November 26, 2010,
E.A. asks from Pittsburgh, PA on November 25, 2010
Coughing, Congestion & Throwing Up... Oh My! Please Help!
I really need some help - and I apologize in advance that this will probably be pretty lengthy.
My son (Christopher) just turned 1 last week. For about the past month though, he has had a cough and some congestion (not constant congestion, but you can definitely hear it when he starts coughing a lot and at night sometimes when he’s breathing).
First he had the cough for about a week and I made him an appointment at his Pediatrician's office. We saw the Nurse Practitioner and she did a full exam - and said that his left ear looked like it was starting to look a little pink but he had no fever. She thought that he was starting to get an ear infection, which she thought could explain the cough so, she put him on an antibiotic (amoxicillin). Then, about a week later he was still coughing just as much but he had also started throwing up. It seemed that each time it would be shortly after he ate - he'd cough and then throw up. It wasn't every time he ate; just every once in awhile.
The first time the throwing up happened it was on a Friday night - that weekend he threw up a total of 4 times between Friday night and Sunday. I called his Pediatrician's office Monday morning and we went in that same day. This time we saw his regular Pediatrician and she said that his ears were both clear, that he didn't have a fever and that his chest sounded clear... She said that she thought it was a viral infection and since he had just finished the other antibiotic that she would prescribe him something different (I think it was called Sefadin?). She also suggested that we use his nebulizer every day to help with the congestion (he had RSV when he was about 4 months old and so we’ve had a nebulizer at home ever since).
The problem with the nebulizer though, is that he absolutely freaks out and throws a fit when we try and use it. He starts crying and getting himself so worked up that he will start coughing, gagging and throwing up while we’re trying to use it. We have tried to not put the mask around his face (but just hold it up so he’s still able to get the mist), but he still gets just as upset. I called to talk to one of the nurses at the Ped’s office and she wasn’t very nice – she pretty much said that it didn’t matter how upset or worked up he got, that we had to do the breathing treatments even if he started gagging… That is definitely not the response I typically get from the Ped’s office. We’ve always had really good experiences with them… By now he’s done with the 2nd antibiotic but he’s no better.
My husband has VERY bad allergies and asthma (he has 2 inhalers that he carries around with him, takes allergy pills anytime we’re going to be outdoors/around animals and is allergic to practically every animal). He has started trying to do ‘research’ online to figure out what’s going on and so far he says that he’s reading it could be allergies, asthma, croup, reflux, etc…
This evening we were at my husband’s parents’ house for Thanksgiving dinner and I had just finished feeding Christopher dinner – Gerber Vegetable Risotto and some Banana Pudding… It wasn’t even 5 minutes after he had finished eating (he was still sitting in his high chair) and he coughed a little and then everything he had just eaten allllll came back up. He gets so scared when this happens and tends to look up in the air as he’s throwing up so I have to try and put my hand behind his head to keep his face forward or looking down so everything comes OUT instead of him swallowing or breathing it back in.
SO, I don’t know what to do. Has anyone had these symptoms before with their child? We are going back to his Ped’s office on Wednesday for his 1-year check up so I’m definitely going to bring everything up again with his doctor… but tonight when this happened my husband and I were seriously talking about taking him to Children’s Hospital because we just don’t know what to do. We want him to get better because it has to be scary and traumatic for him to be throwing up like this but nothing so far is helping.
A friend of mine at work has a 2-year old son who had similar symptoms and her Ped (a completely different doctor/practice than where we take Christopher) said similar things to what our Ped said – and prescribed the same antibiotics… and after about a month of dealing with him not getting any better they finally sent him to the hospital to get an X-ray of his chest – and they finally figured out that he has pneumonia.
So… help please?!
M.P. answers from Lafayette on November 26, 2010
i didn't read other responses. but my daughter does something like this. expect it happens more when she cries, but it has the same concept behind it it sounds like. She is super sensative to the mucous running down her throat. so when she cries it starts running down her throat, and within a minute she will throw up. no matter when she ate or anything. the doctor basically said there's nothing we can do about it. and just clean up the puke when it happens, and if she gets hungry again after throwing up, to feed her. i know this doesn't sound real helpful, but for me to understand what was behind it, because i was so scared of it being reflux or something else, was amazingly helpful, and helped me to calm down. good luck
L.U. answers from Seattle on November 25, 2010
No idea! But, an idea with the nebulizer. My son also had RSV and the nebulizer kind of freaked him out. Is your son a good sleeper? Mine is, so when he fell asleep for his nap or at night I would hold the mask up to him for the required 10-15 minutes and let him breath it all in while he slept like a king. He was none the wiser and the medicine really did help.
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A.A. answers from Chicago on November 26, 2010
Take him to the children's hospital--it can't hurt and they are th best equipped to deal with this. Insist that you want an xray done to check for pneumonia--they should also be checking out his nose. This sounds like it might be post-nasal drip aggravated by allergies to me. They could put him on a nasal spray to clean him out if that is the case and also have him take an antihistamine. Your ped is right about the breathing treatments--if he needs them, then he needs to get them. You need to be firm with him, and not give in when he gets all dramatic. They do not hurt and they are necessary. I have a 4 year old that gets them too as do I. I also just hold the mask up IF she sits still. I let her know that if she starts to move around she will have to put the strap thing around her head--I am not fighting her. Even when she was younger, you really need to make it clear to him that this is not an option. Be calm, but firm. If you have to, put him in the highchair or carseat with the seatbelt on while he gets the treatment. Tell him he can get out and sit on your lap when he can sit like a big boy. The ped is not being harsh--there is just no reason for your son to go crazy over a breathing treatment that does not hurt in any way.
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B.P. answers from Detroit on November 26, 2010
I can see where you're coming from. I've had similar experiences with my son, who has some definite allergies and possible reactive airway or asthma as well.
You stated that your husband has asthma and allergies. You are probably right on in thinking that your son may have these issues as well. (My husband has really, really bad asthma and I'm so it doesn't surprise me that a few of my kids have it as well).
Okay, for the breathing treatment. I have 2 of these. Keep them stocked at all times- no joke. I agree with what another mom said. Go ahead and give your son the treatment while he is at rest (if you really can't get him to take it). Another suggestion might be to put him in a high chair and just wave it in front of his face. My one year old hates it too, so I do see what you're saying (both my boys have asthma like symptoms when their sick).
Your son sounds like he may have some type of upper resp. infection. A lot of upper resp. infections are noisy and you predominantly hear them when they cough. They sound majorly congested. This definitely will cause your little guy to be uncomfortable. The vomiting is a part of the congestion. They get worked up and upset. Their sphincter's are weak (usually) and all the coughing and crying causes them to vomit. Definitely don't be feeding your son while he is having an episode. If he's having a really hard time breathing, most of his energy will be spent on the work of breathing.
Just an FYI, croup is hard to miss (you probably already know this from your research). It has a real characteristic barking sound. It sounds horrible! You will know if your baby has it because his cough will sound very odd (almost like a seal or animal barking). Cool mist and breathing treatments help with this.
I keep an eye out for respiratory distress by watching for accessory muscles being used. Look between his rib cage and just underneath his rib cage. Is the skin being pulled in while he breathes? Is he distressed? Do you see him using his neck muscles to breathe?
If he is struggling to breathe, his color looks bad, he is using these extra muscles to breathe...you definitely need to get him some help. There may be (as you suggested) an underlying respiratory illness.
Just another idea, its not a breathing treatment, but with croup (if it is croup), you can take your son outside (if the weather is cold) and the cold air will help with the breathing difficulty. I live in Michigan, so that's no issue with us.
Good luck to you!
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K.N. answers from Boston on November 26, 2010
Hang in there! Keep in mind that, though this is traumatic in the short term, your son won't remember this. He'll be OK -- and so will you.
Has he had a strep test? I ask because one of my daughters would get a pink throat for a day or two -- but not painful. Then she'd cough for a couple of days & I'd think it was a cold. When she threw up it was either due to congestion or strep (the virus can cause the lymph glands in the abdomen to swell, causing the vomiting).
We went round and round with this, our youngest, for years -- coughing, throwing up, etc. And, although once it WAS pneumonia, usually just her way of dealing with mucus from a cold or else strep. Hang in. Your little one will be fine and so will you (and, btw like your husband, I, too have allergies & asthma).
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J.G. answers from Philadelphia on November 26, 2010
Have you thought that maybe this isn't related to any kind of infection (viral or bacterial)? The constant coughing/congestion as well as gagging can absolutely be related to reflux, as well as the vomiting, espically after eating. I only suggest this because my son has delayed gastric emptying with reflux (he just turned 2) and those were the majority of the symptoms. Just something to look into.
Hope you get answers soon.
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B.M. answers from Philadelphia on November 26, 2010
After my son had RSV, he had breathing problems, instead of using the nebulizer, our dr. At CHOP prescribed a chamber. You use inhalers. It is still not easy to administer, but they only have to breathe in 2 puffs. My advice is to go with your gut, if you feel that you aren't getting the answers you need, find another dr., or like I did, call CHOP. Good luck to you.
L.B. answers from Philadelphia on November 25, 2010
If I were you, I would call the pediatrician first thing tomorrow and demand that he be seen again. Explain to the doctor the family history with Dad having asthma and allergies and request that a chest xray be done.
I know they treat young children for allergies and asthma symptoms perhaps they can put some different medicine in his nebby.
I know when my son has post nasal drip he coughs quite a bit and gags, sometimes throwing up.
Did you elevate the head of his crib (we put folded towels under the mattress)? Are you running a cool mist humidifier? Both have helped my son a lot.
You are a good Mommy, keep up the good work!
L.P. answers from Pittsburgh on November 26, 2010
Hi -- I wrote the following for someone else awhile back. It seems to me that it might be of some use for your situation too, because, when my little guy started throwing up around 9 months of age, our pediatrician thought it was an ear/sinus infection too. We went through 3 rounds of antiobiotics before I said "enough! What else could it be?" So, here you go:
Food allergies. Or rather, a food intolerance. I say this because my son (almost 3) threw up a heck of a lot (about 3 times a day) and it took us months to figure it out. It took us months because food allergies don't typically manifest themselves as vomit, so it wasn't a food allergy, right?! It turns out, he has an intolerance to wheat (which he'll hopefully outgrow), along with some real food allergies (nuts and some others). When we began removing food from his diet, I only removed wheat to humor the doctor. Of course it wasn't wheat! He ate wheat 3 meals a day (bread, pasta, crackers, cookies, etc.) I did the food test (remove and re-introduce) 3 times because I couldn't believe it. Wheat -- he thew up. No wheat -- no throw up. I strongly suggest you remove things from his diet for that it could be for 5 days, and begin reintroducing them one by one in 3-5 day stretches. Things like wheat, eggs, dairy, etc -- I know, big, in everything you eat foods, so it will be a pain in the neck. But, it won't last forever. If you find it IS wheat, the initial home conversion is also a pain, but, now it's no problem. There is lots of info on the internet. I got a cookbook, there are many gluten-free foods out there (we buy crackers, pasta, graham crackers, animal crackers, fish sticks, chicken nuggets, panko, pretzels, and make our own flour blends, in order to make his own bread. But you can buy flour blends and pancake mixes). It's expensive, so we still eat the regular versions of those things, while our son eats the gluten-free. But he doesn't throw up, he doesn't have celiac disease, and he feels much much better. Good luck.