Hi: It is now morning here thus the delay in responding, I apologize if you were looking out for my response earlier. I think that you are really justified in feeling nervous about the medicines being used in your baby. To be honest this is not what I would use in this situation. Please remember that this chat is for informational purposes only and not meant to be any type of diagnostic consultation. I will try to give you as much info as you feel you need about this even though we may need to go back and forth with time zone differences. So the first thought is what is making him cough. Then the second is if his medicine regimen is appropriate for this. I can give you some pointers on how I would decide between different causes and what I would choose medicine wise. I understand you are in Curacao and that pragmatical pediatricians may choose different options there. You may want to consider looking for a children's hospital or a pediatric pulmonary specialist at this point to get another opinion beyond what the local doctors have offered you. You may have to travel a bit but as long as it is not a huge expense it may be worth it! I am going to enter this so as not to loose my response and will continue.

If he is getting better/worse with periods of no cough in between then it is highly possible he has had multiple viral infections with cough that have made him sick. This is sometimes tough to tell as they can seem almost to overlap as if he is always sick. The key to knowing here is that the symptoms get worse/better over time. I tell parents are there days when you know and say thank goodness he is finally better!! A few nights of good sleep for all and then again the symptoms worsen. Have they used any antibiotics at all? I suspect so as this is what most would start with. There is no test for asthma at his age. What you would notice is a wheezing high pitched sound when he breathes out, which could be the peeping you are referring to. Can you hear this without the stethoscope? There are other reasons for having a high pitched sound when breathing out but they are more rare than asthma. In addition there are other reasons to have a high pitched sound at other points in the breathing cycle which include problems with the upper airway or as far down as the voice box. When does he have it? Is is made worse by being active, eating? Asthma type wheezing is made worse by colds in babies his age almost invariably but also can happen at night when well, or when exercising (crawling)...However it would go away temporarily with the proper dosing through a mask/spacer or neb device of ventolin or salbutamol. It may be accompanied by increased work of breathing and you noting him using accessory muscles to help him take a bigger breath (ribs sucking in, nose flaring, collarbone sucking in), and you may be worried about his breathing during these episodes. At his age generally you will have had at least one of these episodes during a cough/cold by now if the process is asthmatic.


The fact that the cough is accompanied with runny nose and otherwise no fever makes me feel that it may be overlapping colds/viral infections. Are there other symptoms like diarrhea, poor appetite, poor sleep, etc... that happen at the same time and then get better? There are many rare reasons for having chronic cough and chronic mucus like cystic fibrosis but these babies are really sick and grow poorly. How is your baby's growth?

Again I will enter this and continue.

Hi Margareth sounds like I need to go to Curacao instead! After this post and finding out he is in daycare it is highly likely he has recurrent viruses. Kids in daycare can have even more of the 10-12 normal colds a year allowed for a healthy child. If his symptoms go away in between this is likely the cause. There is nothing other than increased resistance to virus that comes with experiencing the infections that will protect him, as well as good hand hygeine and plenty of sleep and good nutrition. For colds there is NO treatment that is recommended other than trying to keep him comfortable (with ibuprofen or tylenol, lots of love, fluids and rest). We do not recommend mucolytic syrups for cough or runny nose associated with a cold in the US. If he wheezes with each cold (the peeping sound) he has reactive airways disease or early asthma even though they have not said it this way. There is nothing else that causes temporary wheezing with viral infections in a young child really. The treatment for this is Ventolin with colds 2 puffs every 4-6 hours around the clock with a mask spacer device or a neb machine until his cough clears (usually about a week to 2). If his cough gets worse and he has much difficulty breathing oral steroids for a short course may be indicated. If he frequently gets very sick with breathing and is using the the inhaler most days rather than not than an inhaler with steroid is indicated. If he has cough with exercise, laughing, strong odors, crying, and when he is not sick at night these are symptoms of more persistant asthma and again need an inhaled corticosteroid daily. I would not use Combivent in a child such as your son with apparent mild disease but only the ventolin component (salbutamol). Being born at 34 weeks shouldn't cause him too many problems now unless he had lung disease and spent some time on oxygen (rare at 34 weeks gestation but can happen to a few babies) Te deseo todo lo mejor! Feel free to ask me any direct questions in the future and respond to this feed on this one if you need to.