My five-month-old son has had a persistent cough while being otherwise healthy for the past five weeks. A pediatrician said it sounded like bronchitis and suggested that I give my son Ventolin. I was hesitant to do so, as I had not heard any wheeze. I have asthma and it just didn't seem to me like my son has the same symptoms. Nevertheless, I gave him the Ventolin three times a day as the pediatrician suggested. My son seemed to get much worse within two days, so on the third day I suspended the medication. Later that day I heard him wheeze for the first time ever! After three more days he sounded a bit better, and my baby's health nurse recommended that I try the Ventolin again before returning to the pediatrician. Once again he is much worse.
He has had a chest X-ray which was clear and he seems happy and healthy except for this cough. I am afraid that giving him Ventolin has made him worse and/or given him asthma. Can this happen? If not, can a cough just be a persistent cough or could it be an indication of something worse?
The direct answer to your first question is: no, Ventolin (albuterol) doesn't and cannot cause asthma. But your concern brings up important questions about what wheezing and cough mean in the very young infant.
The most important clue you mention is that you heard wheezing, which means, at the very least, that your son's lungs are 'reactive'. With irritation from dust, infection, cold air, or mold -among other things, the muscles in your child's lungs are reacting by clamping down, making it harder to push air out, and creating the cough and the sound we hear as wheeze.
Asthma is only one of several possible reasons why kids wheeze. Reflux, if a child is very 'spitty', is another, as is infection. In young children especially, certain viruses and infectious agents can be so irritating to the lungs that children wheeze, even without asthma or the presence of asthma in the family. This can happen with each respiratory infection, but, unlike asthma, goes away after the first two years. So, right now, all you know for sure is that your son's lungs are reactive. Whether this is truly asthma or not remains to be seen.
Ventolin, however, is the right way to treat wheezing no matter what the cause. At times, so little air is getting in and out of the lungs that the wheeze is soft, but gets louder after treatment when the muscles relax and more air flows in and out. This may be why you hear more wheezing initially after treatment. Or it could be that the wheezing is waxing and waning as it is known to do. It is also possible that Ventolin is not enough to treat your son and that additional medicines are needed.
Any cough that lasts five weeks in a young child cannot be discarded as 'nothing', and needs an explanation. If the Ventolin isn't adequate to stop his symptoms, return to your pediatrician for another listen, additional medications, or the tests necessary to give you an explanation.