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Pediatrics/4 year old cough, for one year

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Question
Hi there!
My 4 year old son has a chronic dry, extremely loud cough. He probably coughs once every 10-15 minutes while awake, and again, it has been a YEAR of this.
He does not cough at night.  
He does not wheeze.  
It is slightly more frequent on exertion in gymnastics class.
He appears to have a substernal retraction (I'm a nurse, though not a pedi nurse).  His chest, to me, is looking a little barrel shaped compared to a year ago, but perhaps this is my imagination.

He has tried for months zyrtec, Claritin, nasonex nasal spray, veramyst nasal spray and has just started singulair this week.  I am so frustrated; he is frustrated and embarrassed and tired of coughing through movies.

What should be my next step in advocating for a solution for my poor coughing kiddo?  His pedi and ear nose & throat MDs have not done chest xrays or pulmonary function testing, nor are they thinking asthma (I am not sure why?  no nocturnal cough, is that why?)

I feel really helpless.  Having a cough in school may be miserable and distracting for him.

Answer
You have not mentioned his weight and height and investigations. Is there  family history of cystic fibrosis? You should also get him checked by an ENT surgeon. As you are a nurse it is quite likely you are imagining some things. Only examination by a pediatrician can clarify this. You should rule out eosinophilia and tuberculosis if it is  reported in your area. If all these are ruled out you can try giving one teaspoonful of honey in the morning for about a  week.  

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Dr. Arun Kumar Suri

Expertise

I can answer questions in the field of general pediatrics-questions regarding the development of children, immunization, feeding, weaning and common childhood problems like fever, cough and recurrent illness. Many of these topics are dealt with on my website Healthy Family Happy Family. Often a mother imagines that her child is sick when in fact there is no problem. Such a mother needs explanation and reassurance. I will not be able to answer specific questions regarding diagnosis.

Experience

I have more than 20 years of experience as a Pediatrician. I have been involved in the care of premature babies and also many critically ill children.

Organizations
I am attached to a Mission hospital in a small town in the Kannur dist. of Kerala in India. I also have my private clinic in a nearby place.

Publications
Most of my articles are on my website Healthy Family Happy Family. I have also contributed articles to Ezine Articles and Article City. I believe that Pediatrics is more than treating diseases in children. I advocate holistic approach to child health and problems of children giving equal importance to physical, psychological and spiritual health of children.

Education/Credentials
M.B.B.S. D.C.H. I have completed a distant course in adolescent health conducted by IMA AKN SINHA INSTITUTE. I have also completed an online course on Ayurvedic care of children conducted by Jiva Institute.

Awards and Honors
My website has been recognized by HONcode for trustworthy information on health. It has also been listed by familyfriendlysites.com/, healthdirectorymoz.com/Child-Health/ and medindia.net.

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