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Forum Name: Pediatric Topics

Question: 1 month old with cough


 Thillemann - Mon Jan 08, 2007 3:19 pm

I have a one month old who has a horrible cough. He semed to have picked it up right after the holidays. He doesn't have a stuffy nose or fever but a hacking cough that wakes him up at night. I can hear the flem rumbling when i feed him. He also chkes on it sometimes and pukes. He has been spitting up not only formula but what also looks like water. sometimes his puke is clear. I have him sleeping in his bouncer and run a humidifier. I am not sure what else I can do. If any one has any suggestions please let me know.
 Dr. Chan Lowe - Tue Jan 09, 2007 1:50 am

User avatar There are an endless number of causes of a cough in the winter time. Winter is the season of the respiratory illness.

A few infections come to mind when discussing severe coughs. It is possible that he has been infected with RSV, a virus that causes bronchiolitis and is known to cause a prolonged cough. Generally this virus is associated with significant congestion but not always.

Also, if he seems to be having coughing "fits" where he needs to take a deep breath in between to keep coughing, he may have pertussis also known as whooping cough. It gets its name as a whooping noise is often heard when the child takes the deep breath in.

If the cough is not getting better after about 7 days (not gone, but getting better) or if he seems to be getting worse I would recommend that he be seen by his doctor for evaluation. He may need a chest x-ray to look for pneumonia.

If he develops any severe respiratory distress, including having his skin be pulled in underneath his ribs or at the top of his breast bone, rapid breathing or flaring of his nostrils he should be taken to the emergency room for evaluation as soon as possible.

Hope this helps.
 Thillemann - Tue Jan 09, 2007 11:59 am

I brought him to the doctor today and they told me it was acid reflux. She said his lungs sounded great. She said I need to feed him less more frequently. He weighs 12 pounds I bumped him up to 6 oz and he was eating every 5-6 hours during the day and going 6-8 hours at night. But she said 4 oz every 3-4 hours should be good. He also needs to sit upright for 30 min after each feeding. This means I will be getting little sleep I also have a 2 1/2 year old. Is there any thing any one can recommend. Is there a good wedge that can be used at night. Should I switch formula.
 Dr. Chan Lowe - Tue Jan 09, 2007 5:32 pm

User avatar There are a few things you can do to help him. Reflux can certainly cause cough. When he sleeps, I recommend that you elevate the head of his bed to about 30 degrees. This can be done by putting some pillows or sheets under his mattress or some bricks, etc. under the legs of his bed. This way, his entire mattress is elevated. It makes it safer for him than just putting a pillow under him.

Also, you can add a small amount of rice cereal to his formula to help thicken his feeds (Say 1/2 to 1 teaspoon or so). You can add more if needed to give the feeds just a little bit thicker consistency (without making it a solid mush). Keep in mind that his nipple may become clogged easier. You can modify this if needed by making the hole slightly larger.

There are some formulas marketed as antireflux formulas. I've never been particularly impressed with the results of these but you may want to try one.

If these things fail there are some medications that can be used.

The good news is that essentially all babies reflux when they're born and almost all of them grow out of it. Unfortunately it can take a good several months to see any improvement.

At night, as long as he's still gaining weight well I would let him sleep as long as he can. You'll both be better off. However, if he stops gaining weight well he may need more frequent night time feedings also.

Hope this helps.

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