Use of Nebulizers if a baby is wheezing – pros and cons and for how long it should be given

This blog is in reply to Anjali Gupta’s query

” nebulisation pros and cons if baby is wheezing. Some doctors prescribe preventive budecort nebulization for a month if baby gets wheezing issues even after the cough/cold has subsided. Is that correct?”

When a baby wheezes during or after an attack of virus infection, it is what we usually call ‘virus induced wheezing’. Occasionally it may be due to asthma in which case the attacks occur without the virus infection.
Inhalation medicines, given either through the nebulizer or MDI (meter dose inhalers), are certainly better than giving oral medicines, as I have explained in the chapter on asthma in my book ‘Easy Baby Care’. Inhaler medicines have very little side effects as compared to oral medicines and are not habit forming.
As far as the treatment of virus induced wheezing is concerned, several treatment regimens are used. Although many studies have been conducted regarding this problem, none have yielded conclusive results. So, most paediatricians have their own way of treating this problem.
In my practise, for the babies who get virus induced wheezing often, I tell the parents to keep the inhaler medicine always at hand. When the baby starts with a cold and cough, I recommend that they should start giving corticosteroid (budecort or other corticosteroid treatment) 2 or 3 times a day with nebulizer or MDI (used for very young babies involving a small volume spacer and mask). If the baby starts wheezing, then salbutamol via an inhaler (through the nebulizer or MDI) should also be started. Usually, the wheezing is controlled with this. If the wheezing does not get in control, then oral steroids need to be given for 4 to 5 days. When the child is better, I tell the parents to continue the corticosteroid inhaler for another 3 to 4 days and then to stop. I do not recommend usage for one month.

84 Responses to “Use of Nebulizers if a baby is wheezing – pros and cons and for how long it should be given”

  1. Sandie Says:

    My daughter is 2 months old and has been prescribed Budecort 3 times a day. Doctor said she has severe chest congestion. My questions

    1) How to I avoid such situations in future? (She developed cold that stayed for 2 weeks but no runny nose)

    2) Does Budecort make children hyperactive. My daughter didnt sleep 12 hours at a stretch when i gave her the inhalations?

    • Sandie Says:

      Also is there no way that chest congestion can clear up on its own?

      • rajrani Says:

        Dear Sandie,

        It seems you have 3 concerns
        1. Prevention of chest congestion.
        2. Could you have avoided use of budecort inhalers?
        3. Does the baby get hyperactive due to budecort.
        Chest congestion and wheezing at this age is usually due to bronchiolitis, that is infection of small air passages. This infection is caused by viruses, in 50 percent of cases it is due to respiratory syncytial virus(RSV). A baby acquires this from persons who come in close contact with her. Usually an adult or another child who is suffering from cold passes this infection to the baby. So to prevent this, only caregivers should come near a baby who is less than 6 months of age. If the caregivers have cold , they should wear a mask when they are looking after the baby and wash hands frequently. This of course is easily said than done, however you should attempt to do so as much as you can, knowing how much your baby suffers from such an infection.
        As far as treatment is concerned, as this a viral infection, there is no medicines with which we can kill these viruses. However we need to give symptomatic medicine that is if baby has fever we have to give medicine to reduce fever. If baby has difficulty in breathing we have to help baby to breath easily. Treatment depends on the degree of difficulty. In severe cases babies need to be hospitalised, in milder cases they can be treated at home.
        Giving budecort by inhalation does help in drying up the secretions and thus helps in clearing up the congestion. If you do not give any treatment congestion will clear up eventually, but it will take much longer time., so naturally baby will not be able to drink milk, and breath properly. Because of not being able to breath, baby may become hypoxic which means have less oxygen in her body which can be dangerous, so we have to give appropriate treatment to the baby. Inhalation therapy is always better than oral medicines as it has less side effects.
        The fact that your baby could not sleep, cannot be due to budecort. At times when baby has difficulty in breathing, we give bronchodilators (like salbutamol),either orally or with inhalers.This causes hyperactivity so may be your baby was given this medicine. Cold medicines like psuedoephidrine also cause hyperactivity. Cold medicines should not be given to babies. Other reason could be that budecort takes time to act so it is possible that your baby was uncomfortable due to disease itself and that is why she could not sleep.
        if you have any other queries do not hesitate to ask
        Tc

  2. Sandie Says:

    Thank You for detailed response. I will take the precautions
    A few more questions

    1) My baby was able to drink mil without any difficulty. Her nasal passages were clear and breathing was fine. But she was coughing a lot(esp in night- 4/5 bouts of cough in frequent intervals) this sometimes made her vomit milk(Just once a day mostly). Her weight gain was also fine.

    2) Would advice trying home remedies like giving her boiled tulsi water. I understand honey should not be given to under 1 yr old so i wont.

    3) I also tried steam inhalation for her but inspite of steaming 3/4 times a day no mucous used to come from her nose. It was always in her chest or deep inside.

    4) Also, my pediatrician said that her cold was not viral and it is an allergic tendency( I get allergic colds and have atopic dermatitis)

    5) If i do end up using inhalers for her colds in such situations when will she outgrow t hem?

    • rajrani Says:

      Dear Sandie , Thanks for you feed back.

      What I understand from your queries is that you are very concerned about the fact that your child may need becotide inhalers repeatedly.

      Although quite a lot of research is being done on wheezing (congestion in chest) among infants, our knowledge still is far from complete. That is the reason for confusion in diagnosis and prognosis.

      !. A baby may have a wheezing attack once in infancy and may not have attack later on. In such a case we are quite sure that such an attack was due to infection.

      2. A baby may have repeated attacks especially after cold. These are either called transient infant wheezing or virus induced wheezing. We presume that these are due to allergy but at this stage, in infancy, quite often we cannot identify any allergy. These attacks usually subside by 2 to 3 years of age.

      3. Some babies keep on getting attacks even without cold. In such cases there is usually a family history of asthma, and \or atopic dermatitis. One or both parents have asthma, or siblings suffer from this. These babies can be presumed to have asthma and may need treatment for a very long time.

      4. There are some children who have no symptoms in infancy but may develop asthma later on.

      So you can understand that at this stage, it is impossible for you to know whether your baby is going to have attacks again. We hope she does not get any further attacks, but if she does get the attacks, and if you have to use inhalers again, these will not harm the baby in anyway.

      About usage of home remedies among babies, I am concerned about using any unproven remedy for babies especially if they are less than 6 months of age. When your baby is above 6 months of age, you can use tulsi juice in a very small quantity. I used it for my baby but cannot say whether it was of any benefit, or not. Honey has certainly been proved to be beneficial for night time coughing in children.

      Keep in touch and TC

  3. TANISHQA Says:

    Hello Dr, going through the net i came across this article,and i was happy as this topic was something due to which i am in tension so please if you could help advice me ,
    so please help me
    i have a 3 yrs 6 month old son, who had allergy that is his eyelids use to be red by evening at around 3 months old
    and right nasal clear watery discharge from 7 month old
    in between he never was sick , no cough no fever, cold nothing
    he had a dry patch on his left inner fold of elbow, so we took him to skin Dr, and he gave some tube and said it will go within 10days, but also said my son can get wheezing and all in was in August 2011
    later before his 2nd birthday that is 29th Sept. 2011, he got a cough and just would not go his Dr just did not help, only put him on medicines and antibiotics etc, and after four months said that he is allergic to something and has wheezing which she can hear, and he will need a inhaler for three months
    when i asked why she did not tell us all this time she said that as parents will panic she did not
    i changed the Dr, and he put him on inhaler budecort 100, and antihastamine singular 4mg, asthaline incase of bad cough, within a week his bad cough went
    but its not that my son is off cough comlpetely, he gets this off and on, and sometimes his wheezing is there also, and even if no wheezing he gets cough
    from Jan to april 2013 he had no wheezing, but cough off n on, in may he got wheezing and cough

    i dont give him cold rink, ice-creams, junk food, curds nothing
    he is happy child, playful
    fussy eater
    we have no family history from either side of asthama

    please help me with this,
    how Long do i need to give BUDECORT 100, WE STARTED IT IN FEB 2012
    ALSO SINGULAIR ON 28TH DEC 2011
    ASTHALINE AS AND WHEN NEEDED

    WILL HIS GROWTH BE EFFECTE WITH THESE MEDICINES
    IS HE ALLERGIC AND WITH IMMUNITY BUILD , ALL HIS PROBLEMS WILL GO
    ANYTHING FOR IMMUNITY BUILDING
    I COULD NEVER HEAR HIS WHEEZING, BUT IF COUGH VERY BAD ONLY FEEL SOME MOVEMENT IN CHEST WHEN SLEEPING

    please do help me

    thank you so much

    • rajrani Says:

      Your child probably has asthma. There is no single test by which we can diagnose this disease. Firstly, in children who have chronic cough, we have to exclude infection. If the wheezing is only on one side then a foreign body also need to be excluded. Final diagnosis of asthma is only made when after excluding other diseases, we put the child on asthma treatment and the child gets better, which happened in your child’s case.
      1. For how long inhalers need to be used?

      This is different for every child. Usually by 4 to 5 years most children grow out of this especially if there is no family history, however some children may need it for a longer time, while others may get better but may need these again at times.

      As your child still gets cough and wheezing, and needs asthalin inhaler at times you will need budecort and singular, for a longer time. When you find that for 3 months he did not need asthalin then you can attempt to stop budecort.

      Continuous usage of budecort inhaler does effect growth very slightly but once it is stopped he will catch up. However if he does not use these and continues to get cough and wheezing this will effect the growth to a greater extent.

      2. Most children with asthma are allergy to various agents, like house dust mite, pollens, etc. There are certain triggers like cold wind, cold drinks, perfumes, sweating, which can bring on these attacks. Trigger factors are different for each child, so if you find that eating curd etc, do bring on these attacks then only stop these, otherwise there is no point denying these to your child.`

      3. Asthma attacks are not due to lack of immunity.
      Nevertheless the only way to build up immunity is to give your child a well balanced diet.( look up chapter on diet in my book easybabycare which you can get on easybabycare.net).

      4.As asthma is due to allergy, it is worthwhile doing allergy tests and then avoiding these allergens.( You can get further details in the chapter Asthma in my book “easy baby care”, you can download or read this for free from this site)
      tc

      • TANISHQA Says:

        Thank you so very much, i pray that his probelm goes away, as we have no family history,also i forgot to mention that most of the time he get a productive cough when he catches cold,
        but if this cough is not there then he has a dry cough which does not go away with asthalin , he was give omacortil also august 2012, dec 2012 as he was to be operated for hydrocele, and now in may 2013 as we where suppose to go out of town, but in Dec 2012 omacortile had not helped, and i think with out it also in may it could have gone
        some times asthalin also just does not help
        and this dry cough is there, and soemtimes it becomes productive and then wheezing starts
        i dont give curds, banana and ice cream and all that. rather the poor child never ask when told once,
        he is on budecort 1 puff morning 1 night
        now due to his wheezing which was very mild but Dr said to give 2 puff morning evening for 10days and stop and continue with puff only
        do you suggest ayurvedic or homeopathy, do they help
        also to one person you mentioned that budecort has to be given when attack comes and then stop, or give for a month
        does asthaline make nose mucus dry, and also system ,as once after a bad cough and then goes away he gets dry cough and nose dry too
        also he has a cough not his breathless, or something, yes this was in the beging in 2011 not when the cough started but later after 2 months , may be due to no proper treament
        hope these steriods dont harm him, in growth physically and mentally
        is acoril-d, harmful for long time, as his dry cough goes with that,
        also your advice he need budecort and is not really harmful in use for more than year 1 yr 4 months exact
        i will wait for a reply and thank you very much
        allergy dr said he is too small for test and also his dr said that incase allergy test is done there will be more restrictions and he will be deprived,
        but what is the correct age for allergy test, also the spirometer test is that requried too
        i am very confussed and scared, dont know how to handle situation, and what will be happen
        do guide me
        thank you

      • rajrani Says:

        It seems you are still, very much worried about your child..

        Firstly you must realize that many children suffer from the same problem as your child and all of them get better with time.

        The cough is due to many reasons, and one of them is repeated viral respiratory infection which all children who are less than 5 years of age get it. After each infection, the cough remains for a long time, so it seems that the child coughs all the time especially at night. This sort of cough does not get better with asthalin. Ascoril d helps slightly, however honey works better. Asthalin works if there is wheezing with the cough. If you give ascoril d at times it is not harmful.

        As i told you budecort will not effect his growth ,and also when omacortil is given for short intervals, it does no harm in any way.

        Homeopathy and Ayurvedic should not be tried as the these treatments are not scientifically based.

        As i told you in my previous correspondent, that if you feel that when you give curd, ice-cream,and banana, he gets attack then do not give him, but if you find there in no difference then you can give him, these.

        In my opinion curd has no connection with cough. Actually it contains probiotics, which in fact prevents allergy diseases. You should try giving this. However ,if you really think that this does not suit him then you should give probiotics in medicine form.

        At the moment there is no need to do allergy test nor spirometery. These should be done after the child is five years of age. Hopefully your child will be better by that time.

        Sent from my iPad Raj Rani Mitra

      • Tanishqa m m nayak Says:

        Hello Dr how are you been long that i dd not disturb you, but my son who is now 4yrs 8 month old, his cough just dont seem to leave him, at times even the inhaler dont work and then the dry cough is always there, he gets really tried than corex or exiplon hav eto be give buts its coiden and how long can we give, when chericoff dont work, this is given he is other wise healthy child only this cough, and this cough anything is there

        i wanted to know if any deffecency can cause such cough, is there any test for deffecency check as when we visited a patient a lady in 70,they said she had some potassium or something like that deefececy due to which she was hospitalised they also said vit A drops in PHC should be given evry 6 months which i give and B12 and Vit D is necesary

        please doctor help me, please suggest, i will be greatfyl my child has dark circles due to lack of sleep and also exhausted

      • rajrani Says:

        Dear Tanishqua
        I am sorry to know that your child is still suffering from cough.
        Cough is never due to any deficiencies In your child’s case it is asthma.
        If inhalers are not working , you should consult your child’s doctor. perhaps he needs to increase the dose.
        At times cough can also be due to nose blocked. In that case nasal spray like flomist can help.
        tc

      • Tanishqa m m nayak Says:

        Hello, Dr dry cough is asthma , as i thought only wet productive as some one mentioned i though of asking you about deffecency

        i mean yes he does have blockage of nose but even if that not there the cough is there, can it be some thing else, some thing serious

        his dr always happy says nothing will go, after a fever or so he loses weight its not like he is chuby, he is thin but his dr says he is doing well and said if allergy will go with asthalin and will be after midnight or giv corex plain, buts thats not good

        slight wheezing there always can this DRY COUGH be the reason

        if its wet asthaline works but if dry then corex or exiplon but that cannot go on

        another thing when he sleeps i think as if some thing chokes and he coughs, and lot of saliva and his mouth smells if unwell and too much cough and besides i see that the throat is always slightly irritated and darker pink best his dr will do is give omacortil and that will help for some day dr what can it be

        dry cough start stop and its like a attack and moment chericoff given it stops after sometime but some times it does not than corex but with these stops it stops like for 12 hrs plus

        can it be allergy that goes and sits him throat, i will be doing his allergy test as you said once he is 5yrs plus can be low immunity

        are there any vaccines for this

        and what are the vaccine between 4 to 5 yrs and 5 to 6 yrs

        also this nasal spray is it steriod and how long and what are the side effects

        dr please suggest and help advice

        any test or anything

        so i can help my child with whatever problem

        one more thing is this a rare case or are there kids have cough all the time specially dry

        he is a very brilliant kid , happy kid never like sad even when not well

        please please help

      • Tanishqa m m nayak Says:

        sorry dr is there any cough specialist or any other doctor, and presently he not taking any medication only asthalin or cough syrup as when needed

        please even sroflow is stoped will that help

        thank you

        On Tue, Aug 12, 2014 at 10:36 PM, Tanishqa m m nayak wrote:

        > Hello, Dr dry cough is asthma , as i thought only wet productive > as some one mentioned i though of asking you about deffecency > > i mean yes he does have blockage of nose but even if that not there the > cough is there, can it be some thing else, some thing serious > > his dr always happy says nothing will go, after a fever or so he loses > weight its not like he is chuby, he is thin but his dr says he is doing > well and said if allergy will go with asthalin and will be after midnight > or giv corex plain, buts thats not good > > slight wheezing there always can this DRY COUGH be the reason > > if its wet asthaline works but if dry then corex or exiplon > but that cannot go on > > another thing when he sleeps i think as if some thing chokes and he > coughs, and lot of saliva and his mouth smells if unwell and too much cough > and besides i see that the throat is always slightly irritated and darker > pink > best his dr will do is give omacortil and that will help for some day > dr what can it be > > dry cough start stop and its like a attack and moment chericoff given it > stops after sometime > but some times it does not than corex but with these stops > it stops like for 12 hrs plus > > > can it be allergy that goes and sits him throat, i will be doing his > allergy test as you said once he is 5yrs plus > can be low immunity > > are there any vaccines for this > > and what are the vaccine between 4 to 5 yrs and 5 to 6 yrs > > also this nasal spray is it steriod and how long and what are the side > effects > > dr please suggest and help advice > > any test or anything > > so i can help my child with whatever problem > > one more thing is this a rare case or are there kids have cough all the > time specially dry > > he is a very brilliant kid , happy kid never like sad even when not well > > please please help > > > > On Tue, Aug 12, 2014 at 2:29 PM, Easy Baby Care <

      • tanishqa m m nayak Says:

        Hello Dr , thank you, but after the last conversation, about my sons health, WHEN he was on BUDCORT 100 TWICES A DAY SINGULAIR 4MG 1 IN EVENING DAILY AND ASTHALINE AS AND WHEN NEEDED

        NOW HE IS 3.9 MONTHS OLD HIS DR HAS CHANGE FROM BUDECORT 100 TO SEROFLO 50 AND STOPPED SINGULAIR, HE THOUGH BUDECORT 100 WAS NOT WORKING AND AS HE IS GOING TO BE 4 YRS HE SAID ITS OK, AS NORMALY HE DOES NOT FAVOUR SEROFLO FOR KIDS AS IT IS SINGULAIR NEVER HELPED HIM MUCH FOR HIS ALLERGY, NASAL CONGESTION,OR ITCHY EYES

        AFTER READING FEW OTHER PARENTS WORRIES I TOO REALISED THAT MY SON AFTER CATCHING A COLD END UP IN WHEEZING, BUT AT TIMES HIS COUGH IS DRY AND ASTHALINE ALSO DOES NOT SEEM TO WORK, THIS DRY COUGH IS SO STUBBORN, NOR DOES ASCORIL,PLAIN, D/C OR ONLY AFTER 2 PUFFS EVERY FOUR, 4 HRS THEN IT CHANGES IN PRODCUTIVE COUGH, SOME TIMES, KOFFLET WORKS A PARENT IN SCHOOL ASKED ME TO WATCH WHEN HE GETS COUGH MORE WAS IT FOR NEW MOON, FULL MOON. SO I NOTICED THAT JUST BEFORE NEW MOON OR FULL MOON HE DOES GETS COUGH BEFORE, I DONT KNOW HOW FAR THIS IS CORRECT, OR IF AS I AM DISTURB I THINK ITS SO LAST MONTH HE HAD BAD COUGH AND COLD DOCTOR SAID ITS VIRAL AND NEED NOT WORRY AND SLIGHT WHEEZING, HE SAID TO CONTINYE WITH SEROFLO AS PREVENTIVE AND ASTHALINE, AND SALINE DROPS, OR INCASE TOO MUCH NASAL CONGESTION HE GAVE SOME PEDIA DROPS

        NOW DUE TO SEROFLO HE IS OK BUT HIS NASAL CONGESTION IS THERE DUE TO WHICH HE CANNOT SLEEP WELL, BEFORE IT WAS HIS RIGHT NOSTRIL, BUT NOW ITS LEFT NOSTRIL WHICH HAS THIS CLEAR MUCUS, AND HE BREATHS FROM MOUTH, IT BECOMES SOME WHAT LESS AFTER SALINE DROPS BUT BY 4 – 4.30 AM IN MORNING IT GETS WORST HE IS RESTLESS AND CANNOT SLEEP, JUST SITS UP AFTER GETTING UP HE HAS ITCHY NOSE (MORNING, AFTERNOON NAP) SNEEZING, AFTER APPLYING ICE IT SUBSIDES ALSO YESTERDAY HIS LEFT HAD BECOME SMALL AND TODAY IS WAS WORST WITHIN FEW MINS OF GETTING UP HIS EYE WAS RED, SWOLLEN AROUND EYE BLACK BLUE, LIKE HE WAS IN BOXING RING, AFTER PUTTING ICE IT WAS NORMAL THEN HE LEFT FOR SCHOOL HE IS ONE ACTIVE TALKATIVE PLAYFUL LOVING CHILD, HIS TEACHER LOVE HIM NO COMPLAINTS OTHER STUDENTS PARENTS LOVE HIM TOO, BUT I DONT UNDERSTAND WHAT TO DO, ALSO HOW HE GETS ITS I HAVE REMOVED ALL CARPETS FROM HOUSE, ONLY CURTAINS WHICH ARE REGULARLY WASHED, BEDDINGS TOO I DONT GIVE HIM INSTANT NODDLES, PIZZA ETC WE HAVE NO FAMILY HISTORY ON EITHER SIDE WHAT DO I DON LAST TIME HE HAD EAR INFECTION DUE TO THIS COLD, ALLERGY, ENT GAVE AMB CET SYRUP, BANOCIDE, AND INCASE HE GETS FEVER ANTIBIOTIC 5ML A DAY FOR 3 DAYS, WHICH WAS NOT NEEDED HOPE HIS THESE PROBLEMS GET OVER LIKE HIS RECURRENT THROAT INFECTION GOT OVER HIS DIET IS MORE FISH AND RICE HE LOVES IT AND PALAK, METHI ANY VEG, PULSES THOUGH HE HATES, DAL, CHAPATI WITH GHEE, I HAVE TO TELL HIM HOW HE WILL BE STRONG LIKE CHOTTA BHEEM OR HIS DAD, SO HE EATS SCHOOL TIFFIN THEY HAVE A WEEKLY MENU, FROM BHAJI CHAPATI, FRUIT, DOSA,IDLIT, SHEERA PURI ETC I TRY GIVE HIM HALF A FRUIT APPLE WITH HIS REGULAR TIFFIN MENU BREAKFAST HONEY, 5 BADAM AND SOME DRY FRUIT ALSO MILK, BUT HE IS NOT PUTTING ON WEIGHT HE IS ONLY 14 KG NOW WHICH IS LESS FOR 3.9 YRS, HE IS 97.5 CM TALL, INFACT HE WOULD HAVE PUT ON WEIGHT BUT AS HE WAS NOT WELL HE HAD LOST MORE THAN 1 KG, AND AS SOON AS HE GETS SICK HE LOSES WEIGTH AROUND 1-1.5 KG I AM TRYING MY LEVEL BEST TO FEED HIM I HAVE LEFT MY CAREER, GIVEN UP SOCIALISNG EVERYTHING DUE TO HIS HEALTH, NOT THAT I AM COMPLAINING OR REGRET IT BUT I FEEL I AM FAILURE NOT A GOOD MOM I LOVE MOTHERHOOD AND ENJOY EVER BIT BUT CANNOT HANDLE THE PRESSURE OF SEEING HIM COUGH AND SICK DOCTOR DO ADVICE AND GUIDE YOU ARE ANTI-STRESS FOR ME A TROUBLE MOTHER THANK YOU SO MUCH GOD BLESS

      • rajrani Says:

        Dear Tanisqua
        I am so sorry that you are still so confused and worried about your child and also that you hold yourself guilty about his condition.
        I understand that your son gets infection almost every month. Actually it is normal for children of your son’s age to get infection, 5 to 12 times a year. This especially becomes more often when children start going to play school. These infections are part of growing up and necessary also and there is no way you can prevent these. They are mainly virus infections and therefore the child gets better in 4 to 5 days time. At times these are bacterial and in that case one needs to give antibiotics to the child. Because of these repeated infections their immunity gets build up and therefore they get fewer infections when they grow up.
        You mentioned that your son gets infection when it is full moon. There may be some unknown reason for this, perhaps the viruses become more active at this time, but however since you cannot do anything about that, why worry about this as to when he gets the infection.
        The main concern in your child is that he has this allergy tendency so he has wheezing, cough, nasal and eye congestion, whenever he gets infections. Tanishqua about 25% percentage of children suffer from this same problem, and mothers of these children, like you are all good mothers, so stop blaming yourself about this.
        For wheezing you can use budecort or seroflo whatever you think, relieves his wheezing. Singular very rarely helps so I do not usually use it.
        Your son also has allergy rhinitis because of which he gets nose block. Seroflo or budecort inhalation will not help this. For this you need an anti allergy drug like cetrizine plus nasal steroid like flomist nasal spray. The latter should be used after you use nasoclear. If you use this, you may be able to decrease the dose of seroflo. Do not hesitate in using these; they will not affect your child’s growth.
        For his eye congestion, which again is due to allergy, giving cetrizine once a day may help, but if it does not help, then do consult an eye specialist and he may prescribe some drops for his eyes.
        I understand that you have taken all the precautions to get rid of the allergens in the atmosphere. That is a good thing. However there are certains allergens in our atmosphere, perhaps due to pollution, about which we cannot do anything so that is why your child still gets these problems. Since there is no family history of allergy diseases in your family, it is quite likely that your child will be ok when he is about 5 to 6 years of age.
        The diet you are giving to your child is perfect. I suggest that you give him a multivitamin drops like visyneral also, so for any reason he takes less food he will not become vitamin deficient. Vitamins are necessary for immunity.
        Your child is 3.9years of age, weighs is 14kg and his height is 97cms. His weight is absolute right for his age and height. He is neither underweight nor overweight. Remember that a child will gain about 2 kg of weight in 1 year so when your boy will be 5yeas old, he will weigh 16kg. You should take the weight always on the same weighing machine, preferably electronic one. The weight should be taken at the same time of the day and also the child should not be wearing any clothes except for underpants and no shoes. After taking the weight, do write it down immediately. It is impossible to remember.
        I am glad that you enjoy being a mother. Remember that this is the best part of your life, which you will always remember when your children will grow up.
        Do write to me again when you can. if you are in Delhi you can make an appointment to come to my clinic by phoning at 9911101576.
        Tc

  4. mareah Says:

    Dear Dr Raj Rani Mitra…..
    My daughter was 10 months old when she got what doctors termed as “modified measles”, as she had been immunized for measles at 9 months, symtoms were very mild with moderate fever and skin rash which disappeared within a day. She had cough which we thought was due to measle like condition. It subsided within couple of weeks and later came back again after a week when we went to kashmir. Since then she has had cough with wheezing. It would start after 3pm every day and subside by 8 to 10 pm. Every time we would take her to doc the wheezing would never be there. Doctors prescribed oral asthalin. Initially we thought asthalin relieved wheezing but as we stopped giving her asthalin wheezing was mild. When we would gie her asthalin again it worsen wheezing. My grand parents have asthma so doctors prescribed mdi budecort 100mcg 2puffs BD for 3 months and asthalin 2 puffs TDS for a week and SOS. Meanwhile we also did her serum IgE, which was elevated to 132 but her eosinophils were normal.
    Its been almost a month now, she is on budecort and no asthalin. her cough is better sumtyms she will sneeze and cough with no wheezing which will be gone within half an hour or so.But we dont give her asthalin as its not needed much and as we believe it worsens her wheezing.
    My questions are:
    Is she having asthma???
    Will she be better with age??
    Do we have to give her life long budecort??
    How can I prevent side effects???
    Are there any diet restrictions???

    Thanx

    • rajrani Says:

      Dear mareaha

      Befor i answer your queries can you please let me know whether you are still in kashmir and do you attend staying there? Secondly does your child’s wheezing gets relieved with asthalin puffs or not.

      • mareah Says:

        Dear Dr Rajrani
        I have been in delhi for past 3 years . Had gone home town for just 5 days and may go back permanently after 4 or 5 years. I delivered in delhi and went to kashmir, stayed there for 6 months. She was pretty fine durng those days.Actually i am not sure if she gets relieved with asthalin. When i give her asthalin oral or mdi her wheezing worsens.
        Thanx

  5. mareah Says:

    dear dr rajrani….
    i am still waiting for your reply

    • rajrani Says:

      Dear Mareah

      sorry I did reply but somehow the mail did not reach you

      It is possible that your child does not suffer from asthma. Because 1. Your doctor never heard wheezing when he examined your child .2. Wheezing does not get relieved with asthalin.

      It is possible that wheezing that you are hearing is not wheezing but some other noise like due to nose block or stridor. She could be suffering from allergy rhinitis.

      Your child has a allergy tendency as her ige is raised, but this does not mean that she has asthma. Most children with asthma gets better with age. They do not need budecort lifelong.

      There are hardly any side effects with budecort given as inhaler. At times children can get thrush(fungal infection of tongue) you can prevent this by giving her water to drink after giving the inhalation.

      You can get more information about asthma from my book easybabycare which is available free on my site easybabycare.net.

      As you are in delhi you can visit me at my clinic in dwarka. Do make an appointment by phoning me 9911101576.

      Tc

      Sent from my iPad Raj Rani Mitra

  6. mareah Says:

    dear Dr Raj Rani

    thanx a lot. i am relieved…..

    • kusum Says:

      Dear Doctor,
      my daughter is two and half year now. She started getting cough and cold frequently when she was 1 year old. doctor gave ger DERIPHYLLIN syrup and she was better after that. but since than her cold , cough , fever become a monthly routine and my paediatrician suggested to test the total IGE serum. it was found elevated around 400 while the normal range was 19. Seeing the report my paedia suggested to keep her on budecort for two years and mont LCZ for three month. I was not in the favour of giving the medicine for so long continuously, so I stopped them in between. but the problem is, she is countinue with her monthly. Should i put her on budecort for two years or not, i am a bit confused

      • rajrani Says:

        Dear Kusum
        Frequent fever, colds and cough occurs in all the children till they are 5 years of age. The no of attacks will vary from 4 to 10 a year. The attacks cannot be prevented by budecort, however if with the attacks child has wheezing or prolonged severe cough then budecort or \and monteleukast will help.
        Whether you should give budecort continuously or intermittently depends on no of attacks the child gets. If these are almost every month then you can give budecort daily to prevent the wheezing. However if they are less frequent then you can give budecort for about a week, only when your child starts with cold and sneezing.
        For how long to give? This is very variable. If you are giving budecort continuously, in that case after about 3 months, if your child has not had any attack of wheezing then you can attempt to stop ; however if he starts wheezing again then you can restart it. Giving budecort for prolonged period has no side effects.
        As your child’s IGE is very high you should try to find out what he is allergy to and try to take precautions. Usual allergens are housedust mite, Perfumes, Furs, pets etc. Do read the chapter on asthma in my book easybabycare available for free on easybabycare.net. You will get more information on that.
        You can also contact me on my phone +91 9911101576.

  7. Abhilash Says:

    I’m really happy to find your forum easybabycare and your explanations are quite promising. I’m much relieved and eager to reach out to you.
    My son is close to 3 years and he had continuous cough last week which triggered to slight wheeze. Dr suggested to give nebulizer to relieve his cough and congestion momentarily, I did continue to nebulize him for another 3 times the same day which helped him a lot and could sleep better.
    Also Dr prescribed a syrup Ascoril LS to him. At night, he asked us to give Relent along with Ascoril LS.
    Its been 4 days I’m giving him Ascroil LS. Cough is much better, so I’m just giving only night time dose from 2 days. But I can still hear a kinda noise(very slight) when paid high attention to hear his breathe.Does this seem to be infection or due to bad weather it is affected ?
    Is Ascoril LS and Relent both are okay to use? If yes how long is it good to continue?
    And does nebulization make the child vomit? as he has been throwing couple of times when he was nebulized.
    I’m very particular on his food intake and ensure to have a constant watch on what he is eating. Avoid junk food like cold food, ice creams, chocs.
    He loves to eat all fruits and eat unlimited. Many a times as observed more of papaya, banana and Guava led to cough for him. So I prefer to give him papaya in a limited manner. Do you think these fruits are cough inducing?
    Is nebulizer addiction in anyway? if once given should we have to keep on continuing usage of it?

    Awaiting on your valuable response.

    • rajrani Says:

      Dear Abhilash

      I am glad that you like easybabycare. It gives me great satisfaction in reaching out to parents through this.

      Your question has several issues.
      When you use any medicines, it is important that you should know what are the actions and side effects of these medicines. In fact it is the duty of prescribing doctor to do so. However in busy clinics, doctors seldom do so.
      Ascoril LS Contains
      1.Levosalbutamal, this is beta agonist; this relaxes the muscles lining the air passages, thus helps in relieving the wheezing,( the sound that you hear when child is breathing)
      2. Ambroxol and guaifenesin. These 2 medicines loosen the phlegm that is present in air passages and thus it becomes easier for the patient to bring out the phlegm. Remember that no medicine can bring out the phlegm; it is only when we cough that we can bring out the phlegm, so we do not give any medicines to children to suppress the cough. We only give medicines that help in bringing out the phlegm by relaxing the air passages, and loosening the phlegm.
      So you can use these medicines as long as your child seems to have phlegm and wheezing. Once child does not have these you can stop it.
      Relent contains cetrizine.
      This is anti allergy. Although wheezing is due to allergy, but anti allergy medicines do not help. However if child has running nose along with wheezing these may help. Beside that anti allergy medicines cause slight drowsiness, so it is useful to give it to an ill child, if he cannot sleep at night due to cough. So again you can use it as long as your child needs it. Once he is ok you can stop it.
      With nebulizer 2 drugs are given, 1. Beta agonist, usually salbutamol 2. Budecort which is a steroid.
      Salbutamol helps in relaxing the muscles lining the air passages, while budecort gets rid of the inflammatory materials which block the air passages. Thus by using these it becomes easy to breath. Both of these drugs have side effects when given orally, but not when given via nebulizer.
      When a child has difficulty in breathing, one can hear a sound which we call wheezing. In that case giving salbutamol and budecort via nebulizer help. So you have to keep on using nebulizer as long as your child wheezes or has a dry cough. Once he is better you can stop this.
      Just because one has given nebulizer, does not mean that child will need nebulizer all the time. It is not addictive. For how long this need to be used depends on child’s condition. Most of the children need intermittently, whenever they have a viral infection. Very few children may need this continuously. Usually those who have a family history of asthma may need for a longer time.
      Fruits or any other food products do not cause cold, coughs or wheezing. These problems are caused by allergens in the air, like dust, especially house dust, pollens, perfumes, fur and dander from dogs and cats. You can get further information in chapter of asthma in my book on child care, at easybabycare.net.
      You can give any fruit to your child. A child should be given 2 fruits a day. If you give more he will take less of other food products and thus will not get a well balanced diet, see the chapter on diet in my book on child care, at easybabycare.net
      Lastly you mentioned that your child vomits when given nebulizer. He probably gets upset and frightened by the procedure and thus vomits. Try to relax him by talking to him softly and give nebulizer on empty stomach.
      If you have any further queries, or if you did not understand some of what have written, please let me know.
      TC

  8. Abhilash Says:

    Thanks a lot for your excellent explanation in a very detailed manner. True, it is important we parents know every bit of information about medicines to be given to our children.

    From past one week, after the cough is relieved, he has started throwing up at night all his food the moment he lie on pillow. Seems like its just flowing into mouth. Though he is been fed before 2 hrs of his bedtime. This is happening only at night time not in the noon nap(sleeps for some 3 hrs in daytime).
    Many a times I don’t feed again after spitting as I’m scared of the food coming out when he lie down. It is very difficult for a parent to see them throwing up and making them sleep on empty stomach.
    i’m really confused as to why this is happening. Would this be result of nebulization or Ascoril LS?
    Is this a kind of Food Poisoning or because of gas or some infection?
    Should I give Emeset or Domstal? Do they help in anyway?

    Please advice.

  9. durga Says:

    Hi Docrot,I have one query in speech development.My son is 3 year 3 months old and he started talking words since 10 months back including amma,daddy.Now if we count he has nearly 200 words inclding nouns.He knows albhabets,state cpaitals,logo names.But he is not forming sentences and caryying conversations.Iam really worried about this.In childhood he used to watch tv more and iam working mom.Now also he can operated electronic items with ease.How long will it take for him to talk? he wont chew the food also most of the time.I have to mash the food and he has sever hicups also.Since past few days he is chewing even dryfruits.Can chewing and oral motor things effects speech? He is very social and loves to play with kids.at that age of 2.5 years he got febrile seizures.Can you please tell me whether all these are normal?

    • rajrani Says:

      Dear bandaru

      Firstly whether the febrile seizure will effect his brain in any way depends as to how long the seizure lasted. If it was only for few minutes as most febrile seizures are it will not have any effect on his brain.

      Ability to learn to Chew and speak are not related.However care givers have to spend lot of time and effort in teaching the child to chew as well as speak.

      The time a child spends on viewing TV and using electronic items should be restricted.If every one in the family spends more time talking with the child, then he will soon learn to make sentences.

      As far as chewing is concerned, you should try giving him less mashed food. It will take time and lot of patience to teach him to chew solid food as he has got used to eating mashed foods, but he will surely learn.

  10. manpreet kaur Says:

    Can we use whole respule for 6 months baby? Plz reply fast…

    • rajrani Says:

      Dear manpreet

      Dosage of budecort respule for 6 month old baby is 0.5mg. So if the respule contains 0.5mg,you can use the whole respule, if it contains 1 mg use half respule.

      Asthalin respule contains 0.25 mg of salbutamol. you can use half. How ever if baby’s wheezing does not improve with half you can give another dose after 10 minutes.

  11. Prakash Says:

    thank you sir for detailed explanation. I sincerely appreciate all the time taken by you in answering the questions of all the worried parents,

    My daughter is 1 year old is she was admitted to hospital for 3 days due to wheezing and cough .the nebulization was with asthelin every 3 times a day , ipravent 1 mg 3 times a day BUDECORT 0.5 twice in a day for 3 days. and one week after discharge I was been told that her chest is clear now and to continue with only BUDECORT 0.5 for a month. I wanted to know if it is recommended to continue for a month,
    thanks again

    • rajrani Says:

      Dear Prakash

      Before I answer your question, can you let me know 1. Whether this was the first time your baby had this attack? 2. Is there any family history of allergy diseases like asthma, allergy rhinitis,or eczema ?

  12. pramodh Says:

    my daughter is 1yr 5 months old, she is having cough fepeatedly since last 4 months. Upon consultation of doctor, she suspected Asthama as baby’z mother has asthama during childhood and started treatment of levolin and budecort for nebulization with montair granules intake with food. My question is this the right solution? the reason is she is coughing a lot after the use of budecort instead of having relief

    • rajrani Says:

      Dear Pramodh
      Repeated colds and coughs is normal in children after 6 months of age. These are mainly viral infections. Initially usually there is fever which subsides in 3 to 4 days, however cough remains for quite some time, at times for 2 to 3 weeks. Quite often once cough subsides the child gets infection again due to some other virus and then coughs starts again, so it seems that cough is there all the time. If the cough is not troublesome, no medicine is needed.
      A child, who suffers from asthma, will have wheezing also, beside the cough. The cough is usually dry and very troublesome. There is no test by which we can diagnose asthma, however if the cough and wheezing is better with antiasthma medicine like levolin, then that is a proof that child has asthma.
      You said that your child’s cough is worse with budecort. The latter does not have immediate effect. Try to observe whether child is better with levolin or not, if so then you can continue with treatment that your doctor has prescribed, if not then you should contact your doctor again.

  13. max Says:

    HI Dr.

    Our son is now almost 10 months old,he had mild flue about 3 weeks ago, and the DR gave him antibiotics,which helped

    But now is has this cough that doesnt want to go away,especially at night when he is trying to sleep.we bought a Nebulizer with drops at the local pharmacy which is dilute with water that you you buy at the pharmacy in the small chubes

    We are nebulising him 2-3 times a day for the past week,but it seems to go better and then all of a sudden he will cough for 3 hours

    Please help

    • rajrani Says:

      Cough after a viral infection can last uptill 3 weeks. If nebulization does help then perhaps you will have to nebulize him more often, with budecort as well as with asthalin.
      You can nebulize after every 4 hours.
      If he still continues to cough then you might have to investigate to rule out other causes of cough.

  14. Gajendra Says:

    Hi, my baby is almost 7 months old and she is going through chest conjection. doctor advised for nebulization twice a day.which im doing regularly. but still the conjection is there. IS it safe to use budecort and duolin and how much ml it should be given.

    Gajendra, Mumbai

    • rajrani Says:

      Nebulization with budecort is safe.. Duolin is also safe although I prefer nebulization with asthalin rather than duolin.

      Dosage depends on the condition of child, weight of child and also exactly what preparation is being used.
      You will have to take advice of your child’s doctor for this.

      Raj rani

  15. Sarita Says:

    My 3.9yr old son having allegry dr advice allegra n asthalin inhalar whn regurired i feel he is coughing when he got sweat or inhale something from air his unpleast sound from chest releive after using asthlin all this started in march when he has typhoid following by lung infaction his coughing is continue til day i m confuse i have to use asthlin inhaler always or my child wil outgrow allegry he is very active but i have to say him take rest please guide me

    • rajrani Says:

      Dear Sarita
      It is good that your child is active. It just means that he is healthy and loves life. You can try making him rest by removing all the stimulations around him, and you may succeed occasionally.
      The fact that he gets cough and wheezing when he inhales something or gets an attack when he sweats, proves that he has allergy tendency. You can try to avoid these situations however it is again a very difficult thing to do.
      Since he gets relief with asthalin inhaler, it is ok to use it. However if he needs asthalin daily, then it is better to use budecort inhaler 0.5mg also two times a day. With this, frequency of using asthalin will reduce and eventually you may be able to stop asthalin, and later on budecort also. It may happen that once you stop inhaler therapy he may get attacks again; in that case you can start again, and then try to stop again after sometime.
      Most children grow out of this allergy tendency, but it is not possible to say at what age he will recover from this problem. Usually they get fewer attacks after 5 years of age.
      There are no side effects with inhaler therapy nor any long time problem, so you need not worry about inhaler therapy. Main thing is to see that he does not get wheezing and if he gets that he should get relief quickly.
      Allegra will help if he has running nose. It will not help the wheezing.
      Tc

  16. Sarita Says:

    Thanks a lot dr raj rani for reply my son does not need to take asthlin inhalar daily his average is two time a week some time when he cough he got relextion with relent 3.5ml but if i found wheezing then i gave asthlin inhalar mam please guide is it safe to use medicine like this as per required basis it wil effect his growth

    • rajrani Says:

      Saritha
      these medicines will not effect his growth, you need not worry about this.

      • sarita Says:

        Thanks mam for reply mam is it possible to give antiallergic medicine daliy because if I give time suddenly relent to my son he feel ok for whole dwheexingeexicounghcoungh wheezing appear mostly when he play a lot some
        In his cbc repoert esinophill count is 4.5 basophill0 is it shows he has allergy
        His father has a allergy from some food and pollution
        It is possible to have asthma in future I m worried about this

        As I told u my son using asthalin twice a week than budocort will help to stop wheezing or I continue as I was doing giving asthalin on requirement basis
        please guide me

      • rajrani Says:

        Dear Sarita

        Considering the fact that your child gets wheezing when he plays a lot and also you need to give him asthalin inhaler 2 to 3 times a week, I think you should start giving him budecort inhaler twice a day and continue this for 2 to 3 months. You can continue giving asthalin whenever he needs it. Thereafter if you find that he does not need asthalin at all, you can stop budecort but if he gets wheezing again you can restart it.
        Your child has exercise induced wheezing. This needs to be prevented as we should try not to put any restrictions on a child’s activities. You also will be less tensed when you find that he is not wheezing at all.
        His eosinophil count is slightly high, he could have allergy tendency.

        There is no way of predicting whether he will asthma in future or not. Usually if there is no family history of asthma, then children grow out of the wheezing tendency.

  17. Sarita Says:

    Dear doc thanks a lot for reply mam as i told u he need asthlin inhalar two time a week n relent can be any day if i gave him relent one time in day in morning he feel ok for whole day no coughing no wheezing can i gave him daily my question is antiallergic medicine is safe for child if use daily and can i continue using asthlin inhalar as per required basis or i start bedocort too

  18. Sarita Says:

    Can we give antiallergic medicine daily to child

  19. sarita Says:

    My son is having allergy as I told you in my previous post mam his asthlin is quite low by the time but last week he has fever then doctor found wheezing on one side after giving asthlin mam is it shows he has asthma doc ask me to consult a respiratory specialist for asthma treatment

    • rajrani Says:

      Dear Sarita
      I reviewed all your previous posts. Your son has wheezing most of the time, so he needs budecort or some other steroids as inhalers, continuously for 3 to 6 months or may be more. Just giving asthalin is not enough. It is not possible to predict as to how long he will need this therapy. As I have told you before, this therapy will not harm in any way.
      you can consult a respiratory specialist or a good, experienced pediatrician also can treat your child.

      • sarita Says:

        Mam thanks for reply dr said he has HRAD dr prescribe him beducort and 1tab montair4 the day we start giving beducort he has does not need asthlin atall not even for single time now its about month I does not find him wheezing n his cough is also reduced he play a lot also in outer area some time he cough somtime not meabs cough reduced to 90percent mam how long we need this therapy he is gain weight also does it means he has allergy only n he will be fine with time his grand father has same problem and in my childhood me too have same problem but I was ok with in year but his grand father has problem in winters only please guide me urs guidance help me a lot

      • rajrani Says:

        Dear Sarita
        Yes it seems that he has allergy problem. Quite likely he will be better when he grows up.
        Now that he is better, you can continue same therapy for 3 months and then try stopping it, but in case he gets wheezing again you can start it again. For how long he will need the therapy, it is difficult to predict. However remember that even if you have to give it for very long time, there is no harm.
        TC

      • sarita Says:

        Mam as I told u last time doc said he has Hrad but as we shifted to jaipur mam here we consult a new doc he said asthma or hrad both are same is it so n he told us to reduce bedocort 2puff in night only n montair 4tab to continue and he also added a syrup of vitamin d to increase his immunity this is right treatment or we need to fokkow somthing else n his cough reduce a lot when we shift here pkease guide me

      • rajrani Says:

        Sarita, HRAD and asthma are just names. You should not worry as what the problem is called.

        Your child has cough and wheezing which is due to allergy. Treatment for this is budecort and asthalin or livolin inhaler.
        The cough and wheezing in your child will vary from time to time depending on the environment and local climate;the treatment will depend on his condition. Main aim is that he should not be having cough and wheezing, this needs to be prevented and treated. When he is well without these medicines you can stop these and when he has problems you can start treatment again.
        Yes you can give vitamin D to increase immunity. It will also be useful to give Vitamin C.

      • sarita Says:

        Ok thanks alot u r right mam I should concentrate on my child health n treatment but mam when somebody says he has asthma I just become so worride I will keep in touch wid u thanks I hope my son will be fine soon

  20. Baishali Mukherjee Says:

    Hello Doctor,

    Today I found out this website while searching for the efficacy of saline nebulization in babies. Your suggestions are very practical and helpful.

    My baby who is 7 months old is having cough, nasal blockage and also runny nose for one week. She had upper respiratory tract infection which had to be treated with antibiotic 20 -25 days back. She had the similar kinds of symptoms for that initially. So I am really scared whether the same infection is developing again or not. On the last week check up her doctor said clear chest. Then how can I prevent or help her to get out of this cold and cough episodes? Is saline nebulisation safe or effective in this condition? Last time her cough got better with nebulization with bottled saline water. Does it have any side effect? Or can I give in this condition?

    One more observation that I notice whenever she catches cold/cough her stool color, texture and frequencies also get changed. It becomes little loose, sometime mucusy, more in quantity and also increases in times. I can not clearly make out that which comes first the diarrhea or cold.

    Please suggest

    Warm Regards

    BM

    • rajrani Says:

      Dear Baishali
      After 6 months of age, the babies do start getting viral infections repeatedly. Your baby had a viral infection 20 days ago. She recovered, as her system developed immunity against that particular virus, but after 20 days another virus attacked her. There are many viruses in the atmosphere that produce cold, cough and fever and these attack children whenever they come across them. By taking many hygienic precautions you can reduce the no. of microbes around you but you will not be able to get rid of them, so you cannot prevent these infections.
      There is no medicine that can get rid of these viruses. After 6 to 7 days child recovers from these infections by building immunity against these viruses.(the ability to do so resides in every normal individual).Your job during this time is to see that child is 1. Comfortable 2.is getting enough fluids 3.is breathing normally. If child has difficulty in breathing, then she will need nebulizer. If saline helps, that can be given, if it does not help then along with saline nebulizer with asthalin and budecort will have to be used. If child’s breathing is not relieved with these measures then she may need hospitalization.
      Nebulization with saline has no side effects. you can use it whenever your child needs it.
      The viruses that attack your child, not only attacks respiratory system but attacks the gastroentero system also, producing diarrhea. In this case also you should just take care that your child gets enough fluids.
      I am glad you like my blogs. Do read my book on childcare also. You will find this useful also. It is available for free at easybabycare.net.
      regards

      • Santosh yadav Says:

        Hello Doc my baby girl is 8 month old, she is suffering from cold and cough along with fever from last 3 days. My doc was giving her branchiodilater and ashthline for oral, but after two days the problem is as such. so please i need your suggestion.

      • rajrani Says:

        Dear santosh

        Your baby probably had a viral infection. This takes about 3 to5 days before the child gets better. At times you may have to use antibiotics especially if fever is high or child is unwell. Cough may last for 7 to 10 days.

      • sarita Says:

        Mam as I explain in my different post about my child health
        Recently he has viral infection twice in month
        First time he has fever n runnig nose
        Second time he hasfever that stay for 5days by time doc said he has throat infection too means gala khrab so he is coughing too now its about 10days he is fine but still he coughed a lot I found no wheezing no movment in his chest even doc tell us he is notwheezing mam my question is is he still having throats infection I feel when he eat orange n curd or pomegranate hecough when I give him budocort he will fine for some time sometime not

        He tell us pain in his legs also doc said viral attack on his legs he is too weak now even he cough when he runs previoully he never show this symptom

        Is it due to repeated viral infection or start wheezing
        Please guide me

      • sarita Says:

        Dear doc,
        By the you read this post my son is fine now it was viral infection. Mam as he is on 2puff morning n eve beducort. Now we r trying to stop use of beducort we are giving 2puff in evening n a tab of montair4 he is fine does not show any sign of wheezing . Please guide me how to reduce its furthure doses n finally how to stop it. How much time we need to give him 2puff in eve please guidyour guidance help me a lot

        After reading your previous post I come to know it can be cure n I never ask my child to take rest other wise few month back I alwalys ask him to not to play he is now happy n playful . His behaviour is also changed a lot. Otherwise he always annoying n crying beacuse I wont let him play

        I always feel due to lot of activity he got wheezing but you told me how to handle this

        Thanks a lot
        Doctor
        Sarita

  21. Umesh Khosla Says:

    Hello Doctor, My grand son is only 45 days young and as we are in Delhi NCR, he had cough for the last 7 to 8 days which becomes bad in the night after 7pm. Our doctor gave oral medicines to relieve cough but night is very difficult and due to cough and nose block my grand son feel difficulty and due to this doctor advise nebulization using .5ml each Budecort and Levoline mix ed with 1 ml saline 2 times a day. We tried this yesterday it was lil ok as baby was lil less uncomfortable in the night. I need advise that can we continue with this for some more time and as SOS can we increase the frequency and what must be minimum gap between nebulizations. Any known side effects and how the cough gets out.
    Thanks
    Umesh KHOSLA

    • rajrani Says:

      Dear umesh

      I am sorry i did not reply to you earlier, as i was busy.

      It is quite coommon for cough to last for 1 to 2 weaks after a viral infection of respiratory passages.

      It is ok to use nebuliser. You can use it every 4 to 6 hourly at home , more frequently in hospital. It has no side effects. You can use it as long as needed.

      The only way phlegm can be brought out is by coughing. The babies swallow this and then it comes out with stool. However if the phllegm is thick or if the passages have become narrow due to spasm, it can not come out. When we nebulise, the saline and the medicines loosen the phlegm and widens the passages so that it becomes easier for baby to bring the phllegm out.

  22. siddu halemani Says:

    how much quantity of asthalin used for 4month baby

    • rajrani Says:

      Dose of medicines for children depends on the weight of child.

      Asthalin can be given as syrup form orally or can be given as nebulizer.

      5ml of syrup of asthalin contains 2 mg. Dose is 3mg per kg.so if your babie’s wt.is 4mg.you can give 2.5 ml of asthalin syrup three times a day.
      Nebulizer solution contains 5mg in 1 ml.Dose is 0.05mg – 0.15mg per kg.So you have to use 0.1ml mixed with normal saline.

      Asthalin for nebulizer also comes as respules.this contains 0.63mg.you can use half respule for 4 month old baby.

      • dr noopur Says:

        Dear dr

        My baby is 3 month old and she had bad urti at one month of age. Since then she coughs,sneeze and frequent wheezing. I have also allergic rhinitis and asthma. Please guide me what to do as your above advice for others is quit impressive.

      • dr noopur Says:

        Dear dr

        One thing more i have pet in my house and he is shedding lots of hair this time. So please guide me as soon as possibls

      • rajrani Says:

        Dear Dr Noopur

        Glad to know that you like my blogs. Have you read my book on babycare which is available at easy baby care.in. you will find that useful.

        Before I give you advice about your baby, I will like to know

        1. When your baby had urti, was she hospitalized? Did she have any investigation done like X-ray chest and cbc.was she given treatment with nebulizer at that time.

        2. What treatment are you giving now?

        Are you breastfeeding your baby?

        4. Where do you live?

      • dr noopur Says:

        Dear Dr Rajrani

        Thanks for early response. My baby had urti when she was one month old( in may 15). Now she is three months old.

        No investions was done. On examination she was a febrile and chest was clear, only nasal congestion.

        Initially I use to give nasoclear drops only for nose block as her PEDs said that babies don’t need any treatment for urti but she started refusing feeding and had excessive cry and choking during breastfeeding so to reduce congestion I have sinarest AF drops for 5 days. Then she started feeding but very less. So I decide to give with katori and spoon but she spit every spoon of milk, so I get frustrated and tried bottle she slowly started taking that and now she is on formula feed. So it was very sad month for me that my stopped taking breast milk and started formula milk due that bad urti.

        Presently she is on saline nebulization, her PEDs also advised for budecort nebulization when she will have cough but I m not giving that bcoz of fear of habit formation. She has dry cough 10 to 15 times in 24 hour.

        I live in lucknow

      • rajrani Says:

        Dear Dr Noopur

        Since you have allergy problems in form of allergy rhinitis, it is probable that your
        Baby also has allergy. However in my opinion it is wise to get a X-ray chest and cbc done to exclude any other reason for this cough. If you find these normal then you can start giving budecort and asthalin with nebulizer 3 to 4 times a day.once your child is better you can stop it, however do not hesitate to restart again if your baby has problem again. These are not habit forming.
        If your baby has lot of sneezing then you can use cetrizine for her.
        Do write to me again to let me know how your baby is.

        If possible you should keep your dog away from your baby and yourself also.

  23. tanishqa Says:

    Hello Dr how are you, i need help , can you please tell if giving vitamine supplements like VIt C, And D witll help 5 years old child hav ebetter immuntity to fight regular cold cough and wheesing at times
    also what name of the vitamines and how much can be given and for how long
    the child has stop start cough sounds like wet and dry confused

    please reply thank you

    • rajrani Says:

      Dear Tanishqa

      If your child is getting well balanced diet(look up easybabycare.net and read the chapter on diet in my book easybabycare), he will getting all the vitamins that is required for a normal immunity, in that case giving extra vitamins are not required. If your child is fussy eater you can give any multivitamin preparation that is available.

      The fact that the is got cough again does not mean that he has less immunity. It just means he has got in contact with someone who had viral infection. Treat him in the usual way, he should recover.

      • tanishqa Says:

        Thank you but he has wheezing on and off and cough just dont seem to leave him dry or wet, throat irritation like he is clearing it all the time, wet cough turns in dry and dry in wet and last wheezing, poor child dont eat ice cream pizzza nothing, normal food fish rice, dal/ curry, veg, pulses, yes he is fussy feel full soon
        now on inhaler i jsut dont know what to do, though no family history, and he gts this allergy cough, childhood asthma
        some say vit d, vit b will help but dr says no need , only as his iron was less giving vitoflo 5ml syrup , satrted now 15days back, is it ok if capsuoes given as teeth become black yello with this syrup
        wt also not good
        get cramps and leg hand pain complain
        wish things get better soon,
        thank you

    • dr noopur Says:

      Hello Dr Rajrani

      Its dr noopur again. Now my baby is free from ciugh and wheezes after nebulization with budesol. Sneezing 10 to15 times a day is still there. Thanks a lot for your advice.

      One thing more doc my baby 3 and half month old weighted 5.2 kg with birth weight of 2.7 kg is on top feed but she takes only 30 to 40 ml milk at one feed every 2 to 3 hour. Total intake in 24 hr is between 500 to 600 ml. She had not gain weight for last 2 weeks. Her Peds says she may have cows milk allergy as she has allergic genes so adviced soy based formula. So i want to know what is your opinion and what is pros and cons of soy based formula.

      • rajrani Says:

        1.which milk are giving to your baby?
        2. Does she have vomiting, or loose motions, or any rashes?

      • dr noopur Says:

        Lactogen 1

        She has no vomiting, diarrhea, and rashes. Only thing she doesn’t want to drink milk. Only takes 30 to 40 ml after that pushes bottle away.
        During sleep she takes 70ml at one time not more then this amount. So it is very distressing as she is not gaining weight also.

  24. rajrani Says:

    Dear Dr Noopur

    The amount of miilk that your baby is taking in 24 hours is adequate for her. Perhaps you are trying to give her a feed when she is not hungry. At this age you should try to keep a gap of 3 to 4 hours between two feeds.

    Her weight 5.2 kg at 3and a half month is right.

    You said that she did not gain weight in last two weeks. Are you sure about that? Did you weigh in the same weighing scale. A baby should be weighed without any clothes. In two weeks she should have gained about 200gms.as the baby grows the rate of weight gain slows down.

    Soya milk is not harmful but one should have good reason for changing. I usually change to this if baby keeps on having dirrhoea and vomiting.

    • dr noopur Says:

      Dear Dr Rajrani

      She become hungry after 2 hrs sometime start sucking her hands even crying after 1 hr
      Don’t know why she behave like this. It’s very difficult to feed her.
      Yes I have weighted her on same weighing machine. How I can change her feeding pattern? Rest things are fine with her expect her feeding and not gaining weight in last two week.

      • rajrani Says:

        When your baby sucks her thumb,or cries it does not mean that your baby is hungry. Babies’ needs to suck something most of the time,either thumb or poacifier. There is no harm in this, you should let your baby suck. Crying could be for many reasons. Try talking to her as much as possible.as I said try to keep a gap of 3 to 4 between two feeds. Do not wake up your baby for feed when your baby is sleeping.

        Do weigh your baby after 2 weeks and then decide about changing milk, although I doubt if your baby will like soya milk as this not tasty. In two weeks your baby should gain around 300gms.

  25. rajrani Says:

    TABLE 1
    AGE Approx. weight gain / day Approx. weight gain / month
    0-3 months 30 gms 900 gms
    3-6 months 20 gms 600 gms
    6-9 months 15 gms 390 gms
    9-12 months 12 gms 360 gms
    1-3 year 8 gms 240 gms

  26. jawwad Says:

    I like it give me more suggestion as I have 1.3 yr old son who get frequent chest congestion and he stopped eating his weight falls soon

    • rajrani Says:

      I hope you have read the blogs that I have written regarding this problem and also my book easybabycare.net.if there is any thing specific you want to know please let me know.if you live in Delhi you can come to me for consultation.

  27. Vineeta bhatia Says:

    My son is 7 years old he has been given levolin respiules through nebuliser and montair ls junior but he still has cough . I am concerned whether giving these medicines safe for his health and will his wheezing problem be cured permanently with this . And what are the possible side effects of levolin respiules

    • rajrani Says:

      Livolin with nebulizer and montair do not have side effects and they are safe for his health. However if he is still wheezing then you will have to add budecort given via nebulizer or inhalation with this.

      Whether your child will be permanently cured or not depends on lot of factors.

      Do read my book easybabycare available at easybabycare.net. If you read the chapter on asthma you will find answers to these concerns. Do write to me again if you have any further queries.
      Regards

  28. Prashanth S K Says:

    Dear Dr. My son who is 4.5 years old, caught wheezing 2 weeks back. He was recommended for seraflo for 3 months along with asthalin for 2 weeks. Since his coughing did not stopped , we went to pedio pulmonologist . He just changed the canister from seraflo to budate100 for 3 months. We very worried about giving steroids. Is there any way out of wheezing. Any ways to treat cause rather symptom?

    • cause of wheezing is allergy to house dust mite, environment pollution.pollens,etc. Do try to control contact with these as much as possible. I have given some guidelines in my book easybabycare available at easybabycare.net.
      However you will realise that it is not possible to be completely control these.
      Giving steroids by inhaler has no side effects even if you use it for many years.So do a not hesitate to use these if you find that your child is better while using these.
      After using for three months you can stop the inhalers, however if wheezing comes back do not hesitate to use again. Your child should not suffer with wheezing as this will restrict his activities and also hamper his growth.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: