Hi, I have a 3year old who got flu in November, cleared up fine but coincidence or not seemed to be extremely stuffy after making throat clearing noises during the day, and an occasional cough at nigh, almost like choking and wet. We put a humidifier in room since our humidity was22%. We also started to use nasal saline solution 2-3 times a day.  Dr. Thought it was some rhinitis. Things are much better, however on occasion, maybe 1-2 times a week she will give a single cough 1-2 times during night, not a coughing spell, just a single dry cough. Myquestion is what is typical of asthma cough at night. She runs fine during day. No cough, no wheeze, nothing.

Hi Tom,

Good move on the humidifier! If it is a cool mist type, it is VERY important to clean it thoroughly on a regular basis, since, due to the moisture, mold can develop in the unit, and when the unit is operating, the mod can be dispersed in the room. Mold is a major trigger of attacks. Generally less of a problem with ultrasonic and steam units.

Regarding the night time cough, are you familiar with the body's cycle of steroid production (the steroids that reduce inflammation, not hormonal)? I'll assume not.  Early morning, cortisol (the natural anti-inflammatory chemical) begins to rise, and it peaks early mid-day. So, whether one has asthma, arthritis, or other tissue inflammation problems, they are less of an issue at this point. As you indicated, your daughter is doing well during the day. Around midnight, the body significantly drops production of cortisol, and usually after 3am, inflammation increases, and subsequently, if bad enough, will result in coughing and/or wheezing. A single cough, here and there I would not worry about. If she enters a coughing attack that wakes her, that is significant, and an indicator that her asthma control has diminished. If your doctor has instructed you so, go ahead and give an albuterol nebulizer treatment, which should resolve the episode. If it occurs again during that week, follow up with your doctor to investigate what has changed causing a decrease in her control.

I have two websites I recommend for patient and parental education:

1)The American Academy of Allergy, Asthma Na d Immunology:


2)Allergy and Asthma Network: Mothers of Asthmatics

They have outstanding resources that are constantly changing to help you address issues that occur every day: in the home, at school, at work and outdoors.

You sound like a great dad who is being proactive in improving your daughters well-being! IF you have further questions, don't hesitate to get back to me.




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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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