Clinical Reference Systems: Pediatric Advisor 10.0
- The cough reflex expels air and secretions from the lungs
with a sudden explosive noise.
- The cough can be dry and hacking or wet and productive.
- A coughing spasm is more than 5 minutes of continuous
Most coughs are caused by a viral infection of the trachea
(windpipe) or bronchi (larger air passages in the lungs).
These infections are called tracheitis and bronchitis,
respectively. Most children get such a viral infection a
couple of times a year as part of a cold. Keep in mind that
coughing clears the lungs and protects them from pneumonia.
Bronchitis isn't serious.
The role of milk in thickening the secretions is doubtful.
Usually bronchitis causes a dry tickly cough that lasts 2 to
3 weeks. Sometimes the cough becomes loose (wet) for a few
days, and your child coughs up a lot of phlegm (mucus).
This is usually a sign that the end of the illness is near.
- Medicines to loosen the cough and thin the secretions
- Cough drops: Most coughs in children over age
4 years can be controlled by sucking on cough drops
or hard candy freely. (The cough drops or candy coat
the irritated throat.)
- Homemade cough syrup: For children under age
4 years, use 1/2 to 1 teaspoon of corn syrup instead
of cough drops. (The corn syrup thins the secretions
and loosens the cough.)
- Warm liquids for coughing spasms: Warm liquids
usually relax the airway and loosen up the mucus.
Start with warm lemonade, warm apple juice, or warm
herbal tea. (Avoid this if your child is less than
4 months old.) Do not add liquor because it may
aggravate the cough if your child inhales the fumes
of alcohol into his lungs. Also, your child could
become intoxicated from an unintentional overdose.
- Cough-suppressant medicines
Cough-suppressant drugs reduce the cough reflex.
However, the cough reflex helps protect the lungs. Use
cough-suppressant drugs only for dry coughs that
interfere with sleep, school attendance, or work. They
also help children who have chest pain from coughing
spasms. Do not give them to infants less than 1 year
old or for wet coughs.
Most nonprescription cough suppressants contain
dextromethorphan (DM). Your child needs the medicine
recommended by your physician.
You may want to give your child corn syrup during the
day and DM at bedtime and during the night. DM is also
available as a cough lozenge and as a long-acting liquid
(effective for 12 hours).
- Humidifiers in the treatment of cough
Dry air tends to make coughs worse. Dry coughs can be
loosened up by encouraging your child to drink a lot and
by using a humidifier in your child's bedroom.
The new ultrasonic humidifiers are very quiet and they
kill molds and most bacteria that might be in the water.
If possible, use distilled water instead of tap water in
the humidifier. The Environmental Protection Agency
reported in 1988 that tap water may contain harmful
minerals (such as lead and asbestos). If these minerals
are in your tap water, they will also be in the mist
produced by the humidifier. Frequent inhaling of these
particles may cause chronic lung problems. Don't add
medication to the water in the humidifier because it
irritates the cough in some children.
Teenagers and other schoolchildren will find that gym
and exercise trigger coughing spasms when they have
bronchitis. If so, they should avoid such physical
- Active and passive smoking
Don't let anyone smoke around your coughing child.
Remind the teenager who smokes that his cough may last
weeks longer than it would without smoking.
- Common mistakes in treating cough
Antihistamines, decongestants, and antipyretics are
found in many cough syrups. There is no proof that
these ingredients will help your child's cough, and the
antihistamines may make your child sleepy. Expectorants
are of unproven value but harmless. Stay with the
simple remedies mentioned above or use dextromethorphan
Milk does not need to be eliminated from the diet.
Restricting it improves the cough only if your child is
allergic to milk.
Never stop breast-feeding because of a cough.
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- Breathing becomes difficult AND is not better after you
clear the nose.
- Breathing becomes fast or labored (when your child is not
- Your child starts acting very sick.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- A fever (over 100ƒF, or 37.8ƒC) lasts more than 3 days.
- The cough lasts more than 3 weeks.
- You have other concerns or questions.