Child Specialist Doctor at Behala: Winter Cough & Asthma

From late October the air in Kolkata changes. Mornings turn hazy, firecracker smoke from Kali Puja and Diwali hangs low for days, and in many Behala flats a mosquito coil burns through the night. A child specialist doctor at Behala sees the result in the weeks that follow: colds that drag on, coughs that get worse at night, and some children who wheeze for the first time.

Most of these are ordinary viral colds that settle on their own. A few are not. This guide helps you tell the difference, explains childhood asthma and allergy, and shows how to cut the smoke inside your own home.

A normal winter cold, and what actually helps

A typical cold brings a runny or blocked nose, sneezing, a sore throat, a cough and sometimes mild fever for the first two or three days. Young children can catch several a year.

Mucus often turns thick, yellow or green after a few days. That colour alone does not mean your child needs antibiotics. The cough is usually the last thing to go and can linger for a couple of weeks, slowly getting better. A child who plays between coughing bouts, drinks well and passes urine as usual is reassuring.

What helps at home:

• Rest and plenty of fluids; breastfed babies may want to feed more often.

• Plain saline nose drops (no added medicine) before feeds and sleep.

• For children over one year, a little honey may soothe a cough. Never give honey to a baby under one.

• Skip steam from a bowl of boiling water; scalds are a real risk.

• Do not put mustard oil or any oil in a child's nose, and do not rub camphor or menthol balms on babies or put them near a young child's nose.

Antibiotics do not work against cold viruses. Never start them on your own or use leftovers from an earlier illness.

Why cough syrups are not for young children

Coughing clears mucus from the airways, so silencing it is not the goal. Many over-the-counter syrups mix several drugs that can cause drowsiness, restlessness or a racing heart in young children. Indian health authorities have advised that cough and cold medicines should not be given to children under two, and are generally not recommended under five. Good treatment for a child's cough, in Kolkata or anywhere, starts with finding the cause, not reaching for a bottle. Never give an adult's syrup to a child.

When to see a child specialist doctor at Behala

Count your child's breaths for one full minute while they are calm or asleep, watching the chest or tummy rise. The WHO treats these as fast breathing in children under five:

• Under 2 months: 60 or more breaths a minute

• 2 to 12 months: 50 or more

• 1 to 5 years: 40 or more

For a child over five, more than about 30 breaths a minute at rest is fast and needs a doctor's check.

Go to a hospital emergency now if your child:

• has chest indrawing: the lower chest or the skin between the ribs sucks in with each breath

• has bluish or grey lips, tongue or face

• makes a harsh noise breathing in while at rest, or grunts with every breath

• is too breathless to talk, cry properly or feed

• breathes 60 or more times a minute at rest, at any age (in a baby under 2 months, this is already fast breathing)

• has pauses in breathing, or is unusually drowsy, floppy or hard to wake

• has choked on food or a small object (peanuts, chana, seeds, toy parts) and is still coughing, wheezing or struggling to breathe

• cannot drink, vomits everything, or has a fit

• has asthma and the reliever inhaler, given as the written action plan says, is not helping, or the relief lasts less than 4 hours

• is a baby under 3 months with a temperature of 38°C or more

MCR is an outpatient clinic. For any of these signs, go straight to the nearest hospital emergency; do not wait for a clinic appointment.

See a paediatrician the same day if your child:

• is breathing fast by the counts above but is alert, feeding and has no chest indrawing

• is feeding less than half the usual amount, or has far fewer wet nappies (or passes much less urine) than usual

• is wheezing for the first time

• has coughing fits, with or without a "whoop". Babies under 6 months may not whoop at all; if a coughing fit leaves a baby blue, limp or not breathing, go to a hospital emergency now.

• had a sudden choking or coughing episode while eating or playing, even if it seemed to settle

See a paediatrician within a day or two if your child:

• has had fever for more than two to three days (see when a child's fever needs a paediatrician)

• has a cold that gets worse after the first week

• has ear pain or discharge from the ear

• has a cough that wakes them most nights or ends in vomiting

• has had a cough for more than two weeks that is not getting better

• has any cough along with weight loss, poor appetite, fevers that keep coming back or night sweats, or lives with someone who has TB

Wheeze and asthma in children

A wheeze is a high-pitched whistle, usually as the child breathes out. Not every wheeze is asthma. In babies under two, a winter virus can inflame the small airways (bronchiolitis), and many toddlers wheeze only with colds, then outgrow it.

Asthma is more likely when wheeze or cough keeps coming back, is worse at night or early morning, or is set off by running, laughing, cold air or smoke, especially if the child has eczema or allergies, or there is asthma, allergy or eczema in the family.

In children under five, a paediatrician diagnoses asthma mainly from the history and examination; older children may also be asked to do a simple breathing test (spirometry or peak flow). Treatment usually means inhalers given through a spacer (with a face mask for small children); they send medicine straight into the airways and are not addictive. Do not stop a daily "preventer" without the doctor's advice, and ask for a written asthma action plan. The aim is a child who sleeps, plays and goes to school normally.

Allergic rhinitis: the "cold" that never quite leaves

Bouts of sneezing (often in the morning), a clear runny or blocked nose, itchy eyes, nose-rubbing, mouth breathing or snoring, usually without fever, point to allergic rhinitis rather than repeated infections. Common triggers are dust mites in mattresses, pillows and soft toys, dust, mould on walls left damp after the monsoon, cockroaches and smoke.

It is worth treating, as it disturbs sleep and concentration and often goes with asthma. Do not start antihistamines or nasal sprays on your own at any age; your paediatrician will choose the right treatment, often a prescribed nasal spray. Wash bedsheets and pillow covers weekly in hot water, sun-dry them, and dust with a damp cloth.

Less smoke indoors this winter

You cannot clean the outside air, but indoor smoke is in your hands.

• Mosquito coils: a coil in a closed bedroom means smoke all night. Bed nets, window mesh and full sleeves in the evening keep mosquitoes off without smoke.

• Agarbatti and dhuno: light them in an airy spot, away from your child, with a window open.

• Cooking: run an exhaust fan or chimney, and keep small children away while frying or adding phoron to hot oil.

• Tobacco: no smoking inside the home, ever.

• Firecracker nights: keep a child with asthma indoors, windows shut.

Vaccines guard against some serious chest infections too, including whooping cough, Hib, pneumococcal disease and measles. IAP recommends a yearly flu vaccine for all children from 6 months to 5 years, and for any child with asthma; ask your paediatrician when to give it, and about the rest of the national schedule (see our child vaccination schedule guide).

Paediatricians at MCR, Behala

If your child's cough will not settle and you want a paediatrician (pediatrician) near you in Behala, two of the doctors who see children at MCR are:

• Dr. Dikpati Mukherjee - 12 years of experience managing childhood illnesses and development. Consults in Bengali, Hindi and English. Fee Rs 800.

• Dr. Pallabi Hui - paediatrician, sees children by appointment.

For a child with asthma, a paediatrician close to home in Behala makes follow-up visits easy: the doctor can check inhaler technique and explain the plan in your language. See every MCR paediatrician on the paediatrics department page, and for a cough that keeps returning, see child specialist visits for cough, wheeze and allergy.

Blood or urine tests the doctor advises can be done at MCR's own pathology lab in the same building.

How to book at MCR: MCR Super Speciality Polyclinic & Pathology, 11A, Sourin Roy Road, near Behala Tram Depot, beside Ellora Cinema Hall, Behala, Kolkata 700034. Families come to us from Sarsuna, Thakurpukur, Joka, Parnasree, Barisha, Silpara, Taratala, New Alipore and Tollygunge.

The clinic is open Monday to Saturday, 8 AM to 8 PM; closed Sunday. Doctors' own timings differ, so confirm when you book. Call or WhatsApp 9830525004, or tap "Book Now" on the paediatrics department page.

Frequently asked questions

Is it normal for a cough to continue after a cold? Yes, a cough that is slowly getting better can last a couple of weeks. See a paediatrician if it lasts more than two weeks without improving or wakes your child most nights. Fast breathing needs a doctor the same day (a hospital emergency for a baby under 2 months); chest indrawing, blue lips or struggling to breathe need a hospital emergency now.

Does green or yellow mucus mean my child needs antibiotics? No. Mucus often changes colour during an ordinary viral cold. Only a doctor who has examined your child should decide on antibiotics.

Are inhalers safe for young children? Inhalers with a spacer are the standard way to give asthma medicine to children, including toddlers, and they are not addictive. Use them only as your paediatrician prescribes.

Can I give my child a cough syrup from the chemist? Not without a paediatrician's advice. Cough and cold medicines are not advised under two and are generally not recommended under five.

Which child specialist doctor at Behala can see my child for cough or wheeze? At MCR, paediatricians including Dr. Dikpati Mukherjee and Dr. Pallabi Hui see children; the full list is on the paediatrics department page. Call or WhatsApp 9830525004 to book. For chest indrawing, blue lips or severe breathlessness, go to a hospital emergency instead.

This article is general information, not a substitute for a consultation with a paediatrician who has examined your child.