Coughing as a symptom of asthma in toddlers

[MeadowHay]

Does anyone else have a toddler who has asthma/suspected asthma and develops long lasting coughs with every viral infection? She actually coughed most nights between the ages of 6 months and 20 months ish until she had s trial of a steroid inhaler. We stopped it after awhile to see if the coughing came back, which it didn't, but she now has a cold and back it is. Me and DH both had a cold last week so I'm certain she has the same, and her coughing is almost exclusively whilst she's sleeping (which is a symptom of asthma in small children) but there is some occasional coughing in the daytime. If she hadn't had the break from symptoms with the steroid inhaler there's no way I would describe this as a new persistent cough given she'd had it most of her life. However she does now have that break so am I to consider this a new persistent cough and isolate and order a test for her? I can't imagine I'm the only parent facing these kinds of situations? Nursery are aware that she coughs as a symptom of asthma and just prior to lockdown she had HFM and they were fine with that but I dunno how they'd feel about it now (understandably).

Dd has this caused by acid reflux. If it’s not new it should be fine.

Sorry I would do test as a precaution.

This is how dd’s asthma manifests

She had a bronchitis at 13 months which has left her vulnerable to coughs and colds. When she gets them, she needs her inhaler.

She doesn’t get the normal short of breath most asthmatics get. She gets a cough.

She’s 7 now and it’s rare she has to take her inhaler so I’m hoping she’s growing out of it

DD 5 is the same. A nighttime cough with every cold that takes months to go. She gets viral induced wheeze and needs her inhaler. Last winter she had back to back colds and the coughing/throat clearing went on until April this year. The gp but her on the brown inhaler for 2 weeks but it made no difference, he now thinks it had become a habit as she's stopped doing it.

My DD had a night cough, worse after a cold/virus. Lots of asthma in my family including me so assumed it was the same. When she was 3 she was given a blue inhaler and diagnosed asthmatic. Inhaler did little. Turned out she had giant adenoids so couldn't breathe through her nose effectively. Since having them removed the night coughing only happens in conjunction with a cold.

It could be asthma with your DD of course!

DS6 is like this too. When the asthma is not under control he coughs all night, but recently were advised we can drop the steroid dose, which hasn't been an issue at night, but has caused more coughing when exercising. It's not exactly new though as that's the same pattern as last time we tried.

Yes cough was/is main symptom rather than wheeze. Especially at night. Also triggered by pollen and animals. Wheeze only comes when attack becomes severe. Also he coughs a lot when running etc especially when the air is cold. His small school do know him well but I have wondered if they will insist on tests anyway to be absolutely sure.

So what are toy all doing with your children? Test every time symptoms return? Or not test as it's not a new cough and not even really persistent with the fact that it's a typical asthmatic cough in that it's mostly whilst sleeping? And what do you do about nursery/school?

I don't know whether to order a test tonight and just resign myself to it or take her to nursery tomorrow morning and see if they will accept her/send her home or not.

@Herecomethehotstepper my GP said you would need a trial of a brown inhaler for 6-8 weeks, I don't think 2 weeks is a long enough time to know whether it would help or not?

My DC has a steroid inhaler which I am just making sure she takes to control the asthma symptoms. I had to push to get her on one but it has been worth sticking with.

Ds was diagnosed with asthma at 3..
Having his window open during the night helped significantly with the coughing..

@OlivetheTree - we saw a dramatic difference with the steroid inhaler too, literally had symptoms most of her life and then they completely disappeared although she did still have symptoms with the HFM whilst on it. The GP suggested that we then do a trial of not being on it to try and determine whether it was a coincidence or not. Symptoms didn't return - over a 3-4 month period although she'd had no illness in that time - and now she's got her first cold they've come back. I'm not sure if benefits outweigh the risks if she only gets symptoms with a cold?

I’m worried about this. My 4 year old has a continuous cough from September to March and my 1yo has an inhaler for viral wheeze. Come the winter I think the older one is just going to be tested all the time which will be unpleasant for her. We saw a specialist for something else and she suspected asthma but the GP seems to think I’m bonkers.

Both my 2 get coughs after a cold. Im asthmatic.
Olbas oil on tissue usually helps if they arent allergic.
But yes i can see this being a problem this winter.

Im not sure a brown inhaler would completely stop it.

I dont know but doybt cv would just cause nighttime cough.
We may have had cv and both dds coughed for 8w!

Are you giving them 10micrograms of vitamin d a day?

Menthol in the room makes it worse unfortunately, have tried various menthol drops/crystals in hot water which have always made it worse and Calpol plug ins make it worse too.

She has vit D in her multivitamin in her milk each night, dunno the amount. Probably not very much but she's had a lot of sun over the last few months.

She is coughing now and then in the daytime too but not frequently. She's been asleep an hour now and not a cough yet so fingers crossed she will have a better time of it tonight. Partly for my sake as I hardly slept last night constantly being woken by DD coughing through the monitor and DH snoring

Asthma can manifest like this. Extra coughing in the night when they have a cold. If the cough is continuous it is better to use the steroid inhaler as continuous coughing can damage the lungs and make the asthma worse. Our son used to cough I'm the night but when we use the steroid inhaler it completely stops. The doctor advised us to up the dose of inhaler when I anticipate him becoming ill with a cold and then if I want to wean it down again when he's better I can so that he's on the lowest possible dose. Some important things I learnt over the years are: the steroids take about 3 days to properly get into their system. You can't cut out the steroid inhaler abruptly because the lungs become reliant on it. You have to wean off slowly. For example if you give 200mg of the inhaler (100mg in morning and 100 at night), you can start by weaning to 100mg in the morning and 50mg at night and see how that goes for a week before decreasing further. It's really important you don't stop it suddenly. Also the doctor advised us that if for example your child is on 100mg per day it is better to give the child 50mg inhaler twice a day- morning and evening so the dose is more evenly spread rather than a 100mg dose once a day. I hope this is helpful. It sounds like you need to speak to your gp to get proper advise on this.

I'm surprised to read that, as our GP told me to stop it abruptly a few months ago to see how she goes without it. I will deffo make a telephone appt with the GP today to discuss. I think DH is going to call nursery shortly and explain the situation and see if they will take her. If not then he will just have to stay home (HCP) if his work isn't happy either and we will need to order a test as we don't have a car. I am concerned this is just going to happen again and again especially in the winter which is s concern for him having to stay off work over and over again (I WFH so not an issue for me).

Just going to update for other people wondering how this may be dealt with in future for their little ones:

• Called nursery: they said they wouldn't take her as a precaution and to order a test. But they said if her daytime coughing stops by tomorrow they will take her from tomorrow even in the absence of a negative test and even with coughing in her sleep/upon waking.
• DH called his employer (hospital) - they said common sense says this is asthma and not covid and he should be fine to go to work but call 111 and follow their advice.
• DH called 111 - they said DD didn't meet the symptom criteria for a test and the whole household should just isolate for 7 days to see if symptoms develop.
• DH pondered this and realised he couldnt just take 7 days off work for no reason so called 111 again and this operator arranged for a test to be sent out to us. They advised it could be up to 48hrs for it arrive and another 48hrs for a result, and to all isolate til a negative result. So this week is mostly a write off and doesn't look like DH will be able to return to work til next week now. Just because DD has asthma.

The biggest stressor is being told different advice from different people and also the worry that this could happen over and over again meaning repeated unpleasant testing for DD and repeated absences from work for DH who is a newly qualified HCP on a temporary contract. It's a worry.

For context she's been awake since 7.30 and coughed three times since then I think.

DH will make her a Tel appt with the GP too for advice on her inhalers.

Yes nightmare.
When dd2 got ill the week after half term in march. Slight temp then few days later runny nose but no cough till day 9 which is quite typical of a cold. But if now it woudnt be a 'concern' until the day 9.

Whereas when we got ill in apr we had a day of sore throat then straight into a dry cough.

Dc1 is 8 and the coughing was generally a lot better so for her it was maybe swollen adenoids

GP told me to stop it abruptly a few months ago to see how she goes without it

It too kme ages to get my GP to officially diagnose my DD with asthma and just give us an inhaler. I have it so knew full well and found the on/off monitoring thing very difficult to do properly. The GPs have strict guidelines on it but my GP ended up diagnosing and prescribing repeat brown inhalers by telephone and said (I paraphrase) "OK so we haven't done the entire rigmarole but we both know it's asthma".

My DD takes one puff in the morning and one at night and I was given same advice as as a PP for when a virus comes on.

Yes this is / was how ds's asthma manifests.

Ironically I was diagnosed with asthma a year or two before he was. We share exactly the same symptoms and similar triggers; mainly winter air and viruses.

I have rarely wheezed but now cough at the drop of a hat.

In both of us it's non allergic asthma. Both of us were prone to croup (I still am!)

My son can pretty much stop the steroid inhaler at this time of year; we are keeping it going at a half level incase he catches the virus. Before sept we will be going back up so he's covered when back at school, but like me, most colds go to his chest and he coughs.

Ds2 is 2 and seems to also get easy coughs; Bracing for a winter of frequent tests!

Try speaking to the asthma nurse rather than the Gp. If all symptoms stopped on the inhaler, she ought to go back on.

The difference in energy and behaviour for my son was huge; he was actually really affected by lack of sleep and oxygen. His peak flow was actually only 50% at his worst after a cold but still never wheezed.

He had just started school and it made a difference to how tired he was at the weekends and evenings.,

Iirc it's extremely hard to diagnose in children.

It's sometimes based on absence of symptoms when on an inhaler, which may be why the Gp took her off it - it's come back so id imagine they'd be happy for you to go back on.

You could talk to asthma UK who would know the ins and outs of the best guidance.

My DD(7) has this, and she coughs on and off from September to March every year. I am so worried about school come September. Am I supposed to take her for a test every week in order for her to go in? Is our whole family going to have to self isolate constantly? It’s a nightmare