A 7-month-old baby presents with a cough and wheezing. What is the most appropriate initial management?

In the case of a 7-month-old baby presenting with cough and wheezing, supportive care is indeed the most appropriate initial management. This approach focuses on alleviating symptoms and providing comfort while allowing the body's immune system to respond naturally to any underlying viral infections, which are common in young children.

Supportive care can include maintaining adequate hydration, using a humidifier, and providing a calm environment to help soothe the child. In many cases of wheezing in infants, especially when associated with viral illnesses like bronchiolitis, the symptoms can improve without immediate pharmacological intervention.

While nebulized salbutamol may be used to relieve wheezing in certain situations, particularly in cases of asthma or severe bronchospasm, it is not typically the first approach in infants unless there is significant respiratory distress or a prior history of wheezing. The use of steroids, whether orally in the form of prednisolone or intravenously, is generally reserved for more severe cases or when there is a suspicion of underlying conditions like allergic asthma, rather than as an initial treatment for wheezing without more alarming symptoms.

Thus, prioritizing supportive care helps manage the patient’s condition effectively while monitoring for any potential worsening that might require more aggressive intervention.