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Expert Q&A
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| By David L. Fay, M.D. Family Physician Associate Director, Waukesha Family Practice Residency Program | ||
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My son will turn 2 in December. Since July or August, he has had this nagging cough. I like and trust my doctor, but we have tried three different medications to cure this cough. Sometimes it is associated with runny nose and sneezing. Other times it is just the cough. The medications were Cefzil (I think there was a hint of an ear infection that time), Phenergan, and Albuterol syrup. He may have an occasional wheeze. He eats, plays, sleeps great and is very happy. The cough is not a dry cough and we have recently been back to the doctor on call and she said he had a sinus infection. He had the yellow snot and all the mucus which could be contributing to the cough. Cefzil was again prescribed. Could it be allergies? The pediatrician does not seem concerned, but I feel like there must be an answer. Plus, in July, we moved to an older home. Could it be dust? I have covered his mattress and pillow with hypo-allergenic cases.
The short answer is yes, it could be allergies.
There are several signs mentioned in the question which indicate that it could be allergies. Sneezing is a method of clearing the airway; it is rarely associated with infections, but is more frequently a marker of allergies. Rhinorrhea (a runny nose) with clear fluid is suggestive of allergies, although allergies and infection can both cause yellow rhinorrhea. A dry cough may represent allergies, although asthma can also present as a cough in young children. Cefzil is an antibiotic; it will not help with colds or allergies, but may help if there is a sinus or ear infection. Phenergan is an antihistamine most frequently used to reduce nausea; it is rarely used for allergies because it is not very effective. Albuterol is a medication designed to help with asthma.
Other signs of allergies in young children are mouth breathing, "allergic shiners" (dark circles under the eyes), and a line which develops between the bridge and tip of the nose (from an upward rubbing of the nose, called an "allergic salute").
If it is due to allergies, the seasonal aspect may help to determine the cause, although in most cases only testing will tell for sure. If it occurs during the winter, it most likely is due to animals in the house, molds or dust mites (people are not allergic to dust, but are allergic to microscopic mites which live in the dust). Spring to summer allergies are most often due to pollens; late summer allergies are usually grasses.