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EDITORIALS: Dominic Cochran Diagnosing and treating chesty infants BMJ 1998; 316: 1546-1547 [Full text]

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Children with cough

Frank Brennan   (23 May 1998)

Personal questions for Dr. Cochran

David E Bratt   (24 May 1998)

Children with cough 23 May 1998
Frank Brennan, General Practitioner Dublin, Ireland Send response to journal: Re: Children with cough	Dear Editor I read with interest Dr. Cochran's editorial in the BMJ of 23.05.1998. The bulk of infants and toddlers with recurrent cough that I would see in General Practice come from households of smoking parents, but by contrast, I seldom see chesty children from non-smoking households. This makes me conclude that smoke is possibly the most important factor in these children's illness. Many of these children are diagnosed (correctly I believe) with asthma and treated with inhaled steroids or bronchodilators. However, I believe we do many of these children a disservice by labeling them as asthmatics because it implies that they have some intrinsic disease. I think the term 'smoker's cough' though abrupt (and somewhat controversial!) is more appropriate as it powerfully conveys to parents that they are partly responsible for their child's illness. I think it is about time we redressed the balance in favour of prevention in favour of prevention rather than 'cure', Yours faithfully Dr Frank Brennan 48 Summerville Clontarf Dublin 3 Ireland
Personal questions for Dr. Cochran 24 May 1998
David E Bratt, Self employed idem Send response to journal: Re: Personal questions for Dr. Cochran	Very interesting reading. I would like to ask two questions. What are the references for "the two week trial of oral corticisteroids used in older patients.."? Given the difficulty of obtaining compliance with inhaled corticosteroids in infants, why not a similar oral trial, for the infants of say, five to seven days? DB