Suggest Treatment For Persistent Blocked Nose In An Infant

Posted on Sat, 11 Jun 2016

Question: My infant 2 months old has nose blocked since a month now. Doc gave nasoclear and saline nebulization which isn't working. He is not able to sleep at all. Breastfeeding has become difficult. Bottle feeding he accepts with frequently giving gap during feeding.
Can I use asthalin or buedort. What dose. Please help.

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Please do not use Asthalin Or Budecort at this age

Detailed Answer:
Hi... please do not use Asthalin or Budecort at this age group. The safety both these drugs have not been established as safe at his young age of 2 months.

More over what you say is not an indication to use these drugs.

Nasoclear or saline nasal drops is the only safe medication you can use at this age group. I too concur with your pediatrician regarding this.

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (6 hours later)

He has got fever as well. It comes and goes ocassionally since last week. It should be an infection. What should be done?

Answered by Dr. Sumanth Amperayani (31 minutes later)

Brief Answer:
I need more information - please answer my questions

Detailed Answer:
Hi....please answer my questions so that I can guide you through further -

Questions -

1. You say fever since a week intermittently - did you record it and if so how high is the fever?

2. How is the activity of the kid in-between fever?

3. How is the baby feeding?

4. Is there any fast breathing or difficulty in breathing apart from blocked nose?

5. Is there any bluishness of lips or finger tips?

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (11 hours later)

No bluishness. He dI'd not take feeding yesterday from morning 3 to 10 pm. We suctioned mucus from nose at XXXXXXX Hrudalaya and he slept and fed well. Emergency doctor said he has throat infection.

Fever was 100 when it comes. I gave crocine twice last week. Again it came back yesterday. We gave crocine again.

Yes when he sleeps it's difficult to breathes. He struggles and wakes up every 5 minutes. I hold him upright quite often.

He is dull when fever comes. And does not feed. Only cries to sleep but unable to sleep as well.

Now the big question is is there no medication for infant? Or the infant is allowed to struggle so long for months with no sleep and proper feed?

But still medication are not given. Why is it so? I think use of medications once for something so uneasy for an infant won't impact so badly rather then the infant suffering so much?

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Suggestion on medication at this young age

Detailed Answer:
Hi...By what you quote I put forth these possibilities -
1. Congenital airway anomaly - this causes noisy breathing (both inspiratory and expiratory noise, actually inspiratory will be more than expiratory noise). But the child will not struggle to breath and there will not be fast breathing and in-drawing of chest wall. The sound will be more heard during sleeping and feeding.
2. Wheezing - Here the sound will be predominantly expiratory; the kid will be struggling to breathe, might turn blue and require oxygen and may have chest wall in-drawing.
But both are associated with recurrent cough and cold. But these might not always be bacterial infections which require antibiotics and usually are predominantly viral and are self-limiting.

Coming to your question about – whether is it prudent to use medication for young infant – My answer will be to explain you that safety should be the first concern. If we use steroid like Budecort it mighty adversely affect the growth.

Your kid is not having any major illness please – if it really so and he is really suffering and his feeding is getting affected, he should have rapidly lost weight. Which is not the case. Otherwise that would have been your major complain on this platform. What is his birth weight and current weight and what is his date of birth please?

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumanth Amperayani (2 hours later)

Birth weight was 3.05. Date of birth is 12th Feb 2016. He is 5.69 as on 19th April. Yes he is gaining well but feeding is a concern since last 2 to 3 days.
Will suction work? Does the mucus come up again? Why is it persistent since a month now?

Answered by Dr. Sumanth Amperayani (1 hour later)

Brief Answer:
Weight gain is excellent - suction might help

Detailed Answer:
Hi....his weight gain us excellent. So do not worry about his feeding.

1. Suction might work.

2. Mucus might come up again. But it is only transient phenomenon.....so do not worry.

3. It might be persistent due to climatic changes. But it will settle soon.

Regards - Dr. Sumanth

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar