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

Is she vaccinated against pertussis?

Sounds so stressful. Sorry for your daughter. Someone I know swears by an air purifier. There's a Phillips one that is recommended by her.

Definitely start the brown inhaler again (if you haven't already)

Do you have regular reviews with an asthma nurse? I would suggest bringing that review forward ASAP. The inhalers need reviewing. Brown and blue didn’t work for my son’s constant coughing. Asthma nurse changed him to purple preventer with blue for flare ups but purple stopped everything in its tracks and we hardly ever needed the blue then. There’s lots of different inhalers and doses can be changed etc. you need this review urgently

Do you not have a follow up with cardiology??

if my child had a Cardiac arrest I wouldn’t have left that admission/a&e without an implanted defib

did she have to be shocked to be revived?

children with asthma / pneumonia do not just have a cardiac arrest

honestly the cardiac arrest stands out here way more than the asthma

DS was diagnosed with asthma at about 7 months. DD similar and it is still on her records and she's 26.

Next time she has an episode like last night op, please take her to A&E. Her SATs will need checking and it really does sound as though a nebuliser would have helped.

I think you need to insist on a referral to a heart and lung specialist consultant paediatrician. We did that with DS and the plan that was put in place turned him round.

This time of year was always the worst for ds - he's allergic to leaf mould.

He had outgrown it pretty much by the time he was 8.

This. CPR alone doesn't restart someone's heart if it has actually stopped. They need a defibrillator to shock.

Do you mean your child had stopped breathing (respiratory arrest rather than cardiac arrest) so they (999 or similar) advised you to start compressions just in case?
There's not a chance a hospital would just send someone home after an actual cardiac arrest and defibrillator being used.

This sounds like poorly controlled asthma which can be life threatening.

You need to:
-Book an urgent GP or asthma nurse appointment
-Start the brown inhaler (it won’t hurt to do so)
-Write a comprehensive list of symptoms and your questions
-Ring Asthma UK for advice in the meantime
-Do you have any pets which could be causing an allergic reaction? My DS has asthma and is mildly allergic to cats (we have one), and he has antihistamine liquid for if the cat if affecting him (sneezing), but it also ensures his asthma doesn’t kick off (all advice from consultant was to keep the cat, give antihistamine).
-Buy an Oximeter suitable for children to
monitor her oxygen levels and pulse. We have one that the NHS sent us during Covid lockdown and that was what alerted us to there be something seriously wrong with DS’ raspy breathing. They are obviously not hospital-quality but the GP did say they are quite reliable. It’s just another bit of info you can show the GP, as our Oximeter readings matched the GO’s machine.

Don’t allow the GP’s to fob you off with she’s too young for diagnosis, so definitely don’t Asthma UK before you go.

Air purifier - we have this one - Air Purifier Update SY-701... https://www.amazon.co.uk/dp/B07X2132WF?ref=ppxpoppmobappshare

Definitely go and see your GP. They CAN diagnose asthma at her age. I presume you're under an allergy clinic??

Definitely use the brown inhaler. Do you use a spacer?

@PumpkinSpicedLatte you haven’t actually clarified the cardiac arrest part, it would be really helpful if you could do that as I’m not understanding what exactly happened there. it’s really important that you understand what the chain of events have been and what investigations have been done to date. As an HCP, I know full well that patients can really not know what’s going on with their journey due to poor communication at appointments (even seen people at the palliative stage not knowing how to use their inhalers correctly) so I would suggest a few things

1. write a list of all your concerns ,her symptoms, down pre appointment
2. ask to record the appointment or have someone else present to take notes
3. if there is a respiratory clinical nurse specialist ,ask to see them…often they are their weight in gold in checking people understand the illness and how to manage it. There is a whole shebang about managing allergies and triggers of asthma which others have mentioned so I won’t go into that.
4. ask to be referred to a paediatric/ respiratory physio….children who have early and repeat infections from a young age ( or have an added issue due to their anatomy/ genetic predisposition) can end up with some lung scarring which can make future infections more likely. You sound like you need advice on breathing exercises and lung clearance techniques…..when we lie down at night our lungs “ self clean” as such by moving mucous up so it can be coughed or swallowed. If you do certain postural drainage techniques earlier in the day ( eg. Lying on each side and then flat on her tummy) the child will have a clearer chest at night so less likely to trigger coughing. If she’s always needing to sleep upright then there is a problem there ( or is this just when her chest is bad?)

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 sounds exceptionally unlikely that a child who had gone into cardiac arrest at home wouldn't be admitted overnight.

Postural drainage can help with nighttime coughing. Sleeping with pillows under my stomach so my hips were higher than my chest really helped me as a child. www.cuh.nhs.uk/patient-information/postural-drainage/

@waterbottle1234 thank you, I didn’t say we weren’t admitted. What I meant was nothing came of it.

ah I see. You said 'diagnosed pneumonia and sent us on our way' so I assumed that implied discharged.

@Hnourq this is a really lovely yet informal reply. Thank you ever so much.

Honestly we haven’t been told much at all. She was a Covid baby so slipped through the net with quite a few things. I have a heart condition myself and in her red book, at birth, it was noted that she’d need a cardiology referral to check for any possible complications in the future (all was OK on 20 week scan, but mine didn’t show until later in my childhood) and we didn’t see anyone, and I’ve followed up 3 times now.
she then has her allergies, which took a while to diagnose as I was told I was an anxious first time mum. Then we saw a dietician who did the skin prick test which showed egg and dairy, and mild coconut allergy (she’s out grown the coconut).

They told me in hospital last year that the Pneumonia is what caused her heart to stop, and completed a chest xray at the time. We were given antibiotics.
She is under a dietician and then we see a paediatrician who every time, will ask how she’s been and every time we’ve gone for her apt she has had a hospital admission, but they keep saying it’s possibly childhood asthma and that they can’t diagnose her yet.
I just feel at a loss, that’s all. I’m a single Mum too so it’s quite difficult managing this alone.

I sound like I’m slating the hospital, I’d like to make it clear that I’m not. The care when we’ve been there is fantastic, and the staff are lovely. I just feel we are missing something.

@waterbottle1234 no that’s my fault sorry. I’m terrible at working things, it was a quick type up last night in pure desperation.
edit: wording things. That typo was not for effect

Anyway, the next action is the same - you need to go back to the GP for her to be assessed about this cough (you didn't answer about pertussis vaccination, assume she is fully vaccinated?) and then you can talk to her consultant when you see her in 2w. good luck with it all xx

@waterbottle1234 yeah she had the whooping cough. She’s had all her vaccinations. They said she couldn’t have the flu one this year as it contained egg (?) so she’s not had that. But all other childhood vaccinations she’s had.

That's rubbish (re flu and egg) google green book flu then go back and have the vaccine. Unless she has been in itu after anaphylaxis from egg she can have it at the gp and if she has been in it for thst reason she can have it in hospital

My ds suffered with an asthma cough when younger this helped:
increasing his brown inhaler to 3/4 puffs twice a day.
his bedroom window is on vent year round.
montkulcast.

🙈🙈🙈 just go back on the brown one then?! Phone the GP, ask to speak to the asthma nurse/make an appointment and explain you're going back on the brown one because it helped and because coming off it has not worked. Or just go back on the brown and email the GP or something. You can't be formally diagnosed til 5 but you can still see the asthma nurse and still have an asthma plan.

If she is asthmatic then please don’t use Vicks as it can trigger an asthmatic cough. As an aside asthmatics also shouldn’t take ibuprofen - this can also trigger an attack. Please push for medical follow up. I have a child with similar allergies, we have been hospitalised three times with respiratory distress and it’s scary - push push push for better medical follow up

I’d be at the gp first thing listing everything and keeping her off school until we got to the bottom of it. Poor little thing sounds like she’s really suffering, children are great at masking she shouldn’t be living like this and falling asleep at school she is clearly very unwell.

@Lemonademoney I didn’t know this regarding Vicks, and funnily enough I sent her to bed last night without Vicks or olbas oil, and she had her brown inhaler and she was perfectly settled. So this makes sense now.
@Imjustlikeyou2 thank you it’s been so so sad seeing her this way

Just to be clear you have to do the brown inhaler everyday without fail ongoing, not just when she's going through a bad patch. I'm just checking you know that as you said you haven't seen an asthma nurse or had a plan.