Incredibly worried - 18 month old chesty cough for nearly 3 months!

[mom2daisypie]

Hi,
I'm at my wits end and looking for some advice. MY 18 month old started coughing around 10 weeks ago. We think it coincided with a fall in which she struck her nose (it didn't break but was bruised and swollen for a while). Anyway, I have been to the GP twice, both times they have listened to her chest and said it's clear, however her cough is every day, and sounds very chesty and mucousy. The last appointment resulted in us being given an inhaler incase it's asthma (her Dad is asthmatic) however at 18 months old, she has no idea how to inhale deeply enough for it to be of benefit anyway, plus, her cough isn't tight or wheezy so I'm not convinced asthma is the problem.

I recently read about a baby girl who died aged 12 months after months of coughing was misdiagnosed. It had been asthma. Her parents had been told, like me, that it was just catarrh or a cold that she was struggling to fight off.

I'm so worried I have another GP appointment today but really don't hold out hope that they ill do anything. I want an x ray on her chest (and maybe her nose to see if it is catarrh constantly dripping don the back of her throat as a result of the fall)

Has anyone had similar to this??

An X-ray would only be considered if there was a risk of a major lung problem such as pneumonia or tuberculosis.

If your child had either of these, it would not be a case 'worrying she might have', you would know as the child would be VERY unwell. Especially, in the case of pneumonia, the Dr would pick it up and your child would be on IV antibiotics within hours.

The press and word-of-mouth have a habit of highlighting all those few times that a Dr gets it wrong. But most times, in fact nearly all times, their diagnosis is right. Children are perpetually picking up illnesses and they often overlap, in many cases they are viral so antibiotics are a waste of time (especially as an 18 month old child is oblivious to placebos).

If your child's mucous is a green/deep yellow/brown colour, that's the tell-tale sign of bronchitis and many other bacterial lung infections. If it's clear or light yellow/cream, then it's just a cough.

Asthma is a risk but the Doc's have covered that.

I would suggest exercise is as good a cure as any. Build up the lung power.

It is most likely nothing to worry about.

An X-ray would only be considered if there was a risk of a major lung problem such as pneumonia or tuberculosis.

If your child had either of these, it would not be a case 'worrying she might have', you would know as the child would be VERY unwell. Especially, in the case of pneumonia, the Dr would pick it up and your child would be on IV antibiotics within hours.

The press and word-of-mouth have a habit of highlighting all those few times that a Dr gets it wrong. But most times, in fact nearly all times, their diagnosis is right. Children are perpetually picking up illnesses and they often overlap, in many cases they are viral so antibiotics are a waste of time (especially as an 18 month old child is oblivious to placebos).

If your child's mucous is a green/deep yellow/brown colour, that's the tell-tale sign of bronchitis and many other bacterial lung infections. If it's clear or light yellow/cream, then it's just a cough.

Asthma is a risk but the Doc's have covered that.

I would suggest exercise is as good a cure as any. Build up the lung power.

It is most likely nothing to worry about.

They should have given her antibiotics to be honest to clear the mucus but I'm not surprised they didnt... Your doctor seems useless if he gave an inhaler without the special mask for babies!

Could you go to different GP and ask for these?
In the meantime I'd suggest lots of steaming and lots of saline drops to clear the mucus
You could so try warm drinks with lemon and honey

Asthma symptoms in very young children don't look or sound the same as in teenagers or adults. I was in a similar position myself with my DC and I didn't know this and didn't understand why I had been given an inhaler when the symptoms seemed nothing like asthma to me - my DC got very ill indeed because I didn't understand how to recognise the inhaler was actually needed. Fortunately all was well in the end but I think it happens quite regularly that GPs prescribe an inhaler without any explanation or support for parents.

Use the inhaler and see if it makes a difference. The spacer tube you have presumably been given means the "one deep breath and hold it" that adults do is unnecessary - a single squirt into a clean dry spacer breathed for 10 breaths will deliver the medication where needed.

Antibiotics will not clear the mucus unless it is due to a bacterial infection, which, unless she is unwell in herself, is unlikely. Hopefully your GP would not prescribe them unnecessarily.

You do need a spacer for the inhaler which you can ask the GP for a prescription for or buy one yourself from the pharmacy.

An x-ray at her age would be likely to involve sedation to keep her still enough so would not be something that a GP would want to do unless clinically advisable.

Children's chests often sound mucousy because they haven't yet learnt to cough deeply enough to clear it, sounds awful but is not dangerous.

Could it be the start of hayfever or another allergy?

Hmm, my asthmatic son had a chest x-ray at that age, as part of the process towards his diagnosis. (Incidentally, not sedated.)

People have already given the advice on giving inhalers to small children so I won't repeat it. But you need to at least find out whether the inhaler brings relief before you can write it off as irrelevant and pursue other treatment/investigation, I think.

Dd1 had a long lasting cough at around the same age. A few years down the line and we're pretty sure she suffers from hayfever!

There is no reason an inhaler can't be used on an 18 month old if you are struggling you need to make sure you are using it with a spacer and correctly administering it.

You need a spacer as others have said. One press and count to ten and repeat, as she breathes normally. We got ds to play with it so he was used to it and now takes his inhaler beautifully.

thanks everyone. We do have the spacer but I thought she would need to inhale deeply as my husband has to, if not, I'll continue to try it.

We saw the DR again the other day and he suggested we try her with Piriton to rule out allergies as they cause. She has been having piriton twice a day for 2 days now, but we're not really seeing a difference. Maybe it would take time to work?

At least it looks unlikely to be anything majorly concerning which is a relief.

That sound reassuring, small children do sound awful with loose coughs but if she's well in herself try not to worry and persevere with the inhaler.

Its certainly worth perservering with the inhaler and piriton, but also if it doesn't improve, don't be afraid to go back.
FWIW, ds started coughing at 6 months old and kept on coughing. Mostly at night, and GP said nothing to hear on chest. Inhalers didn't really help.
He had an xray at 10 months (no sedation required, just held gently) and it showed he had lung collapse. We saw a consultant, and it took 6 weeks of antibiotics, several sessions of physio a day plus inhalers to shift a very deep seated infection which had plugged his airways.
Ds was well in himself, but we knew something was wrong. He did have repeated chest infections over the next 5 years, but had no long term consequences.