5 mo choking cough in sleep

[Whatthefreakinwhatnow]

Hi All

My 5 mo DD frequently (4/5 times per night and at least once per nap) has coughing attacks that lead to choking and gasping for breath, and has done for 3 months now.

Her GP prescribed Gaviscon for reflux, but she's in no pain and this happens when sleeping sitting up in the carseat /crook of my arm as well as laying flat and feeding doesn't bother her at all.

I've tried the gaviscon for several weeks buy now I'm going to ask for an ENT referral as I wonder if it's something from the sinuses running into her throat?

The choking is awful and truly frightening but doesn't upset DD so it's not painful which surely acid reflux would be?

Has anyone else's DC had the same?

[Whatthefreakinwhatnow]

I meant to add, her lungs are completely clear.

[Diggum]

It does sound like reflux I must say. Some children aren't distressed by it.

I'd probably try the next step which would be a H-blocker like ranitidine if the gaviscon is doing nothing. Ask your GP about it as they should be able to prescribe it. You should see an improvement fairly quickly if it is this.

At 5 mo the sinuses aren't generally developed enough to cause problems like post-nasal drip (which can also cause these symptoms, usually in older children and adults), however does your DD snore at night? Because it could be her adenoids causing a bit of obstruction, in which case an ENT referral may help.

The other thing it could be, though less likely, is something like laryngomalacia ("floppy larynx") which can cause noisy breathing, snoring, etc and generally resolves as the baby gets older and the muscles of the larynx firm up.

Hope this helps and you get to the bottom of it. It's horrible to see them struggling.

[Whatthefreakinwhatnow]

Thank you for replying!

I figured as this happens when upright and only when sleeping not when awake or feeding that it wouldn't be reflux?

I will take your advice though and go back to the GP and ask to try ranitidine or omperazole and see if that helps.

She triggered her breathing monitor last night after choking, had to blow in her face to get her breathing again. It's terrifying

I guess I assumed if it wax reflux there would be pain?! I hsve GERD and the acid is definitely uncomfortable?!

[Diggum]

God. That sounds terrifying and you're right in that it would be atypical for reflux. Does she usually cough before going into those gasping/choking episodes or is it sometimes silent? For instance, last night, was she coughing before hand and struggling, or was her breathing actually paused like she was passed out?

If the latter then get her seen to asap. Alarm bells would be going off for me if she was getting silent pauses in her breathing. Tell the GP that you had to blow on her face to get her breathing. That should give a new urgency to investigating this.

The PPI/h blocker may still be warranted but she definitely needs a more detailed work-up to rule out obstruction or heart problems if she's triggering an apnoea alarm.

[Diggum]

Sorry, I don't mean to worry you, I could probably reassure to a good degree by examining her. That's the difficulty of the Internet!

But just that she definitely needs a very thorough examination and consideration of other causes. Don't want to pre-empt your own GP who I'm sure has thought of the various differentials before now!

[Whatthefreakinwhatnow]

No, last night there was no cough, just seemed to choke on something and then started gasping for breath other times though the coughing does come first before the choking and gasping.

She has a loud heart murmur so my GP was loathe to really investigate I'm case it was heart related but we've had the all clear on that front, no congenital defects or heart disease, just some minor mitral valve regurgitation.

Would gaviscon make any difference at all after almost 2 week if it was reflux? Because she's not getting better at all and it's getting so I am scared to sleep as I am terrified she'll stop breathing

The inside of her mouth and het tongue sometimes seem to be blue during an episode which suggests to me an apnea of some kind, and sometimes her skin goes blotchy and her head is drenched on sweat but her body is cool to touch.

Do you think I should ask for an urgent appointment again or can it wait until the end of the week/Monday for a non-urgent as is the wait at my surgery? I don't want to pester him but I am worried

[Whatthefreakinwhatnow]

Apologies for the typos, typing one handed whilst I cuddle the baby!

[Diggum]

Gaviscon will generally make at least a little difference and generally works fairly quickly so two weeks is plenty of time to see it if there were to be a noticeable difference.

The colour change and blotchiness does sound worrying so I think I'd want to see her soon if it were me. I'd see if you can get an early appointment rather than leaving it over the weekend. If nothing else you won't get a wink of sleep till she settles!

I'm probably being over cautious but you can never be too careful with babies IMO.

[Whatthefreakinwhatnow]

Ok thank you ever so much for your help, I will call in the morning and ask for an urgent appointment. I just want her to be ok, I'm terrified of SIDS

[Diggum]

We all are OP, but you're all over this. You have a monitor and you sound very clued in. She'll be fine.

I'm sure it'll turn out to be something innocent but better safe than sorry and all that.

Best of luck with it.

[Whatthefreakinwhatnow]

Thank you, you've no idea how much I appreciate your advice. the GP looks at me like I'm worrying about nothing, but I will be firm with him regarding further investigations.

I hope you have a lovely weekend Diggum, for you x

[Diggum]

You're welcome! Hope you get sorted. Enjoy your lovely baby snuggles

[scottgirl]

My DS had tracheomalacia, 'floppy trachea' (has grown out of it now) and this caused him to choke and make strange noises. Was pretty scary at times. Worth asking about?

[Whatthefreakinwhatnow]

I definitely will do Scottgirl, thank you!