At the end of my tether with DD's (20m) persistent cough!!

[HammerHorror]

DD, 20 months, has had a cough for over a year. It's mainly at night and it's most nights. Sometimes it's productive, sometimes it's dry.

I've been to the GP about this cough more than 10 times.

Earlier this year she was referred for a chest x-ray which showed inflammation in her upper respiratory tract.

She had another chest x-ray when she was admitted to hospital for pneumonia and had a shadow.

The GPs keep saying "she's picking up viruses at nursery".

She's been prescribed a ventolin/salbutamol inhaler but I don't think it makes much/any difference.

It's really concerning me but I don't feel listened to. Her nursery have expressed concern as she often feels crackly/crepitus in her chest.

She was a full term baby, no one in our household or extended family smoke, we live in a semi-rural low pollution area, the house isn't damp, she's thriving and developing well... I'm just so worried about this cough!

Any advice? Anyone experienced similar?

I'm in Australia op where it seems it a lot easier to get private referrals. I would take her to see a respiratory specialist.

Please google 'walking pneumonia'. They usually need 6-8 weeks of antibiotics to fix it.

And please be careful with Montekulast. It is a fairly new drug and only recently have reports come out about side effects. It can cause behavioural issues and severe depression.

Sorry to say this again but I've been thinking about it. Please make an appointment with a respiratory specialist, private if you can. If she's had shadows on her X-rays then she really needs to be seen. You don't want her to end up with bronchiectasis.

I’d say she needs to see an allergy specialist, especially as she has CMPA she could possibly have other allergies like Soya or house dust mite. Have you tried hoovering her mattress, damp dusting her room including curtains and blinds, freezing her soft toys and washing all of her bedding at 60?

Thanks for all the replies.

I am very concerned that there's chronic inflammation and there was a shadow on her lung but no one else seems concerned!

Also, she has had two bouts of tonsillitis requiring antibiotics.

If I can't get a referral to paeds via the GP we'll have to look into private. It's not fair on her.

Her mattress and bedding is only 2 months old but I'll give it all a good hoover and clean this weekend.

She had two coughing fits last night. I gave her 3 puffs on the inhaler but I really don't think it does anything.

Could you see another GP for a second opinion? I’d go back to the GP today and insist they refer. Cry, plead, do whatever it takes. Call your HV too and get her on your side, tell her how exhausted you both are.

Just generally make a nuisance of yourself until they listen.

If it is house dust mite allergy, the fact that the mattress and bedding is new won’t stop the allergy. There’s sone more info on dust mites and other triggers here

We saw 3 or 4 GPs at our last practice: one prescribed antibiotics, one prescribed the inhaler, one referred for the chest x-ray, and we had lots of "she's picking up viruses at nursery".

We've just moved house and changed practices. We've seen one GP at the new practice who's said to give the inhaler another go, said she couldn't take montekulast because of the CMPA and has prescribed gaviscon.

She's also been in hospital with pneumonia so saw a paediatrician there.

We don't have a very good HV service where we are. It's a centralised hub and very difficult to see an actual human. I attempted to get support from them with the CMPA but I kept getting told "some babies are a bit sicky" "some babies just have reflux" "some babies do poo a lot" "it's colic"!

I must sound very negative but this has been going on for a year.. I've been back to the GPs so many times but no one seems concerned because she's not a sickly child! She's thriving on the 50th percentile, she's chatty and happy... she's a picture of health but she's coughed almost every night since September last year.

I end up feeling like I'm wasting the GP's time and I'm overreacting... but then she has a coughing fit.

It would be very unusual for allergies to cause a productive cough. I have been through years of chronic lung disease and respiratory illness with specialists so I'm just telling you what I've been told. The fact that she's running around well but with a chronic cough sounds very much like walking pneumonia.
There's also a condition that causes liquid when swallowed to go to the lung instead of the stomach. She would need a respiratory specialist to diagnose this too. It would also cause a chronic cough and mucous production. You would probably notice her looking like she's choking when eating/drinking though.

We were made to feel a nuisance too, and one GP even actually said that we were paranoid parents of an only child. Ds was growing and everything, but had to sleep in our bed propped up on pillows to actually get any sleep

I’d also recommend a conversation with Asthma UK. They have a really good helpline which helped me have more productive conversations with medical professionals.

Seriously, push for a general paediatric referral. Working these out is bread and butter stuff (but you can't do it over the internet!)

I've made an appointment with the GP again for next week.

I'll try to give Asthma UK a call too.

We broke all the safe sleeping rules for DD. With the CMPA and this cough, we wouldn't have survived without giving her a pillow!!

I don't think she's aspirating food/drink. She feeds/swallows ok and I haven't noticed coughing when eating.

@ BlueUggs

My son was prescribed a steroid inhaler first and he had horrendous side effects - anxiety, depression, struggling to concentrate, struggling to sleep so they switched him to montelukast

Please take care to monitor your son for side effects as all those symptoms can be caused by montelukast and if he has reacted to one he may well react to another.

My be totally wrong but when my son was a baby he had the worst chest for nearly 2 years. The battle I had with doctors was horrible. He turned out to be allergic to cows milk. As soon as I switched him to an alternative the cough went.

He is also an asthmatic but I don't think that's connected to the above

@NGC2017 she does have CMPA but it's been under control for over 9 months.

Since I posted this she's had another hospital admission with pneumonia and so so many chest infections. No one wants to investigate further or offer an explanation! An A&E doctor did say it was very odd and worth investigating but that's the only person who seemed vaguely concerned!

Oh shit... just realised I'd name changed!!!

Bugger!!

OP we have several of the same things happening.
DD developed a cough at 10 days old and has, more or less, coughed at night or in the car seat since then. She almost always has a runny nose.

I kept taking her to the GP and we were sent away with an inhaler numerous times / and told that children get colds a lot. Luckily she’s never had pneumonia and her chest X-rays so far have been clear, how worrying for you that your dd has had another admission.
I’d really keep pushing your GP for a paediatric referral. My dd has recently been re-tested for cystic fibrosis, she’s also on Montekulast and Had a long course of antibiotics which helped, but when finished the cough came back. She’s in line for some other tests.
I keep asking about allergies, but am told that they wouldn’t present in this way, although I keep asking a respitory specialist so I assume he doesn’t know much about allergies (although he knows a hell of a lot more than me).
Surely in your dds case another hospital admission will prompt your GP to make a referral?

Has anyone mentioned adenoids?
DS had the persistent night time coughing/choking as a toddler. Had a number of different antibiotics, suspected asthma so inhalers for a while but no real improvement.
Eventually got an ENT referral and they suspected enlarged adenoids. Sure enough that's what it turned out to be.
I know that this wouldn't explain the shadow, but maybe ask for ENT referral too if that hasn't been suggested.

Another name change but it's me, the OP, back to cry tears of frustration.

Since my last update 2 months ago she's had a persistent productive cough for about 4 weeks. I took her to the GP and got the usual "viral... nursery... common in toddlers".

I went through her entire history with the GP - she had no idea about the hospital admissions for pneumonia nor the chest x-rays.

I told her I was concerned.

She said she'd ask paediatrics for advice (not a referral) because of maternal concerns... I feel like I have mumchausen byproxy! Why isn't anyone taking this seriously... an otherwise healthy toddler with recurring pneumonia and a chesty cough for over 14 months!!!!!!!!!!!

We're going back to the GP next week to see what advice has been offered.