Winter is in full swing, and with the cold temperatures, I see many families being hit by respiratory illnesses. The viruses circulating this time of year tend to bring an onslaught of symptoms including runny noses, high fevers, and sore throats. But a more concerning symptom, which often develops and can be tough to get rid of, is coughing.
Coughing is a common symptom of many viral illnesses. It can also sometimes be a symptom of a bacterial illness, like pneumonia. The severity and type of cough your child may experience can range from a mild and non-productive dry cough to a severe and productive wet cough. While there are a million different types and tones of coughs, one thing is always consistent, coughing is miserable, whether you are the child who is coughing or the parent who is listening.
Parents usually reach for ibuprofen or acetaminophen to ease the pain of a sore throat or treat a fever. They use saline and suction for stuffy noses. However, treating a cough can present a few more challenges. Should you give medications to your coughing child? When should you take them to your pediatric care provider, urgent care, or even the emergency room?
When A Cough Is A Symptom Of Respiratory Distress
Sometimes a cough is so severe that it requires emergent care. If your child is unable to breath, has a bluish color to their face or lips, is drooling, is having severe retractions (sucking in of the ribs while breathing), or seems to be struggling to move air in and out of their lungs, it is possible your child is in respiratory distress — do not delay calling 911 or getting to the closest emergency room.
Cough Medicine And Kids Under Four Years Old
I know this post is titled how to treat a cough without medicine, but before we get to those tips, I want to tell you why we are looking outside of the medicine cabinet to treat your child’s cough, especially if they are under four years old.
Medications can often help alleviate the symptoms of the common cold. Until about ten years ago, many over-the-counter medications containing dextromethorphan, phenylephrine, and pseudoephedrine were advertised for young children to help relieve their cough. These include medications with the brand names Dimetapp, Delsym, Robitussin, and Mucinex Cough, among others. A lot of parents still believe the use of these medications are safe.
As of 2008, the FDA and American Academy of Pediatrics no longer recommend these cough suppressing medications for children under the age of four years old due to the danger of severe side effects and accidental overdose. Furthermore, a small trial of 100 children showed dextromethorphan and diphenhydramine (Benadryl) to be ineffective for night time cough in children. Pseudoephedrine and phenylephrine are not safe for young children due to their stimulant effects which can cause high blood pressure and seizures. Cough drops are also unsafe for children under four years old and should be used with caution in older children, mainly due to the risk of choking.
How To Treat Coughing Without Medicine
So what’s a parent to do? Let’s look at some safe, proven and effective ways to treat a cough without medicine. These methods are great for your young kids who can’t take cough medicine and for older kids (or even parents) who are dealing with a cough.
- Warm water with 1-2 teaspoons of honey. This is one of the easiest ways to help soothe the cough reflex. It’s especially helpful before naps and at bedtime, as most coughs worsen after a child lays down. Do not give honey to babies under 12 months of age.
- Humidified air is another helpful way to thin out mucus in the lungs and make is easier for your child to cough out secretions. A simple humidifier placed near a child’s bed or crib is effective, as well as steam in a bathroom created by turning on a hot shower.
- Pushing fluids (preferably water) can also help hydrate stubborn mucus making it easier to clear. Milk and dairy products tend to cause increased mucus production, so limit dairy in children over the age of 12 months. Babies under 12 months drinking breastmilk or formula should continue doing so as normal.
- Elevate the head of your child’s bed. You can do this by adding an extra pillow, or by placing a few books underneath your child’s mattress. This will allow them to sleep in a more upright position and prevent mucus from settling in their lungs to allow for a more restful sleep. Take caution when propping the mattress of a baby under 12 months to ensure they don’t roll or slouch down in their crib as this can increase the risk of SIDS.
Coughing can definitely be a stubborn and lingering symptom after a viral illness and can last for several weeks. In most cases, that is okay, and supportive care can help your child find relief with the methods described above and a whole lot of extra love and cuddles. But, sometimes, children develop a constant, nagging cough that just won’t go away.
At what point should you take your child to be evaluated by their pediatric provider? The simple answer is, it’s never a bad idea to have your child’s lungs evaluated. If you’re on the fence about whether or not to call your pediatric provider’s office, go ahead and do it.
A few things to watch when your child has a persistent cough:
- A cough requires prompt attention if it isn’t getting gradually better over the course of a couple weeks, or if it suddenly gets worse and is accompanied by a fever.
- Additionally, a cough that is dry and persistent (sometimes described as “hacking”) could be a sign of wheezing and definitely needs attention.
- Babies under six months, as well as children with a history of asthma, should be checked out if their cough is at all concerning.
Prevention of the nasty bugs that often cause coughing is best achieved by frequent hand washing, avoiding sick people and getting your family a flu shot. Stay healthy this winter, and if your child does develop a cough, these tips will help you get through the rough days ahead.
Guest Writer: Brenna Allsuch, Pediatric RN and KidNurse Community Moderator