Brief Answer:
Needs few more details

Detailed Answer:
Hi XXXXXXX
Welcome to Ask A Doctor service
This is Dr Aslam, Pediatrician here, to help you.
I have gone through your queries including ECHO report in details, and understand your concern.

I will try to address your worries one by one; will ask few additional details in between for a better judgment. Kindly go through, and get back to me as you feel.

1. Ongoing cold and occasional cough: Some sneezing and nasal congestion is very common in infants. We need not worry unless frequently associated with fever or yellowish/purulent/foul smelling discharge. Occasional cough also can be left alone, unless it is wet to hear(like a lot of phlegm inside), is associated with fever or breathing difficulty. But I would like to know whether there is any history of allergy(asthma, nasal allergy or eczema) in siblings or close relatives. Allergic disorders can cause recurring nasal symptoms and cough. Itching over ear might also suggest this.

2. Sweating over forehead: This we have to consider significant only if it worsens during exertion(like when breast feeding or crying). If not related to exertion, this can be take as physiological.

3. Saturation around 94%: this is normal; nothing to worry. Anything above 93-95 is fine.

4. Heavy breathing at night: What you mean by heavy breathing- is it increased rate of breathing, or any noisy breathing? Kindly clarify this. Also try to count number of breaths in 1 minute when this happens next time. More than 50 breaths/minute is abnormal.

5. UTI: A single episode of UTI is okey. No worries. But just want to know whether urine culture was positive then, and what was the report of ultrasound abdomen then(UTI in young children warrants ultrasound abdomen)

6. Poor appetite: This is probably a false perception, as his present weight is pretty normal for age.

7. Gastric issues and reflex: I would like to know the exact symptoms here(like frequency of vomiting and its timing in relation to feeds). Occasional vomiting and regurgitation is normal in infancy, especially after feeds. This need not be worried about, especially as his weight is normal. In pathological reflex, child fails to gain weight as expected.

8. Pain and itching in ears: Is there any rash or discharge? Why you feel there is pain? Skin allergy(eczema) or dry skin can produce such symptoms.

9. ASD: Seeing the report, ASD is still small, and not interfering with heart's function. All that is needed is to keep following up and repeat ECHO testing after 4-6 months. No additional investigations needed now. Size do varry with time. Some progressively becomes smaller and close themselevs, while others persists or progresses demanding intervention later. But, still 6mm is not big, and we can wait now.

Kindly get back with details, so that I can guide you better
Regards, Dr Aslam

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