Baby with persistant cough - Dr has suggested a chest x-ray

[Haribosmum]

My 8 month old baby has had a persistant cough since he was 61/2 months. Everytime I have taken him to the Drs they have said it's a virus he's struggling to shake off. When I took him back this morning we saw a different Dr and she listened to his chest and said it sounded clear but it still could be asthma (my 3yr old has asthma and she was making the assumption based on that even though she said they don't usually diagnose asthma under 1yr of age). She has given him some antibiotics for an ear infection (he has a cold but we both agree that the cold and the cough are separate things. She has told me to bring him back in a week if the cough is not getting better and she will order a chest x-ray just to check nothing sinister is lurking. Have any MNers had similar experiences and just what could a chest x-ray pick up on?

Cheeky bump for the 9 o'clockers!

Hmmm I'm not sure I'd be that keen on a chest x-ray as a first resort for such a young baby.

DS1 had a persistant cough at the same age- the GP referred him to a paediatrician, who checked that he didn't taste salty (can be a sign of CF), listened and said it wasn't a chest infection, but bronchiolitis and he's probably had virus after virus. He did say it was common, particularly in younger siblings to catch everything doing the rounds. Anyway it cleared after a few more months and he's 8 now with no asthma or anything. He also said that GP's have trouble distinguishing different causes of chest wheeziness etc (not in nasty way- he was saying the GP had been right to refer on).

Could you ask for a referral to a peadiatrician first?

Gess. The doctor has already ruled out bronchiolitus. His chest sounds completely clear apparently. I'm not so keen on the x-ray either but they need to double check for nasties.

I'd want to know exactly what an x-ray was going to rule out & whether there was other things that could be checked for first. TBH I'd prefer a paediatrician to have a look first as well, as their decisions are sometimes less random than a GP's.

2 of our kids have been x rayed at various times, but dh did also refuse to allow one on ds2 because he was told the chances of finding something were slim (and they hadn't exactly inspired confidence by initially x-raying the wrong bit of him).

DS2 also saw a specialist as a 5 month old and he was very wary about giving an x-ray to a young baby- and that was regarding a bone problem so would definitely have shown something iyswim- he said that the chances of it being sinister were too slim to justify an x ray and he preferred to keep an eye on him with regular check ups (which he had).

What will an x-ray show, and what won't it show? Nasties like CF are tested for with sweat tests, so there are certainly some nasties that can be diagnosed without an x ray.

I don't know, but the consultant was certainly wary of them uncessarily in young babies - and I think a leg x-ray is more contained than a chest x-ray. I never say no to any medical procedure but I would want to understand the potential benefit vs risk more for such a young baby tbh.

Just another thought - could it be whooping cough. There's a new strain about that isn't a nasty as the old one but isn't protected against by the vaccination. DS2 was dxed with asthma aged 2 because of a cough that lasted from October to April (every night and every time he ran). But it went away and I now think it was whooping cough (read some stuff about the new strain and it sounds identical).

Haribosmum - is he generally 'snotty'? Both my boys had a persistant cough caused by 'post nasal drip' - catarrh basically. It was often worse at night which initially led them to consider asthma.

my dS started coughing at 7 months, and eventually got a chest x-ray at 10 months which showed an area of pneumonia (various GPs had said he'd grow out of it, virus, recurrent cold, ?asthma etc). 2 weeks of antibiotics, then another x-ray 2 weeks after that showed some lung collapse. Put back on antibs and referred on urgently. Had allergy tests, adenoid xrays (apparently a big cause of recurrent infection and cough), and 6 weeks in total of high dose antibs, chest physio and ventolin to try and clear the blockage, get rid of the infection and stabilise things. Follow up chest x-ray was clear, and this morning he's had a sweat test to rule out cf and some bloods taken.
NICE guidelines say that asthma in under ones need referring to a paed, but for the very low dose of x-ray its a good first point to check for an inhaled object etc according to our fab consultant

I would agree that a referral to a paediatrician would probably be best if you can get one. But if you are worrying about the x-ray it might make you feel better to know that my ds was premature and had 3 chest x-rays before his due date (ordered by consultant neonatologist). Like cmotdibbler (like the name ) they found areas of pneumonia. I'm sure a paediatrician would be the best person to balance the risk of an x-ray vs the benefit of what they would find - much more expert than GP! Good luck.

The actual radiation dose received in a chest x-ray is equivalent to a couple of days worth of background radiation or a flight to Spain (cosmic radiation being greater as less is filtered out by the atmosphere when you are at altitude).
The risk to DC will be outweighed be the benefit of checking for problems such as :-

1. inhaled foreign body - may not always show up, but may affect how lungs inflate. Has DC had any episodes of choking related to eating as inhaled food can also lead to
2. infection
3. asthma - lungs tend to get overinflated as airways narrowed so don't let lungs deflate as easily during attack

The other thing to remember is that DC will need to be held during imaging, which you can't do if you are pregnant. Also your 3 year old would be better off left outside the room so try and arrange for someone to go with you to babysit them. Try and make sure you dress DC in something easy to get on and off, or preferably something plain on the top half with no buttons, poppers or metallic type decoration eg printed image or sequins and you may get away without having to undress at all.
You will have to hold DC still during imaging and all children tend to complain about this, but it is better to get it right first time. Sometimes repeat or additional images eg. sideways are necessary. It doesn't necessarily mean anything is wrong, just that more information is needed to be able to get a useful result.

Cmotdibbler your post has just reinforced the idea that I want this done to rule out anything like that. I think I would prefer him to have the x-ray to rule things out. He's already been exposed to radiation as he had an x-ray a couple of months ago because he has got kidney reflux and they wanted to see how severe it was.
smbk - yes he is snotty but he's got a cold atm so not really a good time to see if he is generally snotty or not! But on the whole he's not a snotty baby (unlike DS1 who has ALWAYS got a snotty nose or ear infection!)

DS2 is really sick today. Slept from 6pm last night until 8.15am when DH woke him up so we could take DS1 to nursery. He's to sleepy I just hope he is sleeping his cold off. He's just on milk today because he keeps choking and gagging on solids and so far he's kept it all down.

I hate him being this poorly, he looks so small and helpless. I think I'll take him back to the docs tomorrow if he is still this sick.

BTW I'm in NZ, just so you know I'm not up at ungodly hours every night! LOL!

Which part of NZ? My brother is a GP in Kerikeri

North Shore so Kerikeri is about 20-30 mins away!

As Vole3 says its a really tiny dose, and the risk is very, very small (I can work it out if you really want to know).
Without the x-ray all you would know was wrong with DS was the cough - no fever or weight loss, but could have really developed into something if left.
Of course DS has developed major barking cough overnight which required ventolin every 2 hours to control..

They have a radiology clinic in Hobson Road in Kerikeri or would Whangarei be nearer for you?