Preparing for a paediatric visit
Recurrent infections and night-time cough — consultation (suspected allergy/asthma)
Child: Jake Miller, born Apr 2019 (6 years) · Profile managed by: mum · Regular medication: none; vaccinations up to date
LOGISTICS (when booking the appointment): the referral to an allergist is in place. Bring the child's health book (vaccinations and growth charts),
the infection diary and the packaging/names of medicines given. If blood tests will be taken — check whether the child should be fasting.
1. Questions / topics to discuss
- 7 respiratory infections in six months + cough at night and after running.
Is this already asthma/allergy, or will the child "grow out of it"? What work-up now — allergy tests, spirometry?
- Cough mostly at night and after exertion, wheezing during infections.
Is it worth trying an inhaled medicine and seeing whether the cough settles?
- Year-round runny nose, blocked nose, snoring during sleep.
Allergy (dust mites?) or enlarged adenoid — is an ENT assessment needed?
- Antibiotics 3 times in six months — isn't that too often?
What should we do at the next infection before reaching for an antibiotic? When is one really needed?
- Weight dropped from the 50th to the 25th percentile, poorer appetite.
Is this worrying, or a result of frequent infections? What should we watch?
2. Measurements and results bring the health book
| Growth and infections |
|---|
| Weight | 25th percentile | six months ago 50th |
| Height | 50th percentile | stable |
| Infections | 7 / 6 months | respiratory tract |
| Fever during infections | 38–39 °C | settles in 2–3 days |
| Antibiotics | 3× / 6 months | to discuss |
| Tests (if done) |
|---|
| Blood count | mild eosinophilia | may point to allergy |
| Total IgE | raised | to confirm with the allergist |
| CRP (last infection) | 12 mg/l | viral/mild picture |
| Oxygen saturation (in clinic) | 98 % | OK |
What I am watching (mum): I keep an infection diary (date, symptoms, fever, medicine given), we use a humidifier and air the bedroom, saline drops for the nose, we avoid smoke. The night cough gets worse after playing on the carpet and with soft toys — hence the suspicion of dust mites.
3. Checklist — what to bring
- Child's health book (vaccinations + growth charts)
- Infection diary (7 episodes with dates and symptoms)
- Blood count / IgE results (if done)
- Names and packaging of medicines given
- Referral to the allergist
4. Medicines and products (as needed)
| Product | Dose / schedule | Notes |
|---|
| Paracetamol / ibuprofen | as needed for fever | dose according to the child's weight |
| Saline nasal drops | regularly | for a runny nose |
| Vitamin D3 | 1000 IU | autumn/winter |
| Probiotic | after antibiotics | — |
| Inhaled medicine | under consideration | only after the doctor's decision (trial) |