How to manage a chronic night cough in toddlers?

Question

Hello doctor,

My son is 21 months old. He has a chronic night cough. It changes from very wet to dry, and afterward, he gags and swallows hard. It wakes him during the night. He has been treated with tubes for repeated ear infections.

Could this be due to reflux or very bad postnasal drip?

He is not sick and coughs only three or four times during the day. It has been ongoing for as long as I can remember.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

The most common reason for having a stuffy nose associated with mucus in the nose and throat in an approximately two-year-old age group can be attributed to adenoid hypertrophy.

Adenoids are lymphoid aggregates present in the nasopharyngeal region and represent the first line of defense for the body. They often increase in size, most commonly between the ages of two and eight years. This increase in size can lead to increased mucus production, nasal stuffiness, a nasal twang (called rhinolalia clausa), pressure changes in the ear, and sometimes fluid accumulation, causing infection and decreased hearing.

That is likely the reason he has had tubes placed in his ears to ventilate fluid and pus accumulation in the ears.

There is absolutely nothing to worry about, as this is a very common condition that we come across every day.

I would consider the following advice:

Mometasone nasal spray, two puffs in each nostril, two times a day for six weeks.
Syrup Sinarest (Acetaminophen, Chlorpheniramine, and Pseudoephedrine or its equivalent, 2.5 ml three times a day for the next 10 days.
Otrivin P (Xylometazoline Hydrochloride) or its equivalent, three drops three times a day for the next 10 days.

Make sure that a gap of at least 1.5 hours is kept between the medications mentioned in points one and three.

Also, avoid giving him anything cold or spicy. Avoid junk food as much as possible. Plain steam inhalation two to three times a day should help thin out the mucus in addition to the medications mentioned above.

This may take a while, around 10 days, for the medications to provide significant relief, so it would be best to wait until then.

Reflux can also be a problem in children, which is why I have recommended some dietary changes above. Make sure the child does not go to sleep immediately after meals.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.