Not convinced with GP's diagnosis - toddler 22 months - asthma, cough, eczema

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So my 20 month old has had a cough for a whole month now. With the cough she also has some sort of eczema. GPs have said:

Ringworm
Chicken pox
Eczema
Hay fever
Asthma

We have cream that clears up the skin on their chest and back but it just comes back. At the top of the neck it now looks like tiny whip marks

Their cough mostly at night, where we will wake at least once with a coughing fit (in fact, she now sleeps through them as they're so regular). I don't think it's a tickly cough bc I think she is coughing up phlegm.

I feel it is an allergy. Would that makes sense? Can gave Piritin which made no difference and we inhaler does nothing. The dr basically said give her Calpol. But why? She's asleep and coughing?!

Who can we go and see private if needs be?

(We have changed washing now to eco-eggs and I've monitored food and I can't see a link to that either).

I'm sorry for a few spelling/grammar errors - I have a headache 😣

Why do you think it's an allergy? I have eczema and asthma and I'd be assuming DC had the same with those symptoms.

So when should I be using the inhaler? Do you also cough all the time? Not sure how I can soothe her cough so it's not constant? Also the skin?

Oh forgot to say - dr said unlikely as not in either families 🧐

I cough a fair bit, but look up cough variant asthma - coughing in the night is a very typical asthma symptom. Taking the blue inhaler should relieve it but if it's every night have you tried her on a preventer inhaler? You should use the blue inhaler whenever she has asmtha symptoms, which includes coughing. However using it regularly is a sign that asthma isn't properly controlled and you need something else, so I would push for that. Uncontrolled asthma can be very dangerous and isn't something you want to mess with. The Asthma UK website is very good, as is their chat function and helpline, I would wholeheartedly recommend them.

My skin is just constantly bad on it's bad patches, DH and both DC are the same. You clear it up and have a good few weeks and then it goes downhill again. We're not as proactive about it as we probably should be, but the best success we've had is with DD1 who's 3, the GP prescribed a strong steroid cream and we use it twice a week as maintanance and then for up to a week when needed. Keep moisturising too. Unfortunately it's one of those things where every person has success with something different so you just need to keep trying.

I'm not a doctor so obviously can't rule anything out or diagnose your DC, it just struck me that your post screamed eczema and asthma to me (which tend to come together, along with hayfever) based on my experience. I think allergies might be associated too, so I'm not saying dismiss that possibility or anything.

Did they have reflux as a child?

I went through something similar sounding with my first daughter.
It turned out that she is allergic to cow's milk protein (casein).

Doctor didn't figure it out, I did.

Neither DH nor I have any allergies.

Stick with your gut feeling - we know our children much better than the doctor does.

This is my thought too beach hence my question. It sounds like she is reacting to something in her diet

Night time cough is very typical of asthma, and makes it more likely a diagnosis with the eczema. If someone is atopic, they are likely to have some element of asthma, eczema or hayfever, and maybe have all three.
Asthma is an allergy, allergy to the house dust mite. You cannot eradicate dustmites completely. It sets up an inflammatory process that cause, typically, cough, esp night time, sometimes wheeziness ( often less common in young children), coughing on exertion, chest tightness ( difficult to elicit in a young child) and sometimes shortness of breath.
Is there asthma, excema, hayfever in the family? That would lend veracity to the diagnosis.
The blue inhaler opens up constricted airways to ' relieved the symptoms, so may ameliorate the cough short term ( sometimes this doesn't work though).
Do you have pets? Esp cats or dogs? This can be a trigger sometimes.
The only way to find out, at this stage is trial a ' prevented inhaler, usually a brown one, ( I do hope you have been given a spacer to use with the blue one...it's essential it is delivered to the airways effectively and it just would have no effect given to a young child without one).
The brown inhaler contains a very low dose of steroid, an anti inflammatory, which, due to it being delivered locally, is not systemically absorbed ( or v v little).
It is essential this is given regularly, symptoms or no symptoms, twice daily for at least 3 months. Any less than that, or forgetting some days will render it ineffective and simply reinforce the fact that it hasn't worked and that it therefore cannot be asthma.
You need to go back to your GP and possibly see the asthma nurse for guidance and explanation.
Untreated asthma can be dangerous as can relying too heavily on the blue inhaler as it does not treat the underlying cause which is inflamed, constricted airways, causing the cough. The only way to find out if it's asthma is to follow this path at this stage in your child's life.
It may be reflux, but I would think you would have been aware of reflux symptoms before now?
Good luck, if well controlled, asthma doesn't mean the end of the world, people lead absolutely normal lives usually.

Also, it's not 'unlikely to be asthma if there is no history of asthma, hay fever or eczema on either side of the family...it just makes it more likely if there is.
It absolutely should not be excluded as a possible diagnosis on the basis of no family history of it. That could be dangerous.

Piriton targets different inflammatory mediators, so is good for hives, wasp stings etc. hay fever.. .. it inhibits histamine production as it suggests, Asthma is caused by leukotriene production, esp in young children, so piriton will have no effect if it's asthma and will only make her sleepy ( or sometimes the opposite!) You want neither of those. Piriton is really a one off treatment and shouldn't be used in young children regularly.

Oh my word, thanks guys!!

This is SO helpful! It just makes sense! Thank you so much! Yes she did have reflux when she was a baby!

So we just need to keep on doing what we are doing and stop looking for it to end as it probably won't for a while.

I'll take all of our advice with the different things too!

@Oneearringlost thanks! I was worried to give them something all the time that pointless!

i think it sounds like an allergy to something. I wonder if its worth doing an elimination diet

@Oneearringlost

Hi!
None of those in either families! No pets or anything. She had reflux as a very small baby - however I'm not even sure it was that! The inhaler is blue and has a pipe thing for her to use it as she is young. That's all we have?

@Branleuse

I can do this. It's difficult twice a week as she goes to nursery and eats breakfast, snack & lunch there 🧐

I've requested her to see a paediatrician and they've accepted

I would wait on starting an elimination diet in one so young til you've seen the paed.
Good that you've been referred.

I would consider CMPI then. I have had two with it!

My paed nice and v open minded but admitted I knew far more than he did by the time I got my appointment to see him.

If you do try dairy free you have to be careful with calcium

Noted 👌🏼 I thought perhaps I could just narrow her meals down a little. Keep it a little simple and plain for a week or two. Maybe choose 15 ingredients maybe. I'll not stop milk yet then. I don't think it's that, you know. I honestly think it's something we are using.

I do use that shake and vac on the carpet. I keep thinking is it that!

Omg do you think it IS the Shake and Vac????

As a baby, DS suffered from asthma, eczema, and caugh. He was also often constipated and had a “beer” belly.

It turned out to be a dairy intolerance that caused all the symptoms, but strangely, he could have casein based formula but lactose free one exarcerbated the coughing and asthma horrendously.

Problem is that you are going to struggle to find a gp willing to diagnose an allergy so early, and it is never a good idea to start elimination diets if you don’t know what food to use to replace the nutrients of the one you are taking away.

Is baby still breastfeed or in formula? If the former, stop having dairy for 2 weeks and see what happens. If in formula, try a casein free one. Either way add plenty of broccoli to her diet to make up for the lost calcium (don’t worry if she doesn’t like it, she will be craving it like mad).

You should know within two weeks

Ps. Nurseries are mostly accommodating of special diets. But if you are doing an elimination diet, it might be a good idea to send her with a lunch pack for a couple of weeks.

Once you know what is the issue, you can ask the nursery to avid the offensive allergens. They will do it, within reason.

My sons main symptom for asthma was a night time cough. Stopped cows milk, gave goats milk instead which improved his symptoms massively.

I agree with @oneearringlost that its best to wait to see the paed before you start eliminating foods.

I probably would stop the shake and vac though!!

Keep a diary. What she eats and times, when she coughs etc and as someone who spent my childhood coughing, notes about where she has been and the weather/pollen count. (Two of my triggers were found by chance - the classroom rabbit and being in the school nature reserve with lots of tree pollen...)