Someone help me understand my son’s (3) coughs

[opali]

They seem to follow a pattern. Maybe there’s nothing to work out, but they can get pretty severe.

so it will start randomly at night. He seems fine and all of a sudden he wakes up at night, with a barking cough and stridor. At this point his breathing is very laboured and you can see pulling in on his neck from how hard it is to breathe. The stridor is really loud.

usually at this point I completely freak out and take him to a and e to get steroids, which usually clears it up. Last time he had to have steroids twice in our an and e visit because it wasn’t clearing. He had this episode again a couple of nights ago, but I decided not to go to a and e. Instead, I wrapped him up , calmed him down and sat in the garden with him for 20 minutes. It was around 2 am. I read that cold air can be good for it.

he seemed better and then eventually fell asleep again when we went inside. His breathing was still loud but it calmed. When he woke up in the morning it was really bad again. I started getting us ready to go to an and e but after 15 minutes or so, he seemed better. He was ok for the rest of the day and didn’t really cough much.

i got some steroids from the GP and gave them last nigh. Now the cough has moved further down his chest. It’s no longer a barking cough and the stridor has gone. The cough is horrendous and sometimes he coughs so much that I don’t know how he manages to breathe.

this Has been his pattern since he was tiny. His chest is always clear, he’s never had a chest infection. Only once in all that time did the GP hear a wheeze in his chest, so she prescribed a blue inhaler. He was coughing horrendously in his sleep all night tonight and I put the inhaler over his mouth while he slept and now he’s finally stopped coughing. This works sometimes, but not every time.

any idea ? Is this just the usual coughs kids get ? Or an asthma situation?

Croup. Monitor for fever or worsening.
The steroid is the giveaway.
Have dc take deep breaths of cold air outside or in front of freezer.
(from experience)

If dc is not unwell I'd bet asthma.

It could be many things, but to me it sounds like Cough Variant Asthma. (The fact it improves with steroids; or a puff of blue inhaler, which may not be enough other times).

Cough Variant Asthma: Symptoms, Causes, and Treatments

I don't know anything about asthma, but my little one has recurring croup and it sounds v similar. Every time he has a minor virus such as a cold, he is completely fine during the day but struggles to breathe in the middle of the night. it's so frightening.

Like you, we've had many trips to a&e in the middle of the night for steroids which clear it up quickly. But the last few times I have stayed home and got him up and fully awake, just sitting calmy together in the dark and that seems to be enough to let it pass (he is 4 now and I hope it's generally easing off, but the harshness of winter bugs will be the real test).

My understanding is that the airways narrow over night and that waking them up restores them in some way (not sure of the technical terms, this is my understanding as a simpleton!)

Yes, sounds very much like cough variant asthma. My DS used to suffer terribly, especially after getting over a cold, we’d be up all night from his coughing sometimes. Once we’d worked out that’s what it was, the blue inhaler generally worked for us though, given straight away as soon as he started coughing.

My DS has more or less grown out of it as he’s got older.

Have you had house checked for black mould? It can be in walls where you can't see it.

Asthma

I was the same as a kid and every winter I'm the same. Back in the day the only thing that helped was something called a vaporiser which was like a oil burner. Obviously they don't sell those due to health and safety now but the oil was camphor and I find a few drops of camphor stops my coughing as still. You could burn it in an oil burner if you sat with him whilst he slept.

Ps I developed the cough during a bout of croup

My son was the same. He would be fine during the day and then wake up with an awful barking cough that seemed to come out of nowhere. It usually lasted a few nights and during the day he was fine but at night could not stop coughing. He would have episodes every few weeks.
Last winter we bought a dehumidifier for upstairs and he has been so much better! I can’t actually remember the last time we had a coughing episode.

i had to actually check I hadn’t written this post myself and come back across it as it sounds the exact same as my son was! I can emphasise with you so much.

roll on a year of this happening, I asked to trial inhalers and they have helped massively.

ask your GP to trial them and for a follow up appointment to discuss what happens next. Make a diary of anything you wish to discuss since using the inhalers and whether they have helped or changed anything. Make sure they prescribe brown and blue. We were given just blue initially but guidelines have changed and now brown and blue must be prescribed together.

if you want to message to talk feel free - I can completely understand your situation! X

I would bet it’s asthma. I used to cough relentlessly for weeks on end and absolutely wreck my body. Coughing would start for no particular reason. I would go to the doctors and without fail be told my chest was clear. It was only when my grandson had to go to the Brompton Hospital which specialised in chest troubles that I picked up a leaflet which described what was happening to me and said it was likely to be asthma. Recently my daughter who is 62 was admitted to hospital with an extreme allergy that left her so breathless that it put her life in danger was she told that she was asthmatic and couldn’t understand why she hadn’t been told when she was a child. As a child I took her so many times to the doctors with a wheezing chest and nothing was discovered. She had her adenoids and tonsils out but no mention of asthma. I do hope your little boy can get some help and all will be well

We have a blue inhaler for DS3 (age 4). He's had it since he was 2, I think. Our doctor (not UK) said that what he experiences every time he gets a cold is "spastic bronchitis" and that if this becomes chronic, it's considered asthma but they don't diagnose that any more under 6 years old. We have been advised to give the inhaler 3x a day for 5 days any time he gets a cold and either the cough or the wheezing is audible, and that the inhaler given during the day like this is preventative, not to wait until it gets really bad or he has a temperature or can't stop coughing at night. Since we've been doing this, we've had a lot fewer instances where he gets really poorly with his chest.

Doesn't get croup really - his older brother (now 17) used to get it frequently, was horrendous. Went to A&E with him once for oxygen. The advice when he was little is that croup is just something some children get, and to ignore it because it sounds worse than it is unless there is visible pulling of the chest when breathing.

IIRC DS2 or possibly DS3 had croup once when very small and the doctor instantly gave him steroids and he's never had it again. I was told steroids are now the usual treatment and help avoid hospitalisation.