Q: My 20-month-old is vomiting from severe coughing. Can I use a Pulmicort nebulizer at home?

Sep 4

2 min read

Updated: Sep 7

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My 20-month-old boy (11.9 kg) has been taking medication for a cold and a cough for three days. Since yesterday, he has been coughing so hard that he threw up. He vomited quite a bit twice after waking up, and today he threw up a little bit twice again while coughing. He has a history of a febrile seizure at 17 months, so I have been giving him fever reducers whenever his temperature exceeds 37.5°C. Today, his temperature reached 37.7°C, so I gave him 4 ml of Dexibuprofen. He mostly coughs at night. I have some leftover Pulmicort at home—is it safe to give him a nebulizer treatment with it?

Answer:

It can be very distressing to see your little one struggling with a cough and vomiting.

Understanding the Vomiting:

Vomiting after a coughing fit is actually quite common in toddlers around 20 months of age. A strong cough reflex increases abdominal pressure, which can easily lead to vomiting, especially if the child has recently eaten or has a lot of mucus and phlegm.

Regarding the Nebulizer:

• Pulmicort (Budesonide): Please do not use this medication without a doctor's direct prescription for his current illness.

• Normal Saline: You can safely use a normal saline solution in the nebulizer instead. Using a saline nebulizer for 5–10 minutes, 2–3 times a day, can safely help loosen the phlegm and ease his cough.

Immediate Steps You Can Take at Home:

Elevate his head and shoulders by about 15–30 degrees while he sleeps to help clear his airways.
Use a humidifier to maintain a comfortable indoor humidity level of 40–60%.
Offer him warm water frequently to keep his throat moist and help thin the mucus.
Feed him smaller, more frequent meals rather than large portions to reduce the risk of vomiting.

Regarding Fever and Seizures:

Please note that using antipyretics (fever reducers) does not reliably prevent febrile seizures. However, you can and should continue to give them if the fever is making your child fussy or uncomfortable.

When to See a Doctor:

Please visit your pediatrician for an in-person evaluation, or seek immediate medical care if you observe any of the following signs:

• His breathing becomes unusually fast, or you hear wheezing.

• A fever of 38°C (100.4°F) or higher persists.

• The vomiting becomes more frequent or severe.

• He refuses to drink any fluids, showing signs of dehydration.