Dear Vijoy,

Thank you for seeking a reply through this website, and I hope I am able to help your child.

You are certainly correct in thinking that it may be impossible to keep the child indoors all through her childhood, and this is the very reason why preventive medicines are prescribed to allergy-prone children, so that they may live a normal life.

Romilast is montelukast, a type of allergy-preventive medicine that is used as an initial preventer in toddlers. Your pediatrician took a wise decision in using this drug, as budecort, though very effective, is a steroid, and although most international opinion shows that inhaled budesonide is safe for children, it is definitely a drug with a greater potential for side-effects as compared to Montelukast.

Although your residence is located in open fields, the grass and wild flowers may, in fact, be causing her to develop more symptoms than less, as allergy to pollens and plant derivatives can spread through the air, especially with the agency of wind. Also, Pune is one of the most polluted cities of India today, and regardless of where you stay, chemical and industrial pollutants are damaging Pune's air more than you can care to think.

Using Levolin on a need-to basis is also an excellent choice, and I, for one, fully endorse its use. I trust that you are using the inhaler with spacer device, so that the child can breathe normally and not have to co-ordinate her breathing with the pushing of the device to release the medicine.

If a course of six weeks of montelukast does not reduce the child's cough problems, it may be a good idea to switch back to inhaled budesonide. A combination of budesonide and a long acting bronchodilator like formoterol is also available, and most asthma specialists prescribe such a combination for long-term use in childhood asthmatics too.

It may be possible to study her allergy status by doing a series of tests known as RAST tests. These tests test the child's blood against several common allergens in a lab setting. If specific allergens are found, an attempt can be made to "desensitise" the child against those allergens if they JUST CANNOT be avoided. You should speak to the pediatrician regarding this when you XXXXXXX him again.

Thanks again for the query. Please do not hesitate to contact me again if you should need to do so.

Regards.

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Dear Vijoy,

Thank you for your acceptance of my answer.

You might want to consider a combination of Formoterol with Budesonide rather than a combination of Seroflo and Romilast, as I mentioned in my earlier reply after consulting your physician.

However, this is a purely individual preference, and if the pediatrician wants to give seroflo, there is no harm. On purely monetary grounds, my combination is cheaper than a combination of the two medicines suggested by your doctor.

Pediasure is fine, and there is no need to switch to any other product for health and nutrition maintenance. I don't think any product can GUARANTEE improvement of weight and/or health.

Wishing you good health.
Best wishes,

Dr. Taher

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