Child has constant cough-please help

[PumpkinSpicedLatte]

Sorry for posting here, but it seems to get the most traffic.

I’ll try and keep it as short as possible.

I have a 4 year old in Reception, who has diagnosed allergies of Egg and Cows Milk Protein. She is under a paediatrician.
She is also on two inhalers (brown and blue) with query of Asthma due to lots of hospital visits with a bad chest.
Last year, after just turning 3, she had Pneumonia and was really really poorly, and it ended in her going into cardiac arrest whilst we were at home and I had to perform chest compressions which was traumatic as you can imagine.
We were blue lighted in and they diagnosed Pneumonia and sent us on our way. It was very distressing and it felt like nobody really followed up. I was off work for about 8 weeks with her.

Anyway, we’ve seen the paediatrician twice since, where they have told me her cough is asthmatic. We are due there again in two weeks.
We are now on week 3 of a constant cough. And I’m talking coughing attacks (mostly at night) of about 100 coughs within maybe 5 minutes where she’s almost being sick, sweating, crying. She’s exhausted and so are we. She’s thriving at school and is a really happy girl, but then these attacks happen (again mostly at night) and I feel so awful for her.

I’ll list some things we’ve tried:
Currently using a Vicks humidifier with olbas oil

Vicks on feet with socks
Blue and Brown Inhaler
Different duvet
We are non smokers
No mould in house
Sleeping upright
She is on an allergen safe diet

I am honestly so desperate for help. Can anyone advise what we could try in the meantime? I am going to phone the doctors tomorrow anyway to request perhaps a different inhaler, but not sure if that will help.
She has been sent home from school an hour before home time twice now due to falling asleep, so I’m getting progressively more concerned.
thank you

Blue and Brown Inhaler

Forgive me if I'm wrong, but that sounds like you only start the brown inhaler when she's coughing. Do you realise it needs to be used all the time as it takes time to build up?

Also, is she vaccinated against pertussis?

I'm so sorry what you and your DD have had to go through you're doing everything right, all I can suggest is demanding for all types of tests because that is quite a long time to be having this cough. And I would stress that there wasn't any follow up and it should be looked further into. Given she's had pneumonia in the past and went into cardiac arrest you'd think they'd be going above and beyond?!

Oh, I really feel for you. I've been through some similar but much milder experiences of respiratory problems and hospitalisations with both of my children, and that was stressful enough. I can't believe they are not following up on a cardiac arrest!! If it was me I would be wanting to discuss what can be done to increase or change the medication with either the GP or paediatrician. There is montelukast/singulair which I've heard works really well for some children.

If she's asthmatic she needs to be taking the brown (preventer) inhaler every day (as many puffs and times as prescribed). The blue inhaler is a reliever and is used when struggling to breathe - if it's being used constantly that's a sign if poorly managed asthma. I'd make an appointment to see the asthma nurse or GP to discuss the treatment.

What is her asthma treatment plan? They make a new plan at the asthma review each year I.e brown inhaler 2x puffs twice per day. Blue inhaler as needed etc.

One of mine had cough variant asthma when younger. Keeping on top of the brown inhaler during winter months was key but she was never as poorly as yours. I hope you get a proper asthma plan in place.

My ds was on Montelukast granules when he was small and that really helped him.

Humidifier- warm with plug ins

Or perhaps tell the doctor, who is qualified, what the symptoms are, and listen to their opinion?

but yeah, 'demanding' tests that you possibly don't even know the name of and what they are designed to diagnose or exclude, that'll be the start of a productive long-term relationship with a healthcare professional.

It doesn't sound as though she is having optimal treatment or optimal monitoring.

The brown puffer needs to be given twice a day, usually two puffs through a spacer. It's essential you see your dd actually taking breaths when the spacer is in place. The blue puffer is the reliever, ventolin.

When ds had bad patches he was usually prescribed a three day course of oral steroids and we had a nebuliser and liquid ventolin for when he had a cold, etc.

Are your dd's Sat's and lung function being tested?

Ask to see the consultant. Ask to have a session with the asthma nurse. We didn't get tip top guidance until we paid.

You need to kick up a bit of a stink I think.

Do you have a peak flow meter? An asthma nurse can tell you what peak flow should be based on height and weight and at what point you need to contact GP or seek more urgent help. We’ve also had different brown inhalers prescribed when the one we had wasn’t stopping the symptoms routinely.

This is obviously not a substitute for the vital medical support that you are waiting for, and sounds like such a silly suggestion, but while you are waiting for the appointment try chopping up a large onion into chunks and put it in a bowl by her bed overnight (obviously be careful if you have pets as it is poisonous).

Sounds crazy and it may not work at all but it definitely helps my son who also gets nighttime coughs.

And yes to what everyone else says about the brown inhaler needing to be every day regardless of whether she is coughing.

Really hope you get to the bottom of it x

Her asthma sounds really poorly controlled and I’d definitely be asking for an urgent appointment.

Have then given you a written asthma plan?

I am an asthmatic as well. Coughed a lot as a child, had pneumonia 4 times and plurasey.Things I find helpful in addition to the medication:

Vicks on chest and back

Ice Lollies - can reduce the irritation in the throat.

Sleeping on my front or sleeping propped up.

Just trying something to take your mind off it to break the coughing cycle.

I have dust mite allergies so my mother used to put any cuddly toys in the freezer in the day and get them out at tea time and put them on the radiator to warm up before bed. Very regular bedding changes and hoovering.

My mother paid for me to see a private doctor via Bupa when I was around 6/7. It changed my life really, getting the right inhalers and finding out about the allergies.

Hope it improves for you x

OP@PumpkinSpicedLatte you wrote “Last year, after just turning 3, she had Pneumonia and was really really poorly, and it ended in her going into cardiac arrest whilst we were at home and I had to perform chest compressions which was traumatic as you can imagine.
We were blue lighted in and they diagnosed Pneumonia and sent us on our way. It was very distressing and it felt like nobody really followed up. “. please can you clarify as it appears you are saying that your dd had a cardiac arrest at home, you went to a&e via ambulance, they diagnosed pneumonia and sent her home again???and that despite her having a cardiac arrest no one has followed up on this?

@Hnourq you are correct. Nothing has been followed up since. Other than the paediatric appointments where they tell me she’s fine and that she’s probably asthmatic but they can’t diagnose at her age as she’s not old enough for the peak flow test (I think that’s what it’s called). They’ve said I’ve got to wait until she’s 5 for them to formally diagnose

Thanks for everyone’s responses. Sorry if I didn’t write it very clearly.

to clarify:
Yes I know the brown inhaler is the preventative one so that is used before an attack. She has two puffs in the morning and two at night, but at her last paediatric appointment we were told to stop using it to see if she manages without (despite the fact she had not got any better). Then she has the glue inhaler for attacks.
No we don’t have an asthma plan, as they’ve said they can’t formally diagnose until she’s 5.

She hasn’t been monitored to manage her sats or anything either. We had a terrible night last night and I feel awful sending her to school, but she loves school and requests to go but she was up most the night and is in a really sensitive mood this morning understandably. It’s endless, it’s really awful.

Whooping cough this time?

Does sound like she needs a review of her asthma plan

I think it's very likely she has asthma and it's very uncontrolled. Asthma can kill, back to GP/Paediatrician ASAP.

This might sound a bit random but thought it was mentioning just in case, DS is 5 and also has CMPA and oat allergy and one of the worse symptoms of the oat allergy is a cough, very similar to what you describe, mostly at night and really bad. Things like oat milk and yogurt always affected him worse than just oats in a biscuit or something but it was pretty nasty.

I hope you get some answers soon

Phone Asthma UK, they can support you to ask for the right things from the GP.

See a different GP.

Write everything down as facts - a huge list.

Tell them you feel your DD is at serious risk and you are asking for an urgent review/second opinion.

When she coughs badly at night treat it as an asthma attack and present at A&E.

Have you considered potential triggers in the home - pets, mould, dust mites, allergies?

When you say duvet, do any of her pillows/duvet/mattress contain feathers?

not much of a stretch if she’s allergic to egg she may be triggered by other bird proteins.

have you tried a different bedroom or clearing out everything except the essentials, hypoallergenic foam/microfibre bedding etc.

but yes, agree it sounds like asthma.

Also brown and blue inhalers have been replaced for many with a single combined, and stopping the brown like that seems like outdated/poor practice.

Echo that it sounds like poorly controlled (nothing you’re doing wrong) asthma.
DD was similar and they added in monelukast, which really helped.
I bought a paediatric sats meter (asthma nurse was happy with this), we did peak flow and I was told what to look for in terms of symptoms and what to do (increase salbutamol/GP/A&E).

DD was diagnosed aged 3, by a rather gung ho paediatrician who said “if it looks like a duck and quacks like a duck….”

https://www.asthmaandlung.org.uk/helpline