Giving budecort and livolin as inhalers

Question from a father
Hi my baby is 6 month old she got cold,ccough and fever,after using Ascoril,mantra,Colpal she is ok,again after 2days she got fever and her voice was blocked due to coughf so we went to doctor he gave levolin respules 0.63mg for 18 days and budecort respules 0.5mg for 2months.can u plz tell me whether these medicines can be used or not and any side affects and how they work and I want to know why only these medicines are used is their any other solution to get rid of these medicines and by using these medicines will be addicted to the baby’s body and how long these medicines will be continued plz give me reply.

One more question my son he is 6years old he got allergy in lungs so doctor gave same medicines  in form of inhalers and montair LCD kid n budecort for 2months means till the season changes.but by using these medicines he is doing ok sometimes and after few days the same thing is repeating ,in his case can u say any other solution to this problem


Your children suffer from wheezing bronchitis\ mild asthma\ allergy.
Believe me, that we are fortunate that we can give medicines via inhalation instead of orally or by injections.
Children used to suffer from these diseases previously also. When l was an intern in 1967, we used to admit many babies in hospital for giving these same medicines by Intravenous drip, as inhalation therapy was not discovered. Giving these medicines by injections or orally have many side effects, so we used to give these only for 5 to 6 days, After that they would be better but not normal. The result is they could not play or lead a normal life.
Now days more children suffer from these diseases, but as I said, some children previously also used to suffer.
Giving budecort (steroids) and livolin(anti spasm), by inhalation is the best way of giving these medicines.The medicines go directly to lungs where they are needed. If you give them orally they go to stomach, then to blood and then to all the organs in the body and then to lungs, that is why they have so many side effects.
By giving them as inhalers these have no side effects as the medicines go to lungs and no where else.This therapy is not habit forming. Your children will need them as long as they suffer from these problems. Once they are better they will not need them.
You will find more information about this in my book in chapter Asthma,at
Do write to me if you have any further queries.


Roseola infantum (Exanthema subitum or sixth disease)

Easy Baby Care

Within last few days I have seen quite a few babies with this disease. The reason I am writing about this is because the rash which occurs in this disease resemble measles (khasra, gobri, haam, asba) so that many parents, especially grandparents mistake this for measles and naturally get worried. Fortunately now days measles do not occur in babies who are vaccinated. However this mild febrile illness with rash is very common.

Roseola infantum typically occurs in babies aged 6 months to 3 years of age .Initially they have fever which can range from 38c to 40 c. Baby also has running nose and mild redness of eyes and at times loose motions. In spite of high temperature baby is well except for slight irritation. On 4th or 5th day the fever subsides and rashes appear. Rash is rose colored and discreet. It appears on trunk and then spreads to face…

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TV watching by children

Most parents do realise that watching too much TV is harmful for their children but how much is too much?

AAP(American Academy of Pediatrics) have given some guidelines lines about screening time for children.


Guide lines given by AAP.
For children aged 18 months and under, no screen time apart from video-chatting.
For parents who choose to introduce screen time to their 18–24-month-olds, the AAP recommends choosing high-quality content and apps, and watching the content with their children.
For children aged 2–5 years, high-quality screen time should be limited to 1 hour per day.
Older children should have “consistent limits” on their screen time, with special attention to ensuring they get adequate physical activity (1 hour/day) and sleep (8–12 hours/night for school-aged children).

Repeated colds and coughs.

Dear Doctor
My daughter is 12 years old. She is suffering from cold and cough. Should I give her budecort or levolin?
Dear Priti

Repeated colds and coughs are usually viral or sometimes bacterial infections. Budecort or livolin are needed if child has wheezing with these infections. These two medicines will neither cure nor prevent colds and coughs.
All the children suffer from repeated colds and coughs.Some more others less.
There are few precautions you can take to try to reduce the no of these attacks.
1. See that you child gets well balanced diet, including fruits containing vitamin C.
2. Child should get plenty of rest.
3. Child also should get enough exercise.
4. As far as possible, see that your child avoids coming in contact with someone who has colds and coughs.
Do look up the book easybabycare available at and read the chapter on diet. You will get an idea as to what sort of diet should be given to child.
Let me know if you have any further queries.

B-HAEMOLYTIC streptococcal

Taiyab Ali Saifee Says:

Thanx DR Rajrani for the information regarding tonsillitis….I would like to know if B-Haemolytic Streptococci is detected in throat swab than what should be the mode of treatment.

  • A good question, Taiyab.
    If B-Haemolytic streptococci is detected, then one should give antibiotic, preferably amoxylin, for 10 days. This is necessary not only to cure the child of tonsillitis , but also to prevent rheumatic heart disease.


Query by a parent

My child is 6 year old. suffering from tonsillitis .due to this he getst sick once in a month. Doctor gives antibiotics and he gets well in 6 to 7days. Madam I want to know whether these antibiotics are  good for health or not some people tells me that  these lower the immunity. Is there any better medicine for tonsillitis.   



Tonsillitis,that is infection of tonsils, can be due to virus or bacteria.It is not always possible to distinguish between the two. At times one needs to do throat swab test for diagnosis. If it’s viral, no medicine is required except medicine to reduce fever, however if it is due to bacterial infection antibiotics are must.
I will advice you to get a throat swab done next time your child gets tonsillitis, and if it grows streptococcal bacteria then give antibiotics, otherwise no need for antibiotics.
Antibiotics will not harm your child in any way, however it should be given only if it is necessary.if throat swab grows streptococcal, antibiotics are must.

Side effects of giving steroids (budecort)by inhalation

Wheezing among children is very common nowadays. Medication via inhalation is the best treatnent for this.

Two types of medication is given.

  1. Beta agonist bronchodilator ( asthalin or livolin) .
  2. Corticoid steroids ( budecort) .

The former gives immediate releif and latter prevents wheezing.

Most parents are worried about the side effects of these medicines especially steroids.

When we give the medicines via inhalation, the medicines is delivered directly to lung passages and lungs, where these are needed. Very small amoun ofthese are absorbed in to blood. Thus these medicines do not have any side effects. A number of studies have been done and the results are that steroids even if given for a prolonged time via inhalation, do not cause any side effects.


Side effects of giving steroids like budecort via inhalation for a long-time.

Letter from a mother

Dear doctor
I have a boy who is 1 year and 4 months old. He weighs 13.4 kgs and his height is 80cm.He’s an asthematic and have bin on budecort 0.5mg twice daily since he was 6 months old. He breaths heavy and suffers from frequent cold and cough. Also I have bin giving him montair4m since almost 6 months now with a gap of a month in between, as prescribed by his pediatric. There were times when he fell so ill that my pediatric had to put him on oral steroid omnicortal and told me to nebulize him every four hourly with asthalin. However currently he has prescribed my baby asthalin on sos basis.I just had a few questions. Request you to please help.
1) i wanted to know if the prolonged use of these medicines have any side effects or not. As I vaguely got to know from someone that prolonged use of budecort effect a child’s mental health.
2)Also I wanted to know if it is due to budecort that my child weighs what he does because otherwise he doesn’t eat much. Feeding his meals to him is traumatic as he simply doesn’t open his mouth even of I have a gap of 4 hours in between his meals. 3) what king of food should I include in his meals that’ll help him improve his condition.
4) will this state of asthama slowly go away with time and he’ll return to normalcy.
My husband was an athematic too in childhood but no more. Though he’s highly allergic and suffers from a constant cold.


Many children suffer from this problem nowadays. Most of these children do not have this problem after about 4 to 5 years of age.

Lot of research has been done about steroids like budecort given with nebulizer or inhaling via other methods, continuously, for a long time time. There are no certainly does not effect mental health.

Yes your child is overweight. It is not due to medicines, because if it was due to medicine, your child will have increased appetite, but you said that he does not have appetite.

You should feed your child only four times in 24 between he should have two glassses of milk., If he is breast feeding , you should try to stop that now. If he does not want to eat do not force feed him.
He should have well-balanced diet. Do look up my book on childcare at is a chapter on diet for read that. You will get an idea how to feed him.

As I said before most of these children do not have this problem when they grow up

Repeated colds and coughs

Question from a mother

My son (now 3.4 years)had ear infection this year Jan . Before tat he is prone to cold and we uaed to give allegra for 3 days; he was fine. From February

he used to get cold and infection once in a month. In april we went to ENT and she gave refil antibiotic and omni cortol steroid. The ear infection is gone.she suggested to use septilin for 3 months. She also asked us to use allegra and montair to prevent further cold which might lead to ear infection. From July 24 onwards he has been getting coldevery 2 weeks. We ended up giving allegra for 15 days in a month. Our regular pediatrician has asked us to use avamys steroid spray for 3 it safe to use formy son

In reply to motherYes all these medicines that your doctor prescribed are safe. However they will only help if the reason for repeated colds and coughs is allergy. Mostly these colds and coughs are due to repeated viral infections which a toddler gets when he/she starts going to play school.

To prevent these infections his immunity has to be increased,
1. Do not send your child to school when he is not well.
2. Give him well balanced diet.Dolook up the book easybabycare, chapter on diet.the book is available at free.

Prevention of infection of stomach and intestines

Now in India weather is very hot and with that comes  the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

Prevention in infant

Breast feeding is natural protection for most of the diseases especially diarrhea. World Health Organization recommends that babies should be exclusive breast fed until 6 months of age.

Those who are not breast fed should be fed with breast milk substitute that is infant formula milk. It is important that certain precautions should be taken in preparing the feeds when formula milk is used. The bottles and nipples should be sterilized in a commercial sterilizer (follow the manufacturer’s instruction) or boiled in a pan. The water that is used for preparing the feeds should be boiled even if you are using bottled water. After boiling the water it should be cooled for less than 30 minutes (to not less than 70c) and then should be mixed with measured amount of powder. The reason is that the milk powder may not be sterile, however when it is mixed in hot water the germs in it will be killed. The prepared feed should be cooled down quickly in running cold water or in a pan of cold water. If not consumed within 2 hours it should be thrown away. The prepared formula feeds can be refrigerated for 24 hours. After taking out from refrigerator it can be warmed in a bowl of hot water and then used.

Babies can get germs from the hands of those who touch them; so those who handle them should wash their hands with soap and water or use hand sanitizer before touching them.

Prevention in older children

Using Safe water is most important to prevent diarrheal diseases. Bottled water is usually safe but be sure to check the seal that it is not tampered with. If one is not sure about the water supply then it should be boiled. If boiling is not possible then micropore filtering or disinfecting agents like iodine tablets should be used especially while one is travelling outside the country. Bottled or properly packed beverages are usually safe; again the seals should be checked.

When one is eating in restaurants and is not sure whether proper food hygiene precautions are taken in that place, then be sure that the food you eat is well cooked and steaming hot. The food items that are not cooked like salads should be avoided.

One can get diarrhea from home made food also if one does not take certain precautions. While buying food from stores check the “use before date”. The frozen food should be brought home within one hour of buying and should be placed in the refrigerator immediately. Food once thawed should not be frozen again. Raw food and ready to eat items should be kept separately. Food especially poultry, meat, and fish should be cooked thoroughly. No part of it should remain pink. Uncooked eggs should not be eaten unless they are pasteurized. Cooked food if not consumed immediately should be cooled quickly(within 1 to 2 hours) and kept in the refrigerator. Do not keep hot food in the refrigerator, as with this the temperature in the refrigerator will rise and thus bacteria will grow in the other food items. Cooked food can be kept in refrigerator for 2 days. In the freezer as long as it remains frozen, but the texture and taste will change with prolong storing. Food once taken out of the refrigerator and warmed or kept out for a length of time should not be kept back in the refrigerator.

In the kitchen the sinks, work tops and utensils should be cleaned thoroughly. Dish clothes should be washed in hot water frequently or disposables ones should be used. Hands should be washed after touching uncooked food. The knife and chopping board which is used for cutting uncooked food should be thoroughly washed. It is better to use separate knife and chopping board for cutting salads and fruits. If you are taking the cooked food to be eaten outside home then it should be transferred in a cool bag with ice trays. Lastly hand washing is must before eating. Taking above measures will keep the germs away from you and your loved ones to a great extend. 