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bad cough in child
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bad cough in child

My son has a bad cough that is productive, but it sounds like he has a hard time coughing things up when he gets sick.  It is worse when he lays down during naptime and at night. His teacher at school says it sounds barkier than the other kids. I treat it with robitussin dm and that helps a lot.  We recently went to the pediatrician and I described the cough to him as his main symptom when he has a cold, but it is associated with a runny and congested nose.  The pediatrician suggested maybe he had asthma and we could put him on long term inhaled steroids for this.  Well, both my husband and I are physicians, and we did not really want to go the steroid route.  My question is, could this just be a normal part of the colds that he gets and his cough is just usually a bad part of it.  He is 3 years old.  Also, would something like albuterol help if he were bronchocontricting and that were causing coughing, but no wheezing?  Also, does the asthma cough sound productive?  Thanks for your help.  
Tags: child, bad, cough
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242587_tn?1355427710
Coughing is a significant component of both upper and lower airway illnesses.  This can be a short term symptom or last over a much longer period of time. Coughing can be a complication of sinus inflammation that causes post nasal drainage or a lower airway reflex, both of which cause coughing.  A very common cause of coughing if when the upper airway infection triggers lower airways reactivity, such as with asthma. In most cases in a 3 year old, physicians will try a trial course of upper airway treatment (antihistamines and possibly antibiotics, if sinusitis is suspected) to if this controls the cough.  In other cases, where asthma or lower airway reactivity is considered, a trial with inhaled steroids and or other anti-inflammatory medication (leukotriene inhibitor) is instituted.  When the cough persists, it is better to determine the actual cause rather than continuing trial courses of therapies that may or may not be effective.  In this regard, if the preceding is ineffective, referral to a pediatric pulmonologist or a pediatric allergist should be considered.
3 Comments
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Avatar_m_tn
I was born with asthma and I believe any kind of steroid should be a last resort. Steroids only help with inflammation and I'm sure there are many things as parents and as doctors that you can do to help him out. Starting a kid on steroids only leads to future health problems, I am living proof. Flovent is a mild cortico-steroid, I don't know your child's situation, but it might be better than the alternative of needing dexamethasone or even worse prednisone later on. Allergies and physical exertion cause the cough usually followed by wheezing if it is asthma. Colds by themselves do not cause that kind of prolonged coughing, but it could be bronchitis(are you sure you're doctors?). I would seek treatment with a Immunologist that shares most of your viewpoints, especially about the steroids. To me it sounds most likely to be prolonged exposure to Allergies. Dust mites in your child's bedding and pillows could be a night-time contributing factor. Consider the  Environmental Factors of where your child spends his time or where he plays at school or in the home, maybe more than one thing is acting as a trigger. You should also seek a Pulmonologist just to be sure it is asthma and to educate yourselves more on the pharmacology choices. I recommend singulair and Zyrtec to treat asthma related allergies at my age, as a child I was treated with theophylline and by Immuno-therapy. A humidifier when he gets sick may help with the cough. Warm cider may also help during times that your child needs to recover. As far as inhalers go, he might be to young since he is still developing his lungs. If he truly has asthma a nebulizer (updraft machine) at his age with scheduled treatments might be more productive. Yes, for pulmonary constriction Albuterol is usually a doctors first choice. Given the fact of your childs age I would have to ask my parents for more info if you find that you need it. Hope this helps. Take Care.
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Avatar_m_tn
Thank you for your help!
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Avatar_f_tn
Barking cough will not likely caused by asthma. Acute bronchitis or some infection are possible. Suggest using antibiotics like macrolide. If not effective, add short course inhaled corticosteroid. It will not bring any harm using in short duration.
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1183343_tn?1300886765
hi i am 30 yrs old male from india.i am having some problem since more than 1.5 years.i do throat clearing all the time .more throat clearing after eating. as if a small mucus is stucked in my throat,which is not comming out.i was admitted for this in hospital.they have lots of tests including ct scan of chest,mri scan of throat,barium meal,endoscopy,24 hr esophagal ph monitoring,usg,blood tests.all are normal.no GERD.what should i do now?
please help me.

e thing i must tell u.this started at sep.2009.at that time,one day i sprayed baygon spray(for killing bugs and moquitoes) in my room ,and then i had to sleep in that room.since then my problem increased.there was some smell of spray.

i am doing this for 1 and half years.now i cant cough and hawk anymore.pls help. ..

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