COLD AND COUGH IN CHILDREN

Cough

Coughing is an important way to keep your throat and airways clear. However, excessive coughing may mean you have an underlying disease or disorder.

Some coughs are dry, while others are considered productive. A productive cough is one that brings up mucus. Mucus is also called phlegm or sputum.

Coughs can be either acute or chronic:

• Acute coughs usually begin suddenly and are often due to a cold, flu, or sinus infection. They usually go away after 3 weeks.
• Subacute coughs last 3 to 8 weeks.
• Chronic coughs last longer than 8 weeks.

Causes

Besides recent upper airways infections, such as the common cold and flu, other common causes of coughs include:

• Allergies and asthma
• Lung infections such as pneumonia or acute bronchitis
• Chronic obstructive pulmonary disease (emphysema or chronic bronchitis)
• Sinusitis leading to postnasal drip
• Lung disease such as bronchiectasis, interstitial lung disease, or tumors
• Gastroesophageal reflux disease (GERD)
• Cigarette smoking
• Exposure to secondhand smoke
• Exposure to air pollutants
• ACE inhibitors (medications used to control blood pressure)

Home Care

Although coughing can be a troubling symptom, it is usually your body's way of healing. Here are some tips to help ease your cough:

• If you have a dry, tickling cough, try cough drops or hard candy. NEVER give these to a child under age 3, because they can cause choking.
• Use a vaporizer or take a steamy shower. Both these things increase the moisture in the air and can help soothe a dry throat.
• Drink plenty of fluids. Liquids help thin the mucus in your throat and make it easier to cough it up.

NOTE: Medical experts have recommended against using cough and cold drugs in children under age 6. Talk to your doctor before your child takes any type of over-the-counter cough medicine, even if it is labeled for children. These medicines likely will not work for children, and they may have serious side effects.
Medications available without a prescription include:

• Guaifenesin helps break up mucus. Drink lots of fluids if you take this medicine.
• Decongestants help clear a runny nose and relieve postnasal drip. Do NOT give children under age 6 an over-the-counter decongestant unless specifically told to do so by your doctor. You should check with your doctor before taking decongestants if you have high blood pressure.

Do not expect a doctor to prescribe antibiotics for viral infections like colds or flu. Antibiotics do not work on viruses. Antibiotics also will not help coughs from allergies.

Diagnostic Tests:


The physical examination will include emphasis on the ears, nose, throat, and chest.
Diagnostic tests that may be performed include:

• Bronchoscopy
• Lung scan
• Pulmonary function tests
• Sputum analysis (if the cough produces sputum)
• X-ray of the chest

Prevention

• Don't smoke and stay away from secondhand smoke.
• If you have seasonal allergies like hay fever, stay indoors during days when airborne allergens are high. If possible, keep the windows closed and use an air conditioner. Avoid fans that draw in air from outdoors. Shower and change your clothes after being outside.
• If you have allergies year round, cover your pillows and mattress with dust mite covers, use an air purifier, and avoid pets and other triggers.

Please Note:

 Call your doctor immediately if you have

• • Shortness of breath or difficulty breathing
  • Hives or swollen face or throat with difficulty swallowing
  Call your doctor right away if you have:
  
  • Violent cough that begins suddenly
  • High-pitched sound (called stridor) when inhaling
  • Cough that produces blood
  • Fever (may indicate a bacterial infection requiring antibiotics)
  • Thick, foul-smelling, yellowish-green phlegm (may indicate a bacterial infection)
  • A history of heart disease, swelling in your legs, or a cough that worsens when you lie down (may indicate congestive heart failure)
  • Exposure to someone with tuberculosis
  • Unintentional weight loss or night sweats (may also indicate tuberculosis)
  • Cough longer than 10-14 days
  • Cough in an infant younger than 3 months old

Tips for treating common cold in kids


Treating a kid's cold is trickier than ever. Parents have long reached for over-the-counter cough and cold remedies, but it is no longer recommended  for children younger than four. And, the  investigation is on whether these drugs are safe for older kids.
One thing's clear: None of these over-the-counter medications can cure the common cold or make it go away any faster.

• Keep Them Home

Talk to any school teachers and you'll find that plenty of parents send their children to school or day care when they shouldn't. Don't be that parent.

If your child has a fever over 101 degrees, or any fever just as he is starting to get sick, keep him home, says the American and Indian Academy of Pediatrics (AAP and IAP). Even if your child doesn't have a sky-high fever, consider keeping him home if he's too sick to take part in school activities or if he is contagious.

Staying home may help your child get better more quickly and avoid spreading germs to his peers.

• Treat A Fever

A fever is a sign that your child is fighting her infection. If the fever climbs above 100.2 degrees and she has aches and pains, give her acetaminophen (Tylenol,Paracetamol) or ibuprofen (Advil,Brufen).

Use products and dosages recommended for your child's age (Never give a child aspirin because it's associated with Reye's syndrome.)

If your child is younger than three months old and has a rectal fever over 100.4 degrees Fahrenheit, or is between three months and three years old and has a temperature over 102.2 degrees Fahrenheit, seek immediate medical attention

• Prevent Dehydration

Keeping children well hydrated is especially important when they are sick.

There isn't one best fluid .Water, watered-down juice, flat ginger ale, and Pedialyte are all good.

Frozen Popsicles and even good old-fashioned chicken soup will also ensure that your child is sufficiently hydrated.

• Combat A Stuffy Nose

If your child is congested and having trouble breathing, one natural remedy is to clear the nose with saline drops. Nasal sprays and decongestants are not recommended for children.

Research suggests that children ages 6 to 10 who receive a nasal saline rinse recover faster from colds or flu.

Use two to three drops per nostril while the child is lying on their back. Then have your child gently blow her nose.

If your child is too young to blow her own nose, you can use a nasal bulb (available in drugstores) to suction out the gunk.

• Treat Irritated Skin

Constantly wiping a child's nose can make it red and sore. One way to prevent this is to wipe with a warm, wet cloth.

If your child does have an irritated nose despite your best efforts, gently rub Aquaphor or petroleum jelly on the area to soothe.

• Keep Their Hands Clean

By the time your child is old enough to start day care -- and get exposed to a steady stream of germs -- he is probably also old enough to wash his own hands.

Teach your children to wash their hands regularly, especially after coughing or sneezing and before eating. This habit can go a long way to stop the spread of disease and keep them healthy.

Hand sanitizers containing at least 60 percent alcohol can also be an easier way to get those little hands germ free!

• Consider Honey

Honey is not safe for children under the age of 1 because of the risk of infant botulism, but it may help soothe an older child's throat and cough.

In a study, giving half a teaspoon of honey to children ages 2 to 5 at bedtime seemed to suppress coughing, although more research is needed. (In the study, children ages 6 to 11 and 12 to 18 also benefited from 1 and 2 teaspoons of honey, respectively.)

While there isn't a lot of medicinal evidence that honey works to stop a cough, it may help the child feel a little better.

• Steam inhalation in a different way

If your child has a cough, especially the kind known as croupy cough, which sounds like hacking or barking, run a hot, steamy shower and bring her into the bathroom; it will help open up her airways. Aim for 15-minute sessions, four times a day.

The humidity relieves the upper-airway swelling that can cause the croupy cough.

• Try a humidifier

A cool-mist humidifier can be helpful because the mist can loosen any congestion and help your child breathe better. It is recommended to stay away from warm-mist humidifiers, as a child could get burned if she touches the humidifier.

Regardless of which humidifier you purchase, thoroughly clean and disinfect it at least every few days. Improper cleaning (or none at all) could allow mold and bacteria to grow inside.

• Let the child rest

To help your child get better as fast as possible, make sure she gets adequate rest every night.

Children need at least 8 to 12 hours of sleep every night, depending on their age.Getting enough sleep can help prevent getting colds.If your child is already sick, she might need even more sleep than usual.

• Be smart with antibiotics

Antibiotics can treat some bacterial infections, but these types of infections are usually not what ails your child.

Colds cannot be treated with an antibiotic since colds are caused by a virus. Antibiotics do not have any effect on a cold and are not a useful treatment.

Plus, unnecessary antibiotic use can cause immunity to the medication and the spread of antibiotic-resistant bacteria.

Unfortunately, there are no antivirals for the cold-causing virus. Flu antivirals may be given to kids with conditions like asthma that make it harder for them to fight the flu.

• Skip the cough syrup

Don't worry about a child's daytime cough, as it can help release phlegm and reduce congestion. Coughs usually go away on their own in three to five days.

If your child is older than 4 years old and has trouble sleeping at night because of a cough, you may be tempted to try a cough remedy. But keep in mind that such medications haven't been shown to help coughs in children, and they may be harmful, according to the AAP and IAP, which recommends increasing fluids and humidity to ease coughs.

• Dont ignore serious coughs

If your child has been coughing for more than a week, see his doctor.If a cough has gone on for three to six weeks, especially if the child is on antibiotics, then a chest X-ray may be needed.

A persistent cough, particularly at night, can be a symptom of asthma. And a severe cough, followed by a whooping noise as the child struggles to inhale, can be an indication of pertussis, or whooping cough. A drop in immunization rates has led to pertussis outbreaks in recent years. Children may be at risk, even if they have been vaccinated.

• New research information

Zinc supplements

Zinc supplements may reduce the length and severity of cold symptoms, when taken within 24 hours of the first symptoms of a cold. However, there were possible side-effects such as unpleasant taste and nausea. The review concluded that it is not yet clear whether zinc should be recommended as treatment for colds.

Vitamin C

Vitamin C seem to reduce the length and severity of symptoms. Also, in trials where people were exposed to short periods of extreme physical stress (for example, marathon runners and skiers) vitamin C halved the risk of developing a cold. More research is needed to answer the question of whether vitamin C can help once the cold symptoms have already started.

Other treatments

Echinacea (a herbal treatment) and garlic have traditionally been used for treating colds. However, recent reviews of research could not find any clear evidence about whether or not they are helpful.

• Seek help

Don't be afraid to see your child's pediatrician -- even if you think it's just a cold.

This is especially true if a cold lasts more than five days, as your child could have a sinus infection or even pneumonia. An ear infection is also a possibility, especially if your child is pulling on his ear.

When you do see the doctor, find out when he expects your child to feel better. If your child does not get better or feels even worse, a phone call is warranted to discuss the next step.