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Tuesday, March 23, 2010 Crystal L, Community Member, asks

Q: My 2 1/2 month old son has had chronic nasal congestion?

My 2 1/2 month old has had chronic nasal congestion since about 2 weeks of age.  We have tried every formula and it does not change.  He has silent reflux.  He gags and coughs as well on this congestion that seems to be getting worse.  He has no rashes, no diarrhea, no vomiting, etc.  Fussy at times and drinks fine.  He is on Enfamil Gentlease.  How can I tell if he could have a possible milk protein intolerance, could breathing and congestion be the only sign or symptom of a milk allergy?  Or is it just from the reflux?

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Answers (1)
Stephanie, Health Guide
3/23/10 10:02pm

Nasal congestion is said to be a symptom of milk intolerance or allergy but it is also a symptom of reflux. For my daughter, the nasal congestion was always one of the first symptoms to come back when she was outgrowing her Zantac dosage. Basically the reflux causes irritation in the nasal passages which the body responds to by producing protective mucous. Also, the reflux into the throat/nasal passages sets them up for infection.

 

Best of Luck - Stephanie

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Crystal L, Community Member
3/24/10 9:27am

Thank you for responding!  I forgot to mention that my son is on Zantac 2x a day as well, but he has only been on it for about a week and a half now.  He has been congested since about 2 weeks old.  He is usually stuffy, but now he is sneezing and coughing alot, and his mucous is clear, even when I sunction it.  Could this be seasonal allergies?  He has been on milk based formula since birth, if it was a milk allergy, wouldn't he have other symptoms such as constant vomiting and diarhhea, rash, or blood in stools or something?  He has been doing so good on Gentlease, and I just bought Nutramigen last night to give it a trial run for a week, and so far have not seen any changes, except for alittle more fussing, but that may be due to the change.  I have 3 other children who I thought may have had a milk allergy in the beginning, just to find through experience that they all were fine.  For example, my 2 year old had what seemed like a rash only on his face, and I came to find it was infant acne.  I had him on soy for no reason!  At 6 months I changed him back to regular formula and had no problem.  So after much reading and talking to friends with reflux babies, I feel that this stuffiness is more due to the reflux, but I always like to rule everything out. my son does all of the other relux signs:  constant hiccups, drooling and bubbles all over lips, gagging, gulping noises and swallowing shortly after feedings, stuffiness, back arching and wiggling back and forth, head thrashing side to side, etc.  Maybe he needs a stronger med?  Sorry for this being so long, just want some answers from someone with experience, since sometimes those answers are more comforting than a doctor's!  Thanks!  Crystal

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Stephanie, Health Guide
3/24/10 5:30pm

Have you seen any changes with the Zantac? You are right that his symptoms sound very much like reflux and I agree that they sound more like reflux than allergies. Be careful about changing too much at once though, you are like I was with my refluxers - I wanted them to be better so I would try anything but if you change too much at once then it's hard to tell what made the change good or bad.

 

My doctor says you can't get seasonal allergies until your second season alive. Basically, you need to be exposed to the allergen and have time to build up an over active immunity to it before it becomes an allergy.

 

If I were his Mom, I would try to decide if I've seen any change on the Zantac. You may want to ask his pediatrician if he's on a low or high dosage right now. If you have seen some change then that's a good sign that it is reflux but that maybe he needs a higher dosage, more often or a different medication.

 

Stephanie

 

 

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Crystal L, Community Member
3/24/10 7:48pm

Thanks Stephanie.  I will give the ped. a call and let her know what is going on, she will most likely tell me I haven't had him on the med long enough for a change, as when I was taking all the home remedies for reflux, like keeping them upright after feeding for 20 -30 minutes, and told her I've been doing that, she suggested I keep him upright for an hour!  And that was before setting him to sleep upright in his bouncy chair.  I was exhausted as he was waking 2.5 -3 hours to feed all throughthe day and night! 

 

I have not seen much change on Zantac except with the fussing and crying.  He now only does that every 2 days when he is due for a bowel movement.  The past 2 weeks is when I noticed his congestion turning looser and him having a runny nose rather than a stuffy nose.  Now it is a mx.  I put saline in to help him sneeze it out.  His cough and voice sounds hoarse.  I just don't know what else I can do.  It was like pulling teeth to get her to prescribe the med.  He seems to be worse with it coming up as he looks like he is chewing on something and then gulps.  He doesn't spit up unless his burp is forceful occasionally, but it comes up rather than out and goes back down.  He hasn't been in pain, but just very congested with the breathing and that is a huge concern for me.  Did your refluxers have the breathing problem part of it?  If so what did they do for it and when did they outgrow it?  Did they get sick often due to the reflux?  Thanks for all your time.  Oh, by the way... did you formula feed or breastfeed?  If formula, what type did you find worked best?  Thank you so much!

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Stephanie, Health Guide
3/24/10 8:39pm

Yes, my kids had congestion issues with their reflux when the meds weren't working well enough. It was one of the first symptoms my daughter would get when she was outgrowing her Zantac dosage.

 

Your little ones' symptoms definitely sound like reflux to me. The coming up and gulping it back down is what is known as silent reflux in that you don't see it coming out of their mouths. The problem is that it is then still there to keep going up and down. My daughter was a projectile vomiter until about 6 months. This was bad enough but when she stopped spitting it up at 6 months she became a silent refluxer and that's when she got really bad! She became hoarse, refused to eat and was losing weight.

 

It sounds like you did see a difference with the Zantac since the crying got better. Many docs use a prescription to determine if reflux is really the problem. You may need to ask for a referral to GI if your doc isn't willing to work through this with you. With my first, my ped was only willing to go so far with the Zantac. The GI doctor gave her a much higher dosage. With my second we went to GI more as a just in case. By my third, my ped was more comfortable with prescribing for reflux and we never needed GI.

 

I breastfed all three of mine. I do know though that the research has shown that many refluxers go through a variety of formulas only to end up on the most expensive and still be refluxing. Then they get on meds and things finally improve but at that point the parents are scared to try and go off the expensive formulas. Of course, some kids really need the more expensive formulas but for many it's not needed.

 

Generally, you need a full two weeks to see the full effect of the reflux meds. That's because it can take a while to get the healing of the irritated throat and nasal passages. But, you've seen some changes and it's been about a week and a half so it's time to go call the doc. But, I really recommend you write down everything you're saying here. We all tend to get flustered at the docs and then we don't say half of what we want to say. I know faxing a note to the doc has worked well for me in the past as well.

 

Stephanie

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By Crystal L, Community Member— Last Modified: 12/27/10, First Published: 03/23/10