Pharmamum’s Ultimate Guide: Cough
I went to the doctor today with my 4 year old daughter. For the last 4 days she has been coughing and coughing to the point it has caused her to vomit. My doctor said it was viral and there is not much you can give a young child with a cough. It will just subside on its own.
As a pharmacist and a mother of 2 under the age of 4, I am continually being presented with coughs, from my own children as well as giving advice to parents wanting to know what to do with their children’s cough.
In 2012, the Therapeutics Goods of Australia changed the recommendations for cough and cold preparations as a result of a review of safety and efficacy for over the counter cough and cold medicine used in children. It was found that these medicines may cause harm to children and the benefits have not been proven for children under 6 years of age.
When you think about why a baby/child has a cough and what their little bodies are trying to do, it is obvious that they are trying to clear and expel what is irritating their airways. If you give your child a cough suppressant, it will suppress your baby/child’s cough and stop what their body is trying to do.
So what causes a baby/child to have a cough?
Virus- Both bacterial and viral infections can cause a cough however the most common reason a baby has a cough is due to a virus causing an upper or lower respiratory tract infection.
Asthma -Asthma will not be formally diagnosed until your child is 5 years old. However around 70% of children have intermittent asthma, which means they have short, isolated episodes of asthma, usually in response to a respiratory infection or environmental allergen.
Post nasal drip– A cold/flu may start out as congestion in the nasal passage and then often the excess fluid will drip down the back of the throat, irritating the airways and causing a cough. Often by the morning a phlegmy sounding cough arises, as the body is trying to expel the buildup of mucus.
Irritants- Cold air, cold food eg. milkshakes, ice-cream all constrict the airways and trigger a cough. Other Irritants eg smoke and allergens eg. pollen also can a trigger a cough.
So when a parent comes in to the pharmacy, what advice do I give them? I give the advice that works for me with my children:
1.Hedera helix (Ivy leaf extract) – There are a few different brands currently on the market eg Prospan and Little coughs. Prospan is more concentrated than Little coughs. With my eldest daughter Prospan causes her to vomit whereas my youngest can take it with no ill effects. However they both can take the less concentrated Little Cough liquid with no side effects. In 2% of children, Ivy leaf extract can cause vomiting or diarrhoea, it is worth trying as it has been proven to be effective. Ivy leaf extract does not suppress a cough. It loosens mucus so that your baby/child can cough up the mucus and get it off their chest. It also has a soothing effect on the airways and stops the cough that ‘hurts’ whilst relaxes the airways. It can be used in infants and children and is the only cough medicine available and safe for children under 6 years of age.
2. A vaporiser- A vaporiser won’t necessarily stop a cough but it adds moisture to the air in your baby/child’s room. This allows your baby to breathe more comfortably and stops the cold dry air hitting the airways, which often triggers the airway to constrict and cause your baby/child to cough. I recommend just water in the vaporiser as the steam generated is what makes your baby/child breathe easier. I would not recommend the use of menthol/eucalyptus inhalant liquids in the vaporiser until your baby is over 2 years of age for the relief of nasal congestion. Once eucalyptus is added to a vaporiser, always keep the door open to prevent the eucalyptus concentration building up in the room. I would also recommend on those cold nights, if you have heating, to make your child’s bedroom temperature around 19-20 degrees, just for the same reason, it stops the cold air hitting the lungs and tightening.
3. Baby Vicks eucalyptus rub- Rubbing the Vicks on your baby’s feet and putting socks on, really helps a cough. I honestly don’t know how it works but whenever I rub it on my children’s feet, they often have a better nights sleep with a lot less coughing. Vicks BabyBalsam is also great on the chest so the vapour can help a blocked nose. Vicks BabyBalsam can be used from 3 months of age.
4. Speak to your doctor- If the above options are not helping, I would recommend speaking to your family doctor, as once they listen to your baby/child’s chest they may recommend an inhaler that will open and relax the smooth muscle in the airways and/or an anti-inflammatory inhaler. Sometimes oral medication may be prescribed too ( eg a corticosteroid liquid). Often when a baby/child has a virus they can get what is called a ‘post viral asthma’ where the body produces mucus to try and kill the virus and remove it from the body. This mucus production that sits in the airways narrows the airways causing them to constrict. An inhaler relaxes the smooth muscle allowing your child to breath easier and obtain more oxygen. If an inhaler is recommended, a spacer with a mask is important to use to ensure the medication gets to the airways. Obviously a baby would not understand to breath in through the mouth, so using a mask will ensure your child/baby will be breathing in the medication and it will reach the lungs. Once the airways are relaxed, you may notice your baby coughing more initially, as the mucus loosens and expelled. Your doctor will also need to assess whether antibiotics are required. Most commonly a cough is due to a virus and antibiotics will not help, however your doctor will need to gather information from you and make an informed decision.
Unfortunately there is no way of preventing a cough and a cough can often linger on for a couple of weeks after a cold/virus. However if a child is otherwise happy and going about their daily activities with no problem whilst their cough persists, then there is no cause for concern, the cough will pass. However if there are any of the following symptoms, it is very important to see your local doctor:
- Your child has difficulty in breathing and you are hearing a wheezing sound on their breath out
- When your child coughs, there is a ‘whooping’ sound on their breath in.
- Your child gets out of breath when coughing
- Your child’s cough comes on suddenly with a fever
- If your child’s skin turns very pale or even a blue colour whilst coughing
- The cough is just not going away
- You can give a baby older than 1 year, a teaspoon of honey which may give some short term relief by coating the lining of the throat which acts as a barrier to irritants.
- Give your child warm (not hot) drinks.The warm liquid will often help soothe the airways.
- Avoid cold drinks and ice cream, as you will notice it sets off a cough.
- Avoid air conditioners, this will often exacerbate a cough.
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also if you tried a remedy that worked well for your children that was or wasn’t mentioned above, let me know. I hope this information does help.
Disclaimer – The material on this blog is only to be used for informational purposes only. As each individual situation is unique, you should use proper discretion, in consultation with a health care practitioner, before applying the methods, medicines, techniques or otherwise described herein. The author and publisher expressly disclaim responsibility for any adverse effects that may result from the use or application of the information contained herein.