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Kindly Advice What Treatment Should Be Given And What Precautions To Be Taken For Wheezing
Posted on
Thu, 13 Aug 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 13 Aug 2020
Answered on
6 days ago
Last reviewed on
Question : Hello Doctor
Good Morning
My 7yrs daughter is having wheezing in night and we are giving 2.5mg Asthalin nebulisation and budecort 0.5mg . Please advise how many times a day we need to give because after giving one dose the wheezing is gone and again next day night it is coming back . From last three years every rainy and winter season it is the same case.
And any citrus fruit if she eats and if any cold items if she eats she starts coughing and breathing problem is starting. Kindly advice what treatment should be given and what precautions to be taken.
Thank you in anticipation.
Good Morning
My 7yrs daughter is having wheezing in night and we are giving 2.5mg Asthalin nebulisation and budecort 0.5mg . Please advise how many times a day we need to give because after giving one dose the wheezing is gone and again next day night it is coming back . From last three years every rainy and winter season it is the same case.
And any citrus fruit if she eats and if any cold items if she eats she starts coughing and breathing problem is starting. Kindly advice what treatment should be given and what precautions to be taken.
Thank you in anticipation.
Brief Answer:
Kindly give more details
Detailed Answer:
Hi XXXXXXX
I understand your concern
To have a more clear idea, kindly give the following details:
1. What are her present symptoms- cough, audible wheezing, cold, fever?
2. When did the present symptoms started? Is the symptoms more at night and early morning, or same throughout the day?
3. Is there any breathing difficulty or fast breathing? Is she otherwise active and playful?
4. In the past, how frequently she used to get this, and how many times admitted in hospital?
5. Is there any history allergic diseases in her, the siblings, or close relatives(nose allergy, skin allergy, asthma)?
6. Is she on any regular inhalers?
7. How you are giving budecort- via nebuliser or through MDI/spacer?
kindly get back with details, so that I can guide you better
Dr Muhammed Aslam, Paediatrician
Kindly give more details
Detailed Answer:
Hi XXXXXXX
I understand your concern
To have a more clear idea, kindly give the following details:
1. What are her present symptoms- cough, audible wheezing, cold, fever?
2. When did the present symptoms started? Is the symptoms more at night and early morning, or same throughout the day?
3. Is there any breathing difficulty or fast breathing? Is she otherwise active and playful?
4. In the past, how frequently she used to get this, and how many times admitted in hospital?
5. Is there any history allergic diseases in her, the siblings, or close relatives(nose allergy, skin allergy, asthma)?
6. Is she on any regular inhalers?
7. How you are giving budecort- via nebuliser or through MDI/spacer?
kindly get back with details, so that I can guide you better
Dr Muhammed Aslam, Paediatrician
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Might need inhaled steroids with MDI
Detailed Answer:
Hi XXXXXXX XXXXXXX
Tank you for the details given.
Cough ans audible wheezing at midnight and early morning, especially during winter/rains suggests hyper-active airway disease/allergic lung disease. If she gets frequent episodes(like once in every 2-3 months), the best option will be taking inhaled steroids using MDI(metered dose inhalers). This is much better than nebulisers- the dose used in MDI is much lower, and a greater proportion of inhaled drug reaches airways compared to nebulisers. This will be needed for few months- years depending on the severity. Along with this, we can use asthalin MDI(instead of asthalin nebulisation) for 5-7 days during exacerbations. Nebulisers, ideally, has to be used along with oxygen.
Now, how long we have to use:
There are two types of lung allergy in kids- 1. Transient wheezing of childhood, &2. Bronchial asthma.
Transient wheezing occurs only during colds/flu, and will resolve by 6-7 years of age. Here, MDI is used for a duration of 3-6 months or longer, depending on individual severity and level of control. For children having trouble only in winter, we can use only during winter also.
Te second type- Bronchial asthma is a chronic disease(here we get wheezing even without fever/cold/flu also) and is more likely if there is allergic diseases running in family, and if the issue is not resolving by 6-7 years. This will need regular use of MDI for years, with regular dose adjustment depending on the response.
It is important to control the disease, because if left untreated or under-treated, the reversibility of symptoms with inhalers decreases gradually, and finally will become irreversible. MDI helps to prevent this by reducing airway inflammation.
This is an overview of her condition and the framework of treatment. Kindly regularly follow with her pediatrician, as this needs regular direct assessment. In between, I can guide you whenever needed.
If her nasal symptoms(constant sneezing/congestion/discharge/itching) is disturbing, this might suggest nose allergy(allergic rhinitis). Control of this with nasal steroids will not only relieve nasal symptoms, but also will make wheezing management more easy. Your doctor will guide in this.
Another important thing to be done is to avoid all triggering factors- Avoid exposure to cold wind/dust, avoid eating triggering foods(like citrus here), avoid pets and woollen clothes. Keep the house, especially bed room as dust free as possible.
Her weight is inadequate for age(by 6 years, we expect ~20kg). This, along with history of pica(eating mud/dust) might suggest anemia. So kindly get her Hemoglobin and Peripheral blood smear(to look for cause of anemia) and let me know the report. Accordingly I will give you an Iron syrup. This will correct anemia, improve appetite and reduce pica.
Hope I have answered your query
If you need further clarification, I will be happy to help. Otherwise kindly close the discussion and rate the answer.
Dr Muhammed Aslam, Paediatrician
Might need inhaled steroids with MDI
Detailed Answer:
Hi XXXXXXX XXXXXXX
Tank you for the details given.
Cough ans audible wheezing at midnight and early morning, especially during winter/rains suggests hyper-active airway disease/allergic lung disease. If she gets frequent episodes(like once in every 2-3 months), the best option will be taking inhaled steroids using MDI(metered dose inhalers). This is much better than nebulisers- the dose used in MDI is much lower, and a greater proportion of inhaled drug reaches airways compared to nebulisers. This will be needed for few months- years depending on the severity. Along with this, we can use asthalin MDI(instead of asthalin nebulisation) for 5-7 days during exacerbations. Nebulisers, ideally, has to be used along with oxygen.
Now, how long we have to use:
There are two types of lung allergy in kids- 1. Transient wheezing of childhood, &2. Bronchial asthma.
Transient wheezing occurs only during colds/flu, and will resolve by 6-7 years of age. Here, MDI is used for a duration of 3-6 months or longer, depending on individual severity and level of control. For children having trouble only in winter, we can use only during winter also.
Te second type- Bronchial asthma is a chronic disease(here we get wheezing even without fever/cold/flu also) and is more likely if there is allergic diseases running in family, and if the issue is not resolving by 6-7 years. This will need regular use of MDI for years, with regular dose adjustment depending on the response.
It is important to control the disease, because if left untreated or under-treated, the reversibility of symptoms with inhalers decreases gradually, and finally will become irreversible. MDI helps to prevent this by reducing airway inflammation.
This is an overview of her condition and the framework of treatment. Kindly regularly follow with her pediatrician, as this needs regular direct assessment. In between, I can guide you whenever needed.
If her nasal symptoms(constant sneezing/congestion/discharge/itching) is disturbing, this might suggest nose allergy(allergic rhinitis). Control of this with nasal steroids will not only relieve nasal symptoms, but also will make wheezing management more easy. Your doctor will guide in this.
Another important thing to be done is to avoid all triggering factors- Avoid exposure to cold wind/dust, avoid eating triggering foods(like citrus here), avoid pets and woollen clothes. Keep the house, especially bed room as dust free as possible.
Her weight is inadequate for age(by 6 years, we expect ~20kg). This, along with history of pica(eating mud/dust) might suggest anemia. So kindly get her Hemoglobin and Peripheral blood smear(to look for cause of anemia) and let me know the report. Accordingly I will give you an Iron syrup. This will correct anemia, improve appetite and reduce pica.
Hope I have answered your query
If you need further clarification, I will be happy to help. Otherwise kindly close the discussion and rate the answer.
Dr Muhammed Aslam, Paediatrician
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Might need inhaled steroids with MDI
Detailed Answer:
Hi XXXXXXX XXXXXXX
Tank you for the details given.
Cough ans audible wheezing at midnight and early morning, especially during winter/rains suggests hyper-active airway disease/allergic lung disease. If she gets frequent episodes(like once in every 2-3 months), the best option will be taking inhaled steroids using MDI(metered dose inhalers). This is much better than nebulisers- the dose used in MDI is much lower, and a greater proportion of inhaled drug reaches airways compared to nebulisers. This will be needed for few months- years depending on the severity. Along with this, we can use asthalin MDI(instead of asthalin nebulisation) for 5-7 days during exacerbations. Nebulisers, ideally, has to be used along with oxygen.
Now, how long we have to use:
There are two types of lung allergy in kids- 1. Transient wheezing of childhood, &2. Bronchial asthma.
Transient wheezing occurs only during colds/flu, and will resolve by 6-7 years of age. Here, MDI is used for a duration of 3-6 months or longer, depending on individual severity and level of control. For children having trouble only in winter, we can use only during winter also.
Te second type- Bronchial asthma is a chronic disease(here we get wheezing even without fever/cold/flu also) and is more likely if there is allergic diseases running in family, and if the issue is not resolving by 6-7 years. This will need regular use of MDI for years, with regular dose adjustment depending on the response.
It is important to control the disease, because if left untreated or under-treated, the reversibility of symptoms with inhalers decreases gradually, and finally will become irreversible. MDI helps to prevent this by reducing airway inflammation.
This is an overview of her condition and the framework of treatment. Kindly regularly follow with her pediatrician, as this needs regular direct assessment. In between, I can guide you whenever needed.
If her nasal symptoms(constant sneezing/congestion/discharge/itching) is disturbing, this might suggest nose allergy(allergic rhinitis). Control of this with nasal steroids will not only relieve nasal symptoms, but also will make wheezing management more easy. Your doctor will guide in this.
Another important thing to be done is to avoid all triggering factors- Avoid exposure to cold wind/dust, avoid eating triggering foods(like citrus here), avoid pets and woollen clothes. Keep the house, especially bed room as dust free as possible.
Her weight is inadequate for age(by 6 years, we expect ~20kg). This, along with history of pica(eating mud/dust) might suggest anemia. So kindly get her Hemoglobin and Peripheral blood smear(to look for cause of anemia) and let me know the report. Accordingly I will give you an Iron syrup. This will correct anemia, improve appetite and reduce pica.
Hope I have answered your query
If you need further clarification, I will be happy to help. Otherwise kindly close the discussion and rate the answer.
Dr Muhammed Aslam, Paediatrician
Might need inhaled steroids with MDI
Detailed Answer:
Hi XXXXXXX XXXXXXX
Tank you for the details given.
Cough ans audible wheezing at midnight and early morning, especially during winter/rains suggests hyper-active airway disease/allergic lung disease. If she gets frequent episodes(like once in every 2-3 months), the best option will be taking inhaled steroids using MDI(metered dose inhalers). This is much better than nebulisers- the dose used in MDI is much lower, and a greater proportion of inhaled drug reaches airways compared to nebulisers. This will be needed for few months- years depending on the severity. Along with this, we can use asthalin MDI(instead of asthalin nebulisation) for 5-7 days during exacerbations. Nebulisers, ideally, has to be used along with oxygen.
Now, how long we have to use:
There are two types of lung allergy in kids- 1. Transient wheezing of childhood, &2. Bronchial asthma.
Transient wheezing occurs only during colds/flu, and will resolve by 6-7 years of age. Here, MDI is used for a duration of 3-6 months or longer, depending on individual severity and level of control. For children having trouble only in winter, we can use only during winter also.
Te second type- Bronchial asthma is a chronic disease(here we get wheezing even without fever/cold/flu also) and is more likely if there is allergic diseases running in family, and if the issue is not resolving by 6-7 years. This will need regular use of MDI for years, with regular dose adjustment depending on the response.
It is important to control the disease, because if left untreated or under-treated, the reversibility of symptoms with inhalers decreases gradually, and finally will become irreversible. MDI helps to prevent this by reducing airway inflammation.
This is an overview of her condition and the framework of treatment. Kindly regularly follow with her pediatrician, as this needs regular direct assessment. In between, I can guide you whenever needed.
If her nasal symptoms(constant sneezing/congestion/discharge/itching) is disturbing, this might suggest nose allergy(allergic rhinitis). Control of this with nasal steroids will not only relieve nasal symptoms, but also will make wheezing management more easy. Your doctor will guide in this.
Another important thing to be done is to avoid all triggering factors- Avoid exposure to cold wind/dust, avoid eating triggering foods(like citrus here), avoid pets and woollen clothes. Keep the house, especially bed room as dust free as possible.
Her weight is inadequate for age(by 6 years, we expect ~20kg). This, along with history of pica(eating mud/dust) might suggest anemia. So kindly get her Hemoglobin and Peripheral blood smear(to look for cause of anemia) and let me know the report. Accordingly I will give you an Iron syrup. This will correct anemia, improve appetite and reduce pica.
Hope I have answered your query
If you need further clarification, I will be happy to help. Otherwise kindly close the discussion and rate the answer.
Dr Muhammed Aslam, Paediatrician
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear Doctor
Thank you for giving the details about the type of illness and suggested MDI treatment.
I will update you how we go about the treatment of this allergy and anemia.
Another thing i would like to ask about her weight , what we should give her to eat as we are not giving her fruits due to fearing it might trigger cough and breathing problem etc.
Since she is not getting enough vitamins
Please suggest what we can give her to balance her diet.
Also one of her aunt son 6.5half years old have same problem and recently doctor have suggested THEO ASTHALIN - LEVOSALBUTAMOL & THEOPHYLLINE SYRUP and they are saying it reduced and controlled the wheezing.
Kindly advice.
Thank you in anticipation
Mohd XXXXXXX XXXXXXX
Thank you for giving the details about the type of illness and suggested MDI treatment.
I will update you how we go about the treatment of this allergy and anemia.
Another thing i would like to ask about her weight , what we should give her to eat as we are not giving her fruits due to fearing it might trigger cough and breathing problem etc.
Since she is not getting enough vitamins
Please suggest what we can give her to balance her diet.
Also one of her aunt son 6.5half years old have same problem and recently doctor have suggested THEO ASTHALIN - LEVOSALBUTAMOL & THEOPHYLLINE SYRUP and they are saying it reduced and controlled the wheezing.
Kindly advice.
Thank you in anticipation
Mohd XXXXXXX XXXXXXX
Dear Doctor
Thank you for giving the details about the type of illness and suggested MDI treatment.
I will update you how we go about the treatment of this allergy and anemia.
Another thing i would like to ask about her weight , what we should give her to eat as we are not giving her fruits due to fearing it might trigger cough and breathing problem etc.
Since she is not getting enough vitamins
Please suggest what we can give her to balance her diet.
Also one of her aunt son 6.5half years old have same problem and recently doctor have suggested THEO ASTHALIN - LEVOSALBUTAMOL & THEOPHYLLINE SYRUP and they are saying it reduced and controlled the wheezing.
Kindly advice.
Thank you in anticipation
Mohd XXXXXXX XXXXXXX
Thank you for giving the details about the type of illness and suggested MDI treatment.
I will update you how we go about the treatment of this allergy and anemia.
Another thing i would like to ask about her weight , what we should give her to eat as we are not giving her fruits due to fearing it might trigger cough and breathing problem etc.
Since she is not getting enough vitamins
Please suggest what we can give her to balance her diet.
Also one of her aunt son 6.5half years old have same problem and recently doctor have suggested THEO ASTHALIN - LEVOSALBUTAMOL & THEOPHYLLINE SYRUP and they are saying it reduced and controlled the wheezing.
Kindly advice.
Thank you in anticipation
Mohd XXXXXXX XXXXXXX
Brief Answer:
Give fruits and vegetables
Detailed Answer:
Hi XXXXXXX
Welcome back
We need not avoid all fruits fearing allergy. Some children will be sensitive to some fruits, but never to all, and we can not generalise. Best option will be to try different fruits- one at a time at an interval of 1 week. Then make a list of fruits that are triggering problem, and avoid them. Here, since she is sensitive to citrus, you can avoid orange/mosambi. But nothing wrong in giving other family of fruits like apple, dates, XXXXXXX watermelon, pineapple. Try each and exclude triggers. Similarly you can try nuts also(in the same manner). Also, include lot of vegetables i diet. Avoid giving cold items.
To increase weight, we have to control the disease(frequent wheezing will prevent proper growth and weight gain) and increase calorie intake- try increasing frequency of feeds, adding ghee/oil in feeds, give rice water/lassi instead of plain water. Diet should include enough proteins also(dairy, meet, pulses). Also, correcting anemia will improve appetite.
Regarding Theo-Asthalin, this contains a combination of Levosalbutamol and Theophylline. Among this, theophylline is not recommended for routine use in children because of its side effects. I use this only rarely, that too for a very short periods, when the patient is not responding to standard first line treatment. This we can not use frequently. MDI is the safest and most effective way to control allergic cough.
Hope I have answered your query
If you need further clarification, I will be happy to help.
Take care
Give fruits and vegetables
Detailed Answer:
Hi XXXXXXX
Welcome back
We need not avoid all fruits fearing allergy. Some children will be sensitive to some fruits, but never to all, and we can not generalise. Best option will be to try different fruits- one at a time at an interval of 1 week. Then make a list of fruits that are triggering problem, and avoid them. Here, since she is sensitive to citrus, you can avoid orange/mosambi. But nothing wrong in giving other family of fruits like apple, dates, XXXXXXX watermelon, pineapple. Try each and exclude triggers. Similarly you can try nuts also(in the same manner). Also, include lot of vegetables i diet. Avoid giving cold items.
To increase weight, we have to control the disease(frequent wheezing will prevent proper growth and weight gain) and increase calorie intake- try increasing frequency of feeds, adding ghee/oil in feeds, give rice water/lassi instead of plain water. Diet should include enough proteins also(dairy, meet, pulses). Also, correcting anemia will improve appetite.
Regarding Theo-Asthalin, this contains a combination of Levosalbutamol and Theophylline. Among this, theophylline is not recommended for routine use in children because of its side effects. I use this only rarely, that too for a very short periods, when the patient is not responding to standard first line treatment. This we can not use frequently. MDI is the safest and most effective way to control allergic cough.
Hope I have answered your query
If you need further clarification, I will be happy to help.
Take care
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Give fruits and vegetables
Detailed Answer:
Hi XXXXXXX
Welcome back
We need not avoid all fruits fearing allergy. Some children will be sensitive to some fruits, but never to all, and we can not generalise. Best option will be to try different fruits- one at a time at an interval of 1 week. Then make a list of fruits that are triggering problem, and avoid them. Here, since she is sensitive to citrus, you can avoid orange/mosambi. But nothing wrong in giving other family of fruits like apple, dates, XXXXXXX watermelon, pineapple. Try each and exclude triggers. Similarly you can try nuts also(in the same manner). Also, include lot of vegetables i diet. Avoid giving cold items.
To increase weight, we have to control the disease(frequent wheezing will prevent proper growth and weight gain) and increase calorie intake- try increasing frequency of feeds, adding ghee/oil in feeds, give rice water/lassi instead of plain water. Diet should include enough proteins also(dairy, meet, pulses). Also, correcting anemia will improve appetite.
Regarding Theo-Asthalin, this contains a combination of Levosalbutamol and Theophylline. Among this, theophylline is not recommended for routine use in children because of its side effects. I use this only rarely, that too for a very short periods, when the patient is not responding to standard first line treatment. This we can not use frequently. MDI is the safest and most effective way to control allergic cough.
Hope I have answered your query
If you need further clarification, I will be happy to help.
Take care
Give fruits and vegetables
Detailed Answer:
Hi XXXXXXX
Welcome back
We need not avoid all fruits fearing allergy. Some children will be sensitive to some fruits, but never to all, and we can not generalise. Best option will be to try different fruits- one at a time at an interval of 1 week. Then make a list of fruits that are triggering problem, and avoid them. Here, since she is sensitive to citrus, you can avoid orange/mosambi. But nothing wrong in giving other family of fruits like apple, dates, XXXXXXX watermelon, pineapple. Try each and exclude triggers. Similarly you can try nuts also(in the same manner). Also, include lot of vegetables i diet. Avoid giving cold items.
To increase weight, we have to control the disease(frequent wheezing will prevent proper growth and weight gain) and increase calorie intake- try increasing frequency of feeds, adding ghee/oil in feeds, give rice water/lassi instead of plain water. Diet should include enough proteins also(dairy, meet, pulses). Also, correcting anemia will improve appetite.
Regarding Theo-Asthalin, this contains a combination of Levosalbutamol and Theophylline. Among this, theophylline is not recommended for routine use in children because of its side effects. I use this only rarely, that too for a very short periods, when the patient is not responding to standard first line treatment. This we can not use frequently. MDI is the safest and most effective way to control allergic cough.
Hope I have answered your query
If you need further clarification, I will be happy to help.
Take care
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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