Expert: Dr Kondekar Santosh Venketraman Pediatrician MD, Mumbai India, Online Pediatrician - 12/21/2006

Question
Hello Dr. I have a 7 month old and has a mucus cough. H e has been on pulmicort for 2 weeks with no change. He got this cough 9 weeks ago during a cold. He was breastfed until 2 weeks ago with some formula. He is on previcid 30ml. He is happy to starve he does not fuss for food. I have to be persistant with feeding to get him to take any . He is currently eating 12 oz a day and weighs 19lbs He has not gained any weight in two weeks. My questions are
1. could this be a viral or bacterial lung infection
2.Is pulmicort nessasary
3.could it be cystic fibrosis
4. How long can you stay on previcid
Thank you
Thank you  

Answer
have a 7 month old and has a mucus cough.
========= almost always mucus with cough at this age is a problem in nose or throat than asthma.



H e has been on pulmicort for 2 weeks with no change.
-======== i feel unless theer was a wheeze, it wont be wise to start with pulmicort at this age, as it may not effect. its difficult to call this as hyperreactive airway disease only on grounds that he has cough.
http://drpeds.blogspot.com/2006/11/pediatric-asthma-and-wheezing-in.html



He got this cough 9 weeks ago during a cold.
=========== cough following a cold is usually a upper airway disease mostly viral infection, as long as child is otherwise stable.

He was breastfed until 2 weeks ago with some formula.
=========== weaning or complementary feeding should be started from 4-6 mmonth age. read more ......
http://drpeds.blogspot.com/2006_06_22_drpeds_archive.html





He is on previcid 30ml.
========== why was that started? was he vomitting repeatedly ? was any test done for  GERD? neednot be a must.


py to starve he does not fuss for food. prsistant with feeding to get him to take any .
========== they need more frequent but small quantity feeds, as we prefer less frequent, at the end they take less intake. he will ask for sure once he is extreemely hungry when he may take a very large feed.

He is currently eating 12 oz a day and weighs 19lbs
======== sems normal for age.

He has not gained any weight in two weeks.
========== neednot gain weight every month by this age.



1. could this be a viral or bacterial lung infection
========== more likely a sequale of viral infection and cough usually lasts 3 weeks but then settles in significant number, and if persists will respond to some sedation or antihistaminics, as long as nose appears blocked with noisy sound and secretions.

2.Is pulmicort nessasary
========== i feel not! unless you provide clinical details on what ground it was started.


3.could it be cystic fibrosis
====== i doubt! unless the episode recurs and shows some X ray changes too. but its harmless to get the test done if anybody ever doubted.


4. How long can you stay on previcid
usually once started it wont be required by the time child is able to walk. but if there was no reason to start, it can be stopped without reason.