Symptoms of a toddler

Question

My 2-year-old daughter has the following symptoms - my question is if it could be CF underlying and how this could be tested. She wakes up several times at night - 5 to 10 times -, very flat breathing with sounds, very light sleep, almost always a light cold, with rhinitis it is turning worse, slient reflux has been diagnosed, however we have been told, it could not be treated at this age. She is during the day often tired, however she does not sleep; she is moving quite few, does most things in a sitting position; she is often vomiting in the car and it is then very slimy. Thanks.

Answer

Hello,
you report that your 2.5 year-old daughter is sleeping quite uneasily and wakes up 5-10 times at night. Her breath would be quite superficial and is accompanied by a slight noise. In case of rhinitis the symptoms got worse. Your child would be very tired and would not move to much. In the car, she vomits quite often. You ask, if these symptoms could speak for CF.
As you do not report about severe infections of the airways as e.g. several pneumonias and also you do not report suspicious stools or a failure to thrive, the suspicion of CF is improbable.
The symptoms hint rather at quite narrow airways in the nasal-pharyngeal space. This is not so seldom in toddlers, as they partly have still very narrow nasal ways. An ENT specialist should however be consulted, as the tiredness of your child point at an impaired night sleep that does not allow a sufficient recreation.
Of course the symptoms could also be caused by the so-called silent reflux in your child. This could be for sure clarified at a paediatric gastro-enterologist and he could also advise you respectively.
Many toddlers do not tolerate journeys in the car and react with vomiting. Drives with cars that are very much sprung (that "swim") enhance this problem. Mostly this is going to get better already before coming to school. If the vomiting takes place after a great distance to the last meal, only gastric juice mixed with swallowed nasal secretions can be vomited. Also such slimy mixtures when vomiting are not suspicious for CF.
If you are not calmed by our advice, you can ask your pediatrician to send you to a CF center. There it can for sure be clarified with a sweat test, if your child suffers from CF.
I hope to have calmed you a bit with my remarks.
Best regards,
Dr. H.-G. Posselt

16.01.2017