When to treat a cough

It’s an understandable desire among parents to do something when their child has a persistent cough. But experts — including the Food and Drug Administration and the American Academy of Pediatrics — say that over-the-counter cough and cold medicines don’t work for young children, and may be harmful.

“If symptoms aren’t bothering your child, they don’t need medicine or home remedies,” said Dr. Monica Gonzales, a pediatrician at University Health System. “Many children with a cough or nasal congestion are happy, play normally, and sleep peacefully. Only treat symptoms if they cause discomfort, interrupt sleep or really bother your child, such as a hacking cough.”

A new study published in JAMA Pediatrics found that giving young children agave nectar or even a placebo treatment of sweet, colored water reduced coughing at night better than doing nothing.  Either treatment eased symptoms about equally.

Dr. Gonzales typically recommends home remedies for bothersome coughs in children, depending on their age:

For children ages 3 months to 1 year: Give warm, clear fluids such as warm water or apple juice. A dose of one to three teaspoons (5 to 15 mL) four times a day can ease symptoms. Avoid honey with children younger than 1 year because of the risk of botulism. If the child is younger than 3 months, see the child’s pediatrician.

For children 1 year and older: These children can take one-half to one teaspoon (2 to 5 mL) of honey as needed. Honey thins secretions and loosens the cough. If honey isn’t available, corn syrup is an acceptable substitute. Dr. Gonzales says recent research has shown that honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing.

For children 6 years and older: Cough drops or hard candy can be used to coat the irritated throat.

In addition, make sure to give plenty of fluids. Good hydration thins the body’s secretions, making it easier to cough and blow the nose. If the air in your home is dry, use a humidifier to moisten the air, which keeps nasal mucus from drying up and lubricates the airway. Running a warm shower for a while can also help humidify the air.

Exposing your child to the warm mist from a shower can also ease coughing spasms.

Dr. Gonzales says she tells parents that while these steps can ease symptoms, the cause of those symptoms is often the common cold — which is caused by viruses that don’t yet have a cure. Antibiotics don’t work against vial infections.

Acetaminophen or ibuprofen do not treat cough, she added. These medications treat pain or fever temporarily.

But sometimes a cough can result from a more serious illness, Dr. Gonzales said.

“Sometimes cough can be due to other reasons such as asthma or pneumonia. All children  12 months or younger with a cough should be evaluated by a doctor, as they might have a more serious condition. Infants can become seriously ill very quickly. Older children with a cough that persists longer than one week and is not improving should be seen by a doctor. Any infant or child with cough and fever or respiratory distress should be evaluated by a doctor.”

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