It’s that time of year again. In the middle of the night, your child can’t stop coughing. Is it just a cold or something worse? And considering the warnings from the American Academy of Pediatrics (AAP) and the Food and Drug Administration (FDA) about the overdosing and ineffectiveness of over-the-counter cough and cold medications for young children and babies, what’s a weary parent to do?
First, remember that, according to Dr. Daniel Rauch, MD, FAAP, director of the pediatric hospitalist program at New York University School of Medicine, “You want them to cough. You want them to clear out the mucus. You don’t want to suppress it at all.”
Then, you should try to determine what type of cough your child has. “If it’s a bad cold, they have to get through it,” says Dr. Rauch.
Parents should be concerned if the cough lasts longer than a week, disrupts the child’s sleep, and leads to vomiting up phlegm. While a dry, hacking cough can signal an upper respiratory infection like the cold or flu, it can also be bronchiolitis, an infection that causes inflammation of the smallest airways in the lungs and makes breathing difficult. If the child is asthmatic, frequent coughing — whether it’s dry or wet — can be a reaction to an asthma trigger such as cigarette smoke, dust mites or other irritants. “If the cough is lingering, the asthma problem is not being treated,” says Dr. Rauch. “What you want to do is treat their asthma by discussing the best options with your pediatrician.”
It’s also possible that the illness is viral. “There are certain viral illnesses that damage the lungs, and it takes a long time to get over them,” he explains. One of these is the under-diagnosed pertussis, also known as whooping cough. Rapid coughing fits followed by a “whooping” sound upon the next breath can indicate whooping cough, especially if the symptoms are similar to a cold but worse, particularly at night. Dr. Rauch recommends that kids get vaccinated (part of the routine schedule of vaccinations).
An infection of the upper airway can also be croup, which leads to a swelling beneath the vocal chords, causing a “barking” cough or a high pitched sound when inhaling. Croup is treatable with antibiotics.
What can you do to make your child feel better in the interim? Of the AAP and FDA findings, Dr. Rauch explains that it’s not the pseudoephedrine itself, found in many over-the-counter cold medicines, that is harmful. It’s the fact that it’s easy to overdose on the substance and others if medicines are combined (for example, taking one medication for fever, and another that contains the same ingredient for cough/stuffy nose). Besides, over-the-counter cough and cold medicine is not approved for children under age 2 and was found to be ineffective in children under 6.
As an alternative, Dr. Rauch suggests that decongestants like Benadryl, under the guidance of your doctor, can help. “When you decongest, you get rid of the nasal drip, which is the cause of the cough,” he explains.
If a child has a fever, Dr. Rauch advises watching her behavior carefully to see if she really needs medication. “A lot of doctors are starting to say fevers are a child’s friend: the increased temperature is the body’s way of fighting off the disease. A fever doesn’t necessarily mean children need Tylenol or Motrin,” he says. “It can make them feel better, but if you have to chase them around to get them to take it, then they probably don’t need it. If they’re moping, achy and whiny, Tylenol or Motrin is certainly worthwhile.”
Just make sure to tell your doctor what your child is already taking and get his okay.
Buy a humidifier or vaporizer to keep the air moist. Maintaining a humid environment in the house, especially in your child’s bedroom, is important for upper airways, as dry heat causes nasal passages to swell and secrete mucus. “The post nasal drip is what causes the coughing,” says Dr. Rauch. So stay hydrated to keep the mucus membranes from drying out.Just make sure you frequently clean these devices, as they can get contaminated with molds.
Consider zinc supplements, which have been proven to help fight a cold, as well as the daily allowance of vitamin C.
For children on antibiotics, supplementing with acidophilus, also found in yogurt, can help replenish the good bacteria that are killed off by the antibiotics, leading to better digestion. Make sure to check with the doctor to make sure it doesn’t interfere with any medications.
Stay Healthy This Winter
While it’s true that “there are certain illnesses that go with certain times of the year,” according to Dr. Daniel Rauch, MD, FAAP, that doesn’t mean it’s inevitable that your kids will get sick this winter.He shares some tips for keeping kids healthy:
• Have kids wash their hands frequently. And when they’re done, wash their hands again! (Hand sanitizers count).
• Wipe down bedding like mattress and pillow covers, and get rid of carpets and drapes that can trap dust.
• Keep kids out of gyms, a breeding ground for infectious diseases.
• Keep kids away from cigarette smoke. Even if you don’t smoke in front of the kids or in the house, smoke lingers on your clothes and can irritate your child’s cold or asthma.
• Make sure children and teens receive the recommended schedule of vaccinations, including the whooping cough vaccine.