have provided doesn't seem to fit into heart disease. But to be 100% there are distended veins...we need to do an echo cardiogram.

5. Cystic fibrosis has significant effect on children's growth. Kid's height may not be normal and moreover weight also will be less than 3rd centile. His growth parameters does not indicate cystic fibrosis.

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. Prasad

The User accepted the expert's answer

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