Is Your Child's Cough, Just a Cough?

Your child has been up coughing all night…again. Your medicine cabinet has a collection that rivals any drug store’s “cough and cold” aisle- and none of it is working. You are not alone. My waiting room is full of bleary-eyed-up-all-night parents of coughing kids.

Unfortunately, studies have shown that cough medicines and decongestants are no more effective than sugar pills in improving cold symptoms in children. These medications do, however, come with a long list of potential side effects- including things like decreased respiratory drive, lethargy, and changes in mental status. Cough and cold medications are not recommended for children for these reasons. So what can you do to help with your child’s cold symptoms?

  • Honey. There is some evidence that honey can help with cough. Try a teaspoon of honey (it doesn’t matter what kind) before bed and as needed throughout the day. Cough medicines touting honey as the main ingredient are just a more expensive way to get the same results. Honey is not recommended for children under one year of age due to the risk of botulism (I get lots of raised eyebrows when I mention that).
  • Vapor Rub. One study showed that vapor rub (containing camphor, menthol, and eucalyptus oils) applied to the chest subjectively relieved children’s cough and congestion symptoms and improved their parents’ night sleep. Strong scents can make symptoms worse for kids with allergies and asthma, so avoid it in those cases.
  • Humidifiers. Research shows no improvement in cold/cough symptoms with humidified air. Humidifiers can become a breeding ground for more germs if not carefully cleaned between each use. Additionally, humid air can worsen symptoms for allergy-sufferers. One exception is for children with “croup.” Croup is a viral infection that causes swelling of the upper airway. It produces a “barking” cough (which sounds like a seal), a hoarse voice, and sometimes a noisy whistling sound with breathing (call your doctor if this whistling sound occurs). Moist air (from a steam-filled bathroom with the shower running) or cool night air can help children with croup. Remember not to leave your child unattended near a steamy shower (or any water).

The truth about snot

Many people think that dark green or brown mucus is indicative of a bacterial infection. Studies show, however, that the color of mucus does not distinguish whether the infection is viral or bacterial. Therefore, green/brown/yellow snot does not mean that antibiotics are indicated.

Coughs from viral colds can linger for up to four weeks, and the average child gets up to ten colds a year (do the math- that’s a lot of coughing!). You should keep your kids home from school if they have a fever or if you think they are too uncomfortable to be able to pay attention at school. Children are most contagious for the first few days of cold symptoms, but they can continue to spread the virus for several weeks after the cold. Obviously it isn’t practical to keep them home from school for weeks with a cold, so it’s very important to encourage hand washing.

When should you call the doctor? If your child is breathing quickly or working hard to breathe, you need to call your doctor or 9-1-1 depending on the severity of symptoms. If your child has asthma, call the doctor sooner rather than later (your child may need steroids, and early treatment will prevent your child from getting sicker). Call your doctor for persistent fever (greater than 100.4 for more than five days) or if the cough is getting worse instead of better over several days.

For more information, contact your Riley Physician or schedule an appointment with a Riley Physician by calling 844.8.IUHealth.

Danielle N. Wiese, MD

Author of this Article

Danielle N. Wiese, MD is a pediatrician who follows the recommendations of the American Academy of Pediatrics. She practices at Riley Physicians Pediatrics - IU Health North. Dr. Wiese earned her medical degree from the Indiana University School of Medicine and completed a residency at Nationwide Children's Hospital with the Ohio State University. She is an Indianapolis resident along with her husband and daughter Noelle.

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