Chronic Cough in 20 month old

[Anonymous]

As the title says my 20 month old has a chronic cough. I would say it started over a year ago - and it does come and go - but is mostly present. It's a loud racking cough that wakes her up at night and has even caused her to throw up a few times.

We have done everything - nebulizer constantly, steroids, antibiotics for sinus infection, we steam her in hot bathroom, cut back on dairy - nothing seems to work and I am at my wits end. The doctor just sort of shrugs. We're waiting to see an ENT in about two weeks.

Has anyone dealt with this and resolved it?

[Anonymous]

She needs to see either an allergist or a pulmonologist, more than an ENT. This is almost certainly cough variant asthma, and you need allergy testing and maintenance meds.

Undertreated asthma can have long term impact, and pediatricians are not skilled in handling it. You need a specialist.

[Anonymous]

I have one too. Try a allergist, pulmonologist and GI (reflux)

[Anonymous]

Anonymous wrote:She needs to see either an allergist or a pulmonologist, more than an ENT. This is almost certainly cough variant asthma, and you need allergy testing and maintenance meds.

Undertreated asthma can have long term impact, and pediatricians are not skilled in handling it. You need a specialist.

Thanks for this. I feel like I have been hitting a wall with the ped who just keeps saying, kids get sick. I had never heard of cough variant asthma but agree it matches the symptoms. I'll reach out to a specialist.

[Anonymous]

We had a similar problem when my son was that age. We got a similar run-around from all of the specialists.

Eventually, we got an appointment with the ENT at Children’s in DC. After a bunch of tests and scopes, it turned out that he needed ear tubes in and his adenoids out. My DS also turned out to have an abnormally narrow wind pipe (trachea), which made him extra susceptible to these illnesses.

We’d seen multiple pediatricians and children’s ENTs and allergists but only the Children’s ENT was able to figure it all out. It took almost a year (and my son was getting increasingly sick with multiple pneumonias and starting to lose weight) but I will be eternally grateful to that ENT at Children’s.

[Anonymous]

Pp from above here. It turned out that my son had asthma as well but figuring out the ENT issues meant that we could focus on controlling the asthma. Without the ENT issues under control, his asthma (also cough variant) wasn’t well controlled at all and the whole thing kept snowballing into pneumonia. Not saying that’s the case for you, just that ENT issues combined with asthma in our situation to make it harder to discern the underlying problems.

[Anonymous]

Sorry—one last tip. My son’s cough mostly presented at night so a lot of the specialists blew me off as an anxious mom. However, I took some videos of him coughing at night for a few nights and then they started paying more attention.

If your child is falling off the growth chart or losing eight or not growing, that’s another data point you should empathize every time too. Good luck! This can be so stressful.

[Anonymous]

Anonymous wrote:Sorry—one last tip. My son’s cough mostly presented at night so a lot of the specialists blew me off as an anxious mom. However, I took some videos of him coughing at night for a few nights and then they started paying more attention.

If your child is falling off the growth chart or losing eight or not growing, that’s another data point you should empathize every time too. Good luck! This can be so stressful.

Thank you so much. Sorry to hear you went thru the same thing, but it's a relief to know I'm not crazy over here. I feel like the docs just won't take me seriously.

It's a good idea to record the night cough, it's definitely worse at night. So far she is not losing weight (big for her age).

We saw an ENT on 3/12 and DD was very congested so they gave us meds and we go back on 4/5. Have a June appt for a pulmonologist but hoping we can get off a waitlist for something sooner. The ENT said we should look at adenoids. DD is also very susceptible to hiccups and I wonder if she has narrowing. I'll raise asthma when we go back on the 5th.

[Anonymous]

Pediatric allergist (we heard pulmonologist would be good too). Pediatrician couldn’t diagnose anything since they are not specialists and it took us more than 2 years to find out and get cure for my DC.

[Anonymous]

Anonymous wrote:She needs to see either an allergist or a pulmonologist, more than an ENT. This is almost certainly cough variant asthma, and you need allergy testing and maintenance meds.

Undertreated asthma can have long term impact, and pediatricians are not skilled in handling it. You need a specialist.

New poster to this thread and agree with this. I am lucky that my ped specializes in asthma and reactive airway disease and she caught it immediately, but she still referred us to specialists who confirmed the diagnosis. My son has never been hospitalized for breathing problems, and while it’s hard to prove the counterfactual, I really do attribute that to her early diagnosis and keeping him on asthma maintenance meds.

[Anonymous]

It sounds like your daughter has been treated for reactive airway disease which is a term sometimes used before they are ready to diagnose for full on asthma. You said you have used nebulizers and steroids, so is that what the doctor said- that it’s RAD and could be asthma but she’s too young for a diagnosis? I’m interested to hear more about what the doctor said about using these meds that usually point to asthma.

[Anonymous]

Anonymous wrote:It sounds like your daughter has been treated for reactive airway disease which is a term sometimes used before they are ready to diagnose for full on asthma. You said you have used nebulizers and steroids, so is that what the doctor said- that it’s RAD and could be asthma but she’s too young for a diagnosis? I’m interested to hear more about what the doctor said about using these meds that usually point to asthma.

No the doctor did not use the term RAD to me or say she was too young for an asthma dx. Basically she said, treat her with these medicines and kids get coughs and i pushed for more info and clarity which is why she sent me to the ENT.

[Anonymous]

Anonymous wrote:

Anonymous wrote:She needs to see either an allergist or a pulmonologist, more than an ENT. This is almost certainly cough variant asthma, and you need allergy testing and maintenance meds.

Undertreated asthma can have long term impact, and pediatricians are not skilled in handling it. You need a specialist.

Thanks for this. I feel like I have been hitting a wall with the ped who just keeps saying, kids get sick. I had never heard of cough variant asthma but agree it matches the symptoms. I'll reach out to a specialist.

+1. I’d never heard of it either but my son has it too, also started pretty young. He was diagnosed around 4 but it started before that.

[Anonymous]

My son was diagnosed with RAD at that age, and later his diagnosis was changed to asthma. The steroid inhaler with toddler mask worked well for him.

One important component of allergy-driven asthma is to keep the house allergen-free, particularly during pollen season (like right now!). If your toddler is allergic to pets, the pet has to go, because years of unnecessary

Since DS is also allergic to dust mites, we encased his mattress and pillow in dust-mite casing, and got all upholstery/curtain/carpet stuff out of his room, except for his plushes, which were not allowed downstairs or outside. If he wanted them in his bed, they had to be clean. No one was allowed to lie on his bed in street clothes, for fear of bringing pollen into his bed. During the worst of the pollen season, he would get home, change, and even shower if his symptoms were bad. No shoes in the house, obviously.

Now he's a freshman in college and his allergies have decreased somewhat. He usually doesn't need his inhaler except at the worst of the spring pollen and ragweed in the fall, and he manages his symptoms with Flonase, the nasal spray. He's also anaphylactic to nuts, but even that has gotten better, apart from peanuts and pistachios, which he'll probably have lifelong. He has a single room that he vacuums himself. He washes his sheets regularly and generally takes good care of himself.

Generally for serious sufferers like kids who start their asthmatic life as toddlers, allergies peak again during adolescence, so you need to keep an eye out for that.

[Anonymous]

Oops, sentence disappeared: years of constant allergen exposure will cause long-term lung damage.