DD 4 coughing at night--asthma?

[weddell]

I need some advice here. My dd 4 (5 next week) has been coughing every night since we have started staying at my mom's house (about a week). We are leaving Monday.

 

Here's the background. My DH has asthma, is allergic to peanuts and tree nuts, and had eczema as a child (a skin problem related to allergies). My dd has multiple food allergies and terrible eczema. Her allergist pretty much feels that asthma is inevitable (thanks for the confidence :confused:). I haven't really seen signs of asthma in her yet. She takes zyrtec every morning, topical steroids for her skin, and carries an epi pen.

 

Our house is in the suburbs, we have no pets, and mostly hardwood floors (a little carpet). She has an air purifier in her room. At our house I haven't really seen signs of asthma in her.

 

My mom's house is in the country. She has two indoor dogs, outdoor cats and chickens, and tons of plants both wild and a garden. She has lots of knick-knacks in the house that could be better dusted.

 

My dh is on a 10 day business trip and so we are staying with my mom, 4 hours away from our house, for about a week while he is gone. Every night we have been here, dd has coughed ALL night. It's not constant but fairly frequent and seems to clear up after she has been up a while. I listened to her breathe this morning and while she wasn't wheezing, she was breathing harder than normal (although she had just finished coughing so that could be why). She isn't wheezing at night either.

 

Could this is a type of cough related asthma? We will be here a few more days and while she seems fine I'm also leery of doing nothing if she really is having trouble breathing. If she were wheezing or really struggling, I would take her to the ER here, but that's not the case. She doesn't seem bothered by this at all. We are away from her dr and allergist (and they are closed Friday anyway), so I don't really have anywhere to take her here. Plus, she seems fine at home.

 

Any advice about what I should do today? Should I just leave it be while we are here and see if she is better when we get home? Or do I need to call someone today? When we are home next week, should I have her seen then? Ugh, I hate decisions like this where things aren't super clear-cut. I don't want to take her in and have them "why are you here??"

[Denisemomof4]

I don't know much about asthma, but could she be having a dry cough from the dust? Maybe come herbal tea with lemon and honey before bed would help.

[abbeyej]

Okay, for the rest of the time you're there... Can you get to a Target or similar store? I would go buy her a fresh, hypo-allergenic pillow and a hypo-allergenic mattress cover. Then I would come home and wash all of her bedding on the hottest temperature you can manage. (You could even add a pot of boiling water to the machine if it's like mine and just doesn't get all that hot.) While that's washing, vacuum her room really well -- but a minimum of 3-4 hours before she'll go back in there to go to bed. If there are curtains in there, stuffed animals, or moveable pillows, ask your mom if you can put them in another room for the rest of your visit. Dry the bedding on the hottest setting you have available.

 

My reason for all this is the thought that she's probably reacting to dustmites in the pillow and mattress she's using, and that the pet dander is probably making it worse. You can't get rid of it completely, but those steps will do a lot toward making it better at bedtime.

 

I don't think you'll do permanent damage waiting 'til early next week to call the allergist. But I would do what I can about dust and pet dander now...

[weddell]

Okay, for the rest of the time you're there... Can you get to a Target or similar store? I would go buy her a fresh, hypo-allergenic pillow and a hypo-allergenic mattress cover. Then I would come home and wash all of her bedding on the hottest temperature you can manage. (You could even add a pot of boiling water to the machine if it's like mine and just doesn't get all that hot.) While that's washing, vacuum her room really well -- but a minimum of 3-4 hours before she'll go back in there to go to bed. If there are curtains in there, stuffed animals, or moveable pillows, ask your mom if you can put them in another room for the rest of your visit. Dry the bedding on the hottest setting you have available.

 

My reason for all this is the thought that she's probably reacting to dustmites in the pillow and mattress she's using, and that the pet dander is probably making it worse. You can't get rid of it completely, but those steps will do a lot toward making it better at bedtime.

 

I don't think you'll do permanent damage waiting 'til early next week to call the allergist. But I would do what I can about dust and pet dander now...

 

 

Thanks, I think I will wash her bedding. I actually brought her own pillow with dust mite cover and pillow case, so she is sleeping on that, but I'll rewash the sheets and maybe even vacuum the mattress itself. Maybe I'll to Target and get a mattress cover. It's hard when I'm not exactly sure what is going on. I'll definitely do some cleaning today though.

[Harriet Vane]

I agree with Abbeyej but will add this . . .

 

The coughing but getting better could possibly be post-nasal drip. Asthma is also possible but I would not leap to that judgment just yet. Either way she is clearly having an allergic response to something in your mother's house, so clean her room and bedding thoroughly, and get some OTC saline spray to clean out her nasal passages. You might also consider adding in Nasalcrom just before bed to help keep that reaction down (yes it's safe in combination with the other things she's taking--my dr affirmed that for my own ds).

[littlebug42]

If she wasn't having these symptoms before going to your Mom's house, I would think it is an allergy of some kind. My daughter does have asthma (with cough) that is mostly triggered by allergies. Hers doesn't completely stop though when she gets up. I would do what the others have suggested.

 

I would,however, watch her breathing closely. My dd recently had an asthma episode and I took her to the pediatrician. She was breathing harder than normal but I did not even realize she was wheezing but when the doc listened to her lungs, it was definitely there. She ended up on a week of oral steroids because of it. If she continues "breathing hard", I would seek out the advice of a doc.

[Dobela]

I think it may be from post nasal drip as well. I have a very hard time traveling due to dustmite allergies. I always develop a cough and some sort of sinus drainage, even if it is just for one night. A deep cleaning can really help at night, but really, if the whole house has dust, dander and mites, she can still have the symptoms even sleeping in a very clean room. Sometimes I can control the cough if I take another medication that is a decongestant only. It may also helpif she is actually outside or out of the house as much as possible.

 

If your mother hasn't changed or cleaned her air filters in the last month, that would seriously help. I personally buy the expensive 90 day filters but then change them every month. If I don't I can tell they are not working as well after about day 45.

[WiseOwlKnits]

Was she sick a few weeks ago? Is she fine during the day?

 

I ask because DD did this. We thought it was allergies and took her to an allergist. It turns out that it was a sinus infection! The allergist said that a cough at night like that - especially if it's followed up after an illness - is a classic sign of a sinus infection. He put her on antibiotics and the cough was gone in 3 days.

[weddell]

Thanks for all the help guys! I don't know that it is asthma either. It's just what pops into my head first since her allergist is so pessimistic about it. She's definitely got an allergy thing going on and I'm just trying to make sure the symptoms are manageable while we are here. We usually don't stay a long time like this.

 

Although I know my mom vacuums thoroughly before we come, I just vacuumed the downstairs and will do up next. Then wash bedding. I may give a dose of benadryl before bed as well (she is prescribed atarax for night use, but I'm out).

 

Post nasal drip is definitely a possibility I hadn't considered. Maybe I'll try and treat that and see if it helps.

 

I do definitely monitor her breathing. If she doesn't sound better I'll take her in next week after we are home. And of course to the ER here if anything really sounded bad. But again, it could be the coughing is from post nasal drip.

 

Thanks!

[Dobela]

Was she sick a few weeks ago? Is she fine during the day?

 

I ask because DD did this. We thought it was allergies and took her to an allergist. It turns out that it was a sinus infection! The allergist said that a cough at night like that - especially if it's followed up after an illness - is a classic sign of a sinus infection. He put her on antibiotics and the cough was gone in 3 days.

Just want to add that sometimes I develop a sinus infection if I have really irritated my allergies when traveling. I can almost guarantee that I will have one each time I return home from visiting my grandmother in her musty, dusty, old house. I think that is why a decongestant is important for me to take when I travel.

[DianeW88]

Sinuses.

 

Diane W.

married for 22 years

homeschoolind 3 kiddos for 16 years

[Jenn in Mo]

Allergies can certainly cause the coughing whether it is asthma or not.

 

I have one that reacts with asthma by coughing instead of wheezing. We went a month doing Benadryl several times a week due to seasonal allergies. My daughter is 4 and that age wasn't listed on the Benadryl bottle, but our dr. and pharmacist said it would be fine to give her a half dose when she started coughing and did not recommend using claritin or anything since it was only at night and sporadic. I hate giving mine ANYTHING, but they assured me this was safe and should pass when the season passed and it did.

 

If it is just post-nasal drip, getting them to sleep on their tummies and using a sea salt/baking soda wash can really help.

 

Even though there is no wheezing, you might want to check the speed of her breathing and heart rate. Mine will run around and be chipper and playful sometimes and it's not until we hug and hold her that we can tell she's breathing rapidly, with her heart pounding away.

[Dana]

Could this is a type of cough related asthma? We will be here a few more days and while she seems fine I'm also leery of doing nothing if she really is having trouble breathing. If she were wheezing or really struggling, I would take her to the ER here, but that's not the case. She doesn't seem bothered by this at all. We are away from her dr and allergist (and they are closed Friday anyway), so I don't really have anywhere to take her here. Plus, she seems fine at home.

 

Any advice about what I should do today? Should I just leave it be while we are here and see if she is better when we get home? Or do I need to call someone today? When we are home next week, should I have her seen then? Ugh, I hate decisions like this where things aren't super clear-cut. I don't want to take her in and have them "why are you here??"

 

YES, it could be "silent asthma". Dh has asthma (finally controlled, thankfully). We've watched ds but haven't seen what we considered asthma. Ds has food allergies and has been on Flovent in the past and is on Zyrtec daily.

 

In May he started coughing when he went to bed and couldn't stop easily. His allergist said that he probably has environmentally triggered silent asthma - so although he's not really wheezing, the cough is the asthmatic reaction. Ds was on Xopanex through a nebulizer for a couple of weeks and Pulmacort as well. He's now back on Flovent but we've been able to drop the nebulizer.

 

If you have an inhaler, I'd be using it. If not, I'd be monitoring her carefully. If breathing becomes an issue - get to the ER. And do follow up with the allergist when you get back to town.

 

:grouphug: It's tough.

[weddell]

YES, it could be "silent asthma". Dh has asthma (finally controlled, thankfully). We've watched ds but haven't seen what we considered asthma. Ds has food allergies and has been on Flovent in the past and is on Zyrtec daily.

 

In May he started coughing when he went to bed and couldn't stop easily. His allergist said that he probably has environmentally triggered silent asthma - so although he's not really wheezing, the cough is the asthmatic reaction. Ds was on Xopanex through a nebulizer for a couple of weeks and Pulmacort as well. He's now back on Flovent but we've been able to drop the nebulizer.

 

If you have an inhaler, I'd be using it. If not, I'd be monitoring her carefully. If breathing becomes an issue - get to the ER. And do follow up with the allergist when you get back to town.

 

:grouphug: It's tough.

 

See that's exactly what I'm concerned about. DH's asthma is allergy triggered. He doesn't need regular (everyday) medicine. But when he goes into a house with cats he definitely starts having breathing problems and needs an inhaler. I'm concerned that although dd doesn't have asthma symptoms at home, she might when she's in contact with severe allergens. In other words, she may not need daily asthma treatment, but may be having previously undiagnosed allergy-induced asthma being triggered right now.

 

I gave her some decongestant tonight so we'll see if that helps. I was wrong too, she isn't just coughing at night, but during the day as well. I'm already planning on taking her in when we get home just to be sure. And if she does sound extra bad or doesn't seem "okay" I'll bring her into the ER. She's really annoyed with me right now because I keep listening to her breathe!

Edited August 29, 2010 by weddell

[Dana]

See that's exactly what I'm concerned about. DH's asthma is allergy triggered. He doesn't need regular (everyday) medicine. But when he goes into a house with cats he definitely starts having breathing problems and needs an inhaler. I'm concerned that although dd doesn't have asthma symptoms at home, she might when she's in contact with severe allergens. In other words, she may not need daily asthma treatment, but may be having previously undiagnosed allergy-induced asthma being triggered right now.

 

I gave her some decongestant tonight so we'll see if that helps. I was wrong too, she isn't just coughing at night, but during the day as well. I'm already planning on taking her in when we get home just to be sure. And if she does sound extra bad or doesn't seem "okay" I'll bring her into the ER. She's really annoyed with me right now because I keep listening to her breathe!

 

My husband just has asthma. It's under control now that we don't have a cat anymore (he's highly allergic to cats).

 

With ds most recently, we gave the Xopanex with the cough a couple of nights but we weren't seeing the warning signs we saw when he was really young ("cuts" in ribcage with breathing, more rapid breathing). There were no signs of respiratory distress, but we did finally reach the point where we took him in to our pediatrician's Saturday hours just to get another point of view. The pediatrician didn't hear a wheeze (despite the coughing for about a half hour before ds falling asleep the night before), pulse ox was fine, and we were prescribed a different antihistamine (thinking he'd built up a tolerance to the Zyrtec).

 

We did get in to see his allergist that Monday. The breath test (lung capacity?) showed a bit lower than his regular check up about 3-4 weeks earlier (when he looked fine). There were signs of a sinus infection as well, so we got loaded up with an antibiotic, Pulmacort, Xopanex, and Flovent (and stayed with the antihistamine).

 

We're down to the Flovent and back on the Zyrtec (while watching to see if we'll need to switch antihistamines). So far, so good.

 

Ds did humor me when I'd keep asking him how his breathing was doing and how he was feeling (generally I managed not to ask more than once an hour). Listen to your gut too. You may want to go back home early. I know we had to stay in a hotel when we visited dh's folks and dh would still end up on steroids from the visit.

 

I'd think getting out of the house during the day might help (field trip tomorrow?), breathing in steam, and watch for things to get worse. Give your husband a call and get his opinion - he knows how he feels with his asthma and may be able to put your mind at rest or suggest you head out tomorrow.

 

And it may not be asthma... you've got a lot of other ideas here...

Don't know that it'd help too much... but we'll sometimes do a spoon of honey for a cough.

 

Good luck. It's so tough when they're sick & you're questioning what to do. :grouphug:

[SailorMom]

After months of trying to figure something like that out - my son was finally diagnosed with "cough variant asthma" - you may want to look in to that.

[Marylou]

It definitely sounds like cough variant asthma to me. Both of my girls coughed during allergy season for years until one of them had to travel to the ER in an ambulance (last June). I had never heard of it before.

 

With your husband's history, it sounds like she may have it too.

 

Do you have an inhaler with you? I would give her some and see how she does with it. And go to the allergist as soon as you're home, if possible.

[NoPlaceLikeHome]

I would do the remediation measures but also get her checked out. Asthma can present with coughing and without wheezing. Has she had a methalcholine challenge test for asthma? Has she seen an asthma specialist? I would not ignore hard breathing that does not let up quickly IMHO.

 

http://www.webmd.com/asthma/default.htm

[Murmer]

A night cough is a sign of asthma BUT it could be allergy induced. So something at your mom's house could be an allergen that is bothering, possibly upon removal of the allergy the cough will go away. My dd had an awful night cough for abt a year before we discovered her milk allergy (don't get me started on doctors that won't listen to parents) as soon as we removed milk her cough has disappeared and its now been a year.

[weddell]

Thanks guys! I ended up taking her to an urgent care place here just to get an opinion on her breathing. They said she sounded ok this morning but that given her personal history and family history that it could be either asthma or just a post nasal drip cough both from allergies and that of course all that stuff is worse at night.

 

Since it was urgent care they just want to treat the immediate symptoms and refer to you to your regular dr and so they gave me an inhaler for her and said to follow up for a better opinion when we are home again. That's pretty much what I expected and all I really wanted anyway. I feel a little better having some emergency medicine for her just in case.

 

She's due for a pediatrician appointment next month and I'll ask then unless it seems more urgent before. Like I said, she hasn't had problems at home so I'm expecting it to clear up tomorrow once we leave my mom's.

 

Thanks for all the help!