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Almost 5 month old has been sick with nasal congestion for…

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Almost 5 month old has...
Almost 5 month old has been sick with nasal congestion for over a month. Been to pediatrician 3x and just finishing today a 10 day course of antibiotics. They wanted to give him super high dose of amoxicillin but pharmacist thought 4ml 2x daily was too much for his weight and we have given him 2.5 ml 2x day instead. Not sure if that made antibiotics less effective?Not getting any better. Pediatric***** *****stened to lungs and they are clear several times. We have him sleep upright. He has a humidifier. We put saline drops in nose numerous times a day. We suction tooNo fever and generally pleasant mood.Does get yo coughing so much it triggers gag reflex and he vomits. Usually 1x per night.At a loss on so is pediatrician. Would albuterol help? We have nebulizer due to other children. Please help.
Submitted: 4 months ago.Category: Pediatrics
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Answered in 6 minutes by:
12/2/2017
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Doctor John MD
Doctor John MD, Doctor (non-pediatrics specialty)
Category: Pediatrics
Satisfied Customers: 790
Experience: Medical Physician
Verified

Hello and welcome to JustAnswer.com

This is Dr. John and I will be helping you today.

I will be reviewing your question and will respond shortly.

I may need to ask a few more questions in order to best serve you.

Thank you for your patience.

Answers here are for education and information only.

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

was he born full-term?
has he had any fevers with the congestion?
any cough or other symptoms?
is he up to date on his immunizations (already had his 2 and 4 month shots)?
any sick contacts at home?

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Customer reply replied 4 months ago
Full term. A little late actually.No fever at all.Cough because of congestion it appears.He was scheduled to get hib but hasn’t yet because of illness and antibiotics. Had all the others.Has 3 sisters that has illness. 2 had bronchitis. 1 had sinus and ear infection. I had bronchitis too.
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

did they do a chest xray or any other tests on him?

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Customer reply replied 4 months ago
Two sisters better after 6+ weeks. One almost better. I still have a little cough after 5 weeks. All of us had antibiotics.
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

this sounds more likely viral rather than bacterial if no fever and chest involvement.

is he feeding normally?

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Customer reply replied 4 months ago
Mostly normal feeds. A little lessNo other tests
Customer reply replied 4 months ago
He is breastfed.Anything we can do?
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

would continue the bulb suction and saline drops.
a humidifier can also help.

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

its good that he is breast fed since that will boost his immune system.

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

it also sounds that he most likely picked up two (or more) different viral infections and thus the longer length of time for his symptoms. This longer time period happens with some infants where they get a second viral infection right after the first.

As long as no fever, difficulty breathing and he is feeding normally, then really its managing the symptoms

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

does that help answer your question?

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Customer reply replied 4 months ago
No albuterol or saline water in nebulizer?
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

if the lungs are clear, then most likely no benefit from albuterol or saline and would recommend holding off on these treatments unless his pediatrician has recommended that you do these treatments for him.

The issue is that at 5 months, its difficult to make sure that he is inhaling enough of the albuterol or saline to make a difference.

One tip is to run the shower so the bathroom steams up and then sit with him in the bathroom (not under the shower) for 10 minutes as he breathes in the humidified air.

Does that make sense?

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Customer reply replied 4 months ago
A final question. When is being sick too long since we are already over 1 month and who else would we turn to for help...ENT?Thank you for your time.
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

I would see your primary care doctor first. They are well qualified to handle most of those conditions. If they feel that you need to see the ENT, then they can refer you.

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

I would like to thank you for your question and I hope you found my answer informative and helpful.

Please remember to leave a rating by clicking the series of 5 stars at the top of the screen.

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- Dr John.

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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

its not unusual for infants to have several back-to-back infections like this, especially when others in the house are also sick. The good news is that as his immune system develops and is better able to handle exposure to all these cold viruses, the number of infections should drop

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Customer reply replied 4 months ago
I am sorry to be a bother but I have 1 more question
Customer reply replied 4 months ago
My wife and I got freaked out by his breathing pattern and gave him a nebulizer albuterol treatment of 2.5mg/3ml
Customer reply replied 4 months ago
It was not with a mask but a tube we waved in front of his face. Should we take him to Er since his weight was 8.3kg so not quite the 20kv for that dosage.
Customer reply replied 4 months ago
Wife is freaking out now we harmed him. He is not acting any different
Customer reply replied 4 months ago
Hello?
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Sorry. Was away from the computer
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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
How is his breathing right now?
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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
If no change, and acting ok, then would be appropriate to watch him for right now
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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Would be tough for him to inhale much of it thru “blow-by” versus having the nebulizer tube in his mouth.
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Customer reply replied 4 months ago
Respiratory rate ranges from 48-60 pre and post
Customer reply replied 4 months ago
is that ok or is that a sign of distress? Been that level for a couple weeks.
Customer reply replied 4 months ago
He still is smiling laughing etc
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Does his stomach seem to go in and out as he breathes or does he seem comfortable?
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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Smiling is a good sign, but it you or your wife are concerned, you can take him to a local urgent care, which may be quicker visit than the ER
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Customer reply replied 4 months ago
In and out
Customer reply replied 4 months ago
You swear you feel it rattle inside and you can see sides of abdomen go in and out with breathing
Customer reply replied 4 months ago
3x pediatrician has listened in last 3 weeks and says the lungs are cleanlr
Customer reply replied 4 months ago
Clear. We have told them about breathing rate and physical way he does it too
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Ok. And no change since the last visit?
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Customer reply replied 4 months ago
No different than last visit 6 days ago.
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
Ok, then would be appropriate to continue to watch at home. Use the bulb suction and nasal saline drops to relieve his nasal congestion.If fever or difficulty breathing, then would take him in for evaluation.Does that make sense?
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Customer reply replied 4 months ago
We suction numerous times and never get anything but a wee bit of clear liquid out. He sounds so congested and we Feel mentally and physically like the rumble is in his back and chest but each time the pediatrician gives his lungs a clean bill of health. He just sounds so garbled all the time I struggle to believe that it is all sinus related because I can get nothing out suctioning.
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
I can understand how it’s frustrating. But good news is that it sounds like it’s all upper airway (nasal) and not pneumonia. Saline drops and steam will eventually help
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Customer reply replied 4 months ago
Does upper airway cause gurgling sounds? Or make the back feel as if you can feel the gurgling?
Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago
The upper airway causes transmission of the sounds throughout the chest because of his small size. But we can tell the difference when we listen to the chest with a stethoscope
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Pediatrician: Doctor John MD, Doctor (non-pediatrics specialty) replied 4 months ago

just wanted to follow up and see how your son is doing

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