YANMD but help me figure out why my kid is sick so often.
May 21, 2024 4:14 PM   Subscribe

My five-year-old is sick for I think the 12th time since fall. Help me piece together what I am missing, if anything, to get her some relief from missing out on life/activity so much because she is constantly sick. YANMD but if any of this sounds familiar from your own parenting adventures and anything you did, tried, or advocated for that we are not.

My kid has been sick I think 12 times since the fall. When I say sick, I mean she's actively sick for 7-10 days and then has a persistent, terrible night cough for 2-3 weeks afterwards each time that requires 2-4 interventions from us each night (water, puffer, re-position, etc.) for her to even get a reasonable amount of sleep.

My partner and I trade off nights when she is sick (so one person is well rested each day) and I think we slept together for 8 nights in four months...so that's a relative estimate on how many nights where she was fully healthy overnight this winter. She missed a bunch of school, we miss a fair amount of work, and she has had a difficulty keeping up with sports and it feels like we are all running pretty ragged and weary most of the time.

Some relevant details:
- She has asthma. She takes a steroid nose spray, Singulair, anti-histamine, steroid puffer 2x every day and a rescue inhaler as needed. It feels like a lot and it's difficult to know what is or is not helping. When she is not sick (most of the summer), she is well managed and sleeps well and can do all her activities without a rescue inhaler. We manage common allergens well on the preventative side. She had a common inhalants allergy test done recently and nothing came up positive which surprised everyone.
- We are followed by a primary care physician and an asthma specialist and both haven't had a lot more to suggest in our recent visits that we should be doing - which is frustrating considering how constantly sick she is. I don't know what else I would be advocating for either as she's on a fair amount of medication already.
- We add some cold meds, a humidifier, saline for nose, elevate her bed, to the mix when she is sick to get her some relief. We have started to bring in pseudoephedrine during the day which seems to help a little. She's had to go to antibiotics 2-4 times a year to kick things too after 7-10 days but this is the first year we have avoided an oral steroid via an emergency room at some point...so yay I guess?
- She sucks her thumb, which we know is a magnet for illness, and have been working to ween her off it but it is difficult - especially when she's at school, where her teachers try to remind her, but we know at least a couple times a day she is putting germs directly in her mouth without thinking about it. I also wonder if her thumb sucking contributes to some of her overnight issues as it's her default for falling back asleep.
- Her issues seem to be less her lungs and more her upper respiratory and nose - often when she has a cold, we will put her down sounding okay/clear and then 10 minutes after she falls asleep she is basically choking on how much mucus she is producing. She has a small nose and with the thumb sucking at night I imagine it's putting a lot of pressure on her sinuses. Her post-nasal drip seems persistent, thick, and often requires us to prop her up, get her a drink of water, in order for it to pass. She will get an asthma attack if we don't as her lungs get triggered by all the mucus and coughing. So we are in and out of her room at night for weeks on end each time she gets a respiratory virus. She's juuuust starting to be aware enough overnight to grab a water bottle on her own without us but it's inconsistent.

Maybe this is more normal than we realize - but the parents with kids who have asthma we know told us that it got better right around now for them...and we feel very much like we are out of answers on what else we can do for our kid. We have the hope that getting out of a daycare centre and into proper school in the fall she will not be as consistently inundated by illnesses as she is...but is there something your similar-sounding kid responded to that is not in this lengthy post that we might try?
posted by openhearted to Health & Fitness (38 answers total) 2 users marked this as a favorite
 
Best answer: I know some families that have had some relief from running HEPA air purifiers, whether in the bedroom or as part of a whole house fan. You might reconsider her bedding - she might have some allergies or sensitives to her pillow, her bedding, her mattress or her rug that are making things worse.
posted by vunder at 4:34 PM on May 21 [3 favorites]


Best answer: Our six year old, who goes to an outdoor school, was congested for 5 months this winter. She was on antibiotics twice for ear infections which cleared things up for about 3 days afterwards before the congestion came back. Her tonsils are normal sized. How about your daughters? Enlarged tonsils can make this stuff worse.

Next winter we are going to go back to masking and I am going to be fanatical about handwashing. I honestly don’t know what else to do.

I think this is normal, but very frustrating.
posted by CMcG at 4:36 PM on May 21 [3 favorites]


Best answer: Has she been in day care/kindergarten for the first time? I know that when kids start communal education everyone gets sick a lot, because of exposure to many, many viruses in communal situations. If that's it, you can probably look forward to this calming down.

Has her doctor checked her tonsils? My kid had repeated infections because her tonsils remained infected after bouts of antibiotics cleared the sore throat symptoms but not the bacteria seeded in her tonsils. Docs are incredibly hesitant to remove tonsils these days (while mine were removed as a toddler because of constant infections). My daughter's doc finally agreed to have them removed - when she was 15, after 4 severe strep infections in a year.

Is it possible that this isn't all asthma, but asthma aggravated by new infections?
posted by citygirl at 4:40 PM on May 21 [1 favorite]


Best answer: Is there some kind of blood test your doctor can order to check whether your kid's various immune cell counts are normal?
posted by heatherlogan at 4:50 PM on May 21 [4 favorites]


Best answer: I used to get repeat sinus infections, though nothing near as bad as what your kid is going through. One thing that helped is to cut dairy out of my diet, especially milk and yogurt. (But be sure to supplement calcium if you try this)
posted by qxntpqbbbqxl at 5:46 PM on May 21 [6 favorites]


Best answer: I want to agree with the above comments re tonsils. Bacteria seated in my tonsils gave me very similar symptoms as a child, also utterly unconquerable by antibiotics. It cleared up with a tonsillectomy and adenoidectomy, which my parents had to advocate for heavily - the doctors really didn't want to go to surgery, but it was the only thing that helped. YMMV with this anecdata.
posted by branca at 6:06 PM on May 21


Best answer: This sounds unfortunately typical for a kid with asthma from my experience. A couple thoughts in addition to what you are doing:
1. Warm/hot bath or shower EVERY night can help with congestion right before bed. Similarly first thing in the morning as well can also help.
2. Does she mask? Can she at least part of the time in public spaces?
3. Any chance you'd consider moving to a climate that is more mild year-round so it lessens indoor time? It's a pretty radical change, but could help a lot. If not, then consider what you'd need to do in your current climate to have more outdoor time/events/playdates.
posted by Toddles at 6:10 PM on May 21


Best answer: I know you are using a puffer, it might be worth it to ask if you can try using a nebulizer instead during exacerbations. You will still need the puffer for times when out and about and mild stuff. Yes they are loud but you can slip a mask out hold it to the face of a sleeping child instead of trying to wake then up and breathe in the most optimal way for the spacer and such. Also the mist can break up some sinus stuff. Yes the neb is longer than doing puffs but can do a better job especially in children.

They say they are the inhaler and the nebs are equivalent in medicine but that's never been true for me anyway.

My child uses an expectorant when sick like mucinex to help loosen congestion as well. But you'll have to ask your doctor.

Asthmatic kids do get sick alooooot and stay sick aloooot. It's tough. My kid who is in Kindergarten is an asthmatic kid whose in a 504 basically due to absences. I missed on average 20 days of school a year when I was a kid until middle school, and my mom was a pediatric RN.
posted by AlexiaSky at 6:11 PM on May 21 [2 favorites]


Best answer: I think the frequency of the illness sounds not abnormal but the severity seems worse than what is typical.

I have a friend whose kid had similar symptoms and it turned out to be a casein allergy, so you might look into that.

In the meantime, I would change pillowcases daily, long bubble baths every night, without fail, and run a HEPA filter. And put the anti-thumb sucking stuff on her thumb because it's not great for anyone for her to be sick so often.
posted by luckdragon at 6:14 PM on May 21 [2 favorites]


Best answer: Re thumb sucking. My daughter had an issue with her front teeth projecting too far forward so that she couldn't get a good bite between her bottom and top front teeth. Orthodontist installed a guard that fit into the roof of her mouth that meant that she could no longer get her favored fingers in the proper position for satisfying sucking. It was really the only way to break something that was such a strong unconscious habit. We also had do a first round of braces for a few months at that point to get things roughly back into alignment with a second round more extensive round of othodontia at age 12 when her adult teeth were all in.
posted by metahawk at 6:22 PM on May 21


Best answer: My instinct is pediatric ENT next, both for the tonsil possibilities mentioned by others and to check for chronic sinusitis and anything else they might come up with. I agree that this sounds like more severe illnesses than the typical frequent daycare crud.

For you and spouse, based on the mention of missed work: just want to throw out there that FMLA can protect intermittent leave for frequent short-term absences and appointments associated with a child's long-term health condition. It might make sense to look into the paperwork if you are otherwise FMLA eligible.
posted by LadyInWaiting at 6:34 PM on May 21 [5 favorites]


Best answer: Seconding an ENT doctor, especially to look for nasal polyps.
posted by SyraCarol at 6:44 PM on May 21 [2 favorites]


Best answer: I was similar to your daughter and I know this sounds very woo but eliminating dairy really, really helped. It might also be worth testing for food allergies if you haven’t.

My son has asthma and some issues vomiting at night as well, and our doctor just put him on probiotics. It seems to have helped.
posted by warriorqueen at 6:50 PM on May 21 [4 favorites]


Best answer: I mean, also possibly covid-related immune dysregulation?
posted by shadygrove at 7:10 PM on May 21 [11 favorites]


Best answer: post-nasal drip seems persistent, thick, and often requires us to prop her up

Changing sleep positions — specifically, to sleeping on the back with head and shoulders supported by a wedge pillow — helps some adults with asthma and post-nasal drip; others opt to elevate the head of the bed entirely. If this approach hasn't been tried yet, maybe run it by the doctors. And check your whole house, not just her bedroom, for environmental triggers? She's troubled less during the summer, when there may be a) more fresh air flowing through the house and b) less time spent indoors.
posted by Iris Gambol at 7:10 PM on May 21 [2 favorites]


Best answer: IANAD and I know neither are you, but did you shine a flashlight in her mouth and see if there are lesions or nodules? Someone in our family eventually needed a tonsillectomy and adenoidectomy after the appearance of lesions/nodules were clearly visible and would go away but then come back again. I didn't notice you mention whether you checked for visual signs. It seemed primarily you were trying to relieve her discomfort, which is understandable.
posted by forthright at 7:15 PM on May 21


Best answer: ENT time. My anecdata is that sinus surgery helped someone with a profile similar to your daughter.

It’s possible that your daughter’s immune system doesn’t have a lot of practice with germs due to Covid related reasons.

Also talk with your daughter’s dentist about the possible use of an appliance to discourage thumb sucking.
posted by oceano at 8:06 PM on May 21


Best answer: I know it's not ideal, but masking at day care/ school would be less miserable than this (and reduce thumb sucking as well). The reduced sleep may be reducing their ability to fight anything off, and a period to catch up and really get healthy again may make a big difference.
posted by metasarah at 8:12 PM on May 21 [3 favorites]


Best answer: Have they checked for whooping cough (pertussis)? I was out of work for three weeks on year; I am a person who was rarely, if every sick, and had accumulated 1000+ hours of sick leave. For at least two of those weeks, I'd get out of bed, thinking it was getting better, and then cough so much I just went back to bed.

Many people, including many doctors, believe this has been eradicated but that is incorrect.
posted by TimHare at 9:19 PM on May 21


Best answer: Have you had your house checked for mold?
posted by toucan at 1:01 AM on May 22 [2 favorites]


Best answer: Has she had covid - ever? Covid can damage the organs and dysregulate the immune system. After having covid, even up to a year or two years afterward, the dysregulation is such that people can be more susceptible to other infections. The effects on the organs and immune system can be cumulative ie more episodes of covid can mean greater/more problems in the months and years afterward. This happens even with mild infections and even in kids. This is independent of vaccination, though vaccination does appear to reduce the risks of long covid/post acute sequelae of covid by a small amount.
posted by lulu68 at 1:33 AM on May 22 [6 favorites]


Best answer: Allergies. Take her to a pediatric allergist. This could have been me as a child. The asthma diagnosis and all. Early 70’s so “allergies” were rarely talked about. My parents had exhausted all outlets and took me to see my Dad’s pediatrician (Dr Leila Denmark, Google her, cool story). She took one look and said allergies. They took me to an allergist, I started shots and was remarkably improved by the 3 month check in. Good luck! My child was frequently ill when they were young and I know how hard it can be.
posted by pearlybob at 3:01 AM on May 22 [4 favorites]


Best answer: Adenoids and tonsils, also ask your doctor to test immunoglobulins. I had a very similar parenting experience and it turns out to be selective IgA deficiency. There's nothing to be done for it, but at least I have an explanation.
posted by notjustthefish at 6:49 AM on May 22 [1 favorite]


Best answer: Of course you should check with your pediatrician. I'm going to offer a theory that might explain what your seeing.
When my son was a toddler, he was bringing home everything from daycare and sharing it with all of us. There was one winter where nobody was healthy. I complained about it to my doctor and they said, "I'd be more worried if your son wasn't coming home with a cold every 3-5 weeks. This is how is going to build a strong immune system later in life." Now, here's the theory - your child missed a lot of the socialization and attendant colds that most toddlers get because of COVID and you're getting them now.
posted by plinth at 7:56 AM on May 22 [1 favorite]


Best answer: I would check the house and classroom for allergens. Essential oil diffusers, plug-in air fresheners, wax warmers are ubiquitous and exacerbate asthma. If the school has old carpet holding old yuck, or brand new carpet that offgasses, , that could be a trigger. Use unscented detergent, no softener/ dryer sheets. Is the mattress foam? Consider a wool or cotton topper. Do you live someplace with clean air? Open a window in her bedroom for an hour before bedtime.

Does anybody in the family have Cystic Fibrosis? Does she have really salty skin/ sweat? Really unlikely, but even being a carrier of the gene has increased risk of sinusitis.

Can you do sinus irrigation? Get a spray bottle of sterile salt water for this purpose to see if that will help.

The asthma doc should also be looking for allergens, but maybe see an allergist. Good luck, it's hard to see your child sick, and you're all probably losing a lot of sleep.
posted by theora55 at 8:16 AM on May 22 [1 favorite]


Best answer: I agree with all of the above re: seeing an ENT and an allergist.
Check her room for allergens and mold. Consider getting her all new pillows and washing all the bedding at once, on hot, to kill dust mites and see if that makes a difference?
Get a HEPA air filter to run in her room at night.

Could she take a small thing of hand sanitizer with her to school? Maybe even something "fun" if she would like that. Get permission from her teacher for her to use it throughout the day since she's probably going to suck her thumb anyway.
posted by purple_bird at 9:46 AM on May 22


Best answer: I mean, also possibly covid-related immune dysregulation?

This is what I came in to say, plus could there have been covid infections causing some of the illnesses? Has testing been done recently?

I hope you find some answers 🙏🏻
posted by ellieBOA at 10:41 AM on May 22 [1 favorite]


Best answer: Also, my pet theory around the younger years is that most kids are sick pretty constantly during their first 2 winters of group care. (And usually during their first summer too.)

So if, for example, she was at home or in a small nanny share, she wouldn’t have had much exposure. If she’s in her first or second year of preschool or in Kindergarten, she might still be in this window of first two winters if she wasn’t in group care before that. So it might be a lot better next winter.
posted by vunder at 11:19 AM on May 22 [1 favorite]


Best answer: Oh man kids that age are sick ALL THE TIME! And my pet theory, unproven by any data, is that mild long covid is probably making a lot of minor viruses much worse.

I would work on the thumb sucking. Do whatever it takes to get her to stop. It's making it harder for her to breathe when she sleeps, exposing her to more viruses, and also just bad for her skull and teeth overall. So I'd say prioritize that by any means - bribes, rewards, bitter lotions, etc.

More sleep will help her recover, fewer viruses in her mouth will solve a lot of the sickness problem, and the bonus is that it'll save you some cash in 5 years at braces time, too!

Oh and for weird allergens - do you have a lot of house plants, or a ficus plant in your house? Especially a Benjamina? Or any other large houseplants? A lot of plants bleed small amounts of sap, which dries, turns into powder, and MANY people are allergic to it! When I got rid of my Ficus Benjamina, my allergies reduced.
posted by nouvelle-personne at 11:45 AM on May 22


Best answer: Pollution? Do you live in a city? Asma might make her way more sensitive to pollution.
Mask, not the blue one, the 3m white one, HEPA filter, salt water spray and weekends up a mountain.
posted by thegirlwiththehat at 1:37 PM on May 22


Best answer: Since you asked if this is more normal than you realize — I have similarly aged kids and my impression is that 12 colds in one school year in a kid’s first year of school/group childcare is worse than average, but not out of the realm of normal. After the first year, it usually gets a little better, but preschool & early elementary is a lot of illness for everyone. Neither of my children were at a new school this year and we still all got several colds in a row in the fall.

However, a week+ of active sickness then a couple weeks of significant symptoms every time seems unusual - that kind of lingering illness seems to hit most kids something more like once or twice a year.
posted by maleficent at 7:44 PM on May 22 [1 favorite]


Best answer: 1) if this is her first year of group care I agree that the frequency sounds normal but the severity sounds extra.

2) I have an asthma kiddo and when we started daily saline sprays and replaced a steroid spray with a non-steroid mast cell blocker (nasal crom)(it’s perfectly cromulent) that worked better.

3) daily allergy medication (Zyrtec) is a must and a big help

4) really controlling dust in her areas may help also. Dust frequently, replace carpet with flooring if possible, vacuum frequently if not, maybe an air purifier?
posted by bq at 9:41 PM on May 22


Best answer: On the other hand, according to Your Local Epidemiologist: "Feeling sick? Lots of children are testing positive for viruses that cause common cold symptoms, which means adults are feeling it, too. This is not abnormal for this time of year. We don’t know why these typically follow flu and RSV season."
posted by SteveInMaine at 10:21 AM on May 23


Best answer: I would absolutely have her iron levels checked and look at other vitamins and minerals as well. Low iron makes people much more susceptible to illness. Make sure they run a full iron label and don’t just check her hemoglobin. Insist on finding out her ferritin levels in particular—low ferritin can cause all kinds of issues and is chronically overlooked , especially if hemoglobin is normal. The normal range starts very low but if I recall correctly healthiest levels are at least 50. Good luck!
posted by Amy93 at 4:51 PM on May 25 [1 favorite]


Best answer: This is my kid, to a T. Please find an immunologist and have them do immunoglobulin and immune function testing. Insist on it. I’d bet you $100 your kid has selective IgA deficiency. Research it. This means, among other things, her body doesn’t make the immune protein to fight off upper respiratory viruses. For some reason most primary care doctors know nothing about this, or they think it’s not important to know about, which is crazy.

One of the good things about knowing if she has it is that you can qualify for accommodations at school, in case she misses a lot of days due to being ill. Another benefit is once my son was diagnosed, I can now quickly get the medications we need to help him get better fast (antibiotics, steroids, etc), versus before when the doctors would say ‘it’s a virus’ and he’d be so sick for 2-3 weeks straight. Also have the immunologist run vaccine titers. My kid makes no immune response to vaccines. Again, even though there is nothing they can really do for it, it’s good information to have about your kid’s health. Good luck. Please report back if this was helpful. Or send me a message to discuss further.
posted by curtains at 3:03 PM on May 26 [1 favorite]


Best answer: "She missed a bunch of school, we miss a fair amount of work" — are you or your partner catching your daughter's frequent respiratory viruses, or are you missing work to take care of her? Adults often come down with a milder version of their young child's cold, and you're trading off nights when she's presumably highly contagious. If the two of you are seldom ill, that's something to mention to the doctors when discussing tonsillectomy and advocating for immune-related testing. Seconding curtains' rec; IgA deficiency is underdiagnosed (some patients are asymptomatic), and linked to recurrent sinusitis and bronchitis, and to asthma and allergies. Please check your mailbox.
posted by Iris Gambol at 9:30 PM on May 26


Response by poster: Thank you all - I found so much to think about and consider in the above. A lot of what is suggested has been tried and this is year three in a daycare centre so the "once you're through them it should get better" hasn't emerged liked we'd hoped. I will give some best answers but every answer provided some of the tactical and emotional support I needed during a tough week. Appreciate you all.
posted by openhearted at 5:44 AM on May 27


Has she seen an ENT? That level of congestion can be anatomical. I ended up needing sinus surgery.
posted by decathecting at 2:24 PM on May 31


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