Cough

What to Do if Your Child Has a Cough

Coughing is a natural reflex that allows people to clear their lungs and upper airways. Coughing in children is extremely common. It can be very bothersome to children and their families and can be difficult to treat. It also can be confusing, as there are several different possible causes of cough. These include viral infections, bacterial infections, asthma, and toys or food “going down the wrong tube.” Here we are going to focus on viral coughs since they are by far the most common. If you have questions or concerns about other possible causes of cough in your child please call the office.

The Common Cold Viruses are the single most common cause of cough in children. So chances are, if you child is coughing, a virus is to blame. Children with viral infections often also have a running or stuffy nose and a fever. Unfortunately, there is no specific medication your doctor can prescribe that can treat a virus. Antibiotics make no difference in coughs caused by a virus. Despite all the advances of medicine, we still have not defeated the common cold!

Cough from a virus can be the last symptom of the infection to go away and can last up to 2-3 weeks. As long as your child is active and eating and drinking you do not need to be seen by the doctor for a cough following a common cold infection.

Though no treatment can eliminate cough altogether there are many remedies and over-the-counter treatments. Some can be helpful, some may be of no use, and a few can even be dangerous!

Recommended Treatments

These have been shown to have some benefits and minimal risks.

Vicks Vapor rub

This treatment is rubbed on the chest or feet. This treatment can be used on children of any age.

Honey

This treatment can only be used in children who are at least one year old. Honey is given mixed in liquid or directly on a spoon. In children who are old enough to have this treatment, it has been shown to be as effective or even more effective than cough syrups.

Cool Mist Humidifier

Dry air can further irritate the throat and airways, so it can be helpful to keep the air moist with a vaporizer in a child’s room at night. We do NOT recommend the hot steam vaporizers, as they have a risk of accidental burns from the steam. It is also important that your regularly clean your humidifier as per the manufacture’s instructions.

Not Recommended

These treatments are not very helpful, and can have serious side effects.

Cough Syrups

One of the biggest problems with cough syrup is that they make it extremely difficult to know which medications you are giving your child. The same brand name company can make products with 6 or 7 different medications. In addition, multi-drug combination products are everywhere, further confusing the issue. Just because they are sold over the counter for children does not make them all safe. We do not recommend using cough syrups for any child younger than 6 years of age. Even in children who are old enough, we strongly urge you to read the ingredients carefully so that you know what you are giving your child. One ingredient to watch out for is Dextromethorphan, found in Robitussin syrup, Delsym syrup, and Dayquil. It can be dangerous in young children and if too much is given in older children it can cause sedation or altered mental status.

Albuterol (Ventolin, Proventil)

Unless your child already has a diagnosis of asthma, this mediation is not going to help their cough. This medication requires a prescription, but it is common for parents to use medication that has been prescribed for another family member. If you think your child might be wheezing or have asthma you need to seek care with your pediatrician. For children without asthma, Albuterol does not have any impact on their cough.

References:

Paul IM, Beiler JS, King TS, et al. Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms. Pediatrics 2010; 126:1092.

Cohen HA, Rozen J, Kristal H, et al. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study. Pediatrics 2012; 130:465.

Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database Syst Rev 2012; 3:CD007094.

American Academy of Pediatrics. Caring for a child with a viral infection.http://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Caring-for-a-Child-with-a-Viral-Infection.aspx.

Ebrahim MK, Bang RL, Lari AR. Scald accidents during water aerosol inhalation in infants. Burns 1990; 16:291.

Use of codeine- and dextromethorphan-containing cough remedies in children. American Academy of Pediatrics. Committee on Drugs. Pediatrics 1997; 99:918.

Smucny JJ, Flynn CA, Becker LA, Glazier RH. Are beta2-agonists effective treatment for acute bronchitis or acute cough in patients without underlying pulmonary disease? A systematic review. J Fam Pract 2001; 50:945.